title: Shifting Patterns of Physician Home Visits.
abstract: OBJECTIVE
  Home visits have been shown to improve quality of care and lower medical costs for complex elderly patients. We investigated trends in physician home visits and domiciliary care visits as well as physician characteristics associated with providing these services.
  
  
  METHODS
  Longitudinal analysis of Medicare Part B claims data for a national sample of direct patient care physicians in 2006 and 2011. Descriptive statistics were used to characterize the physician sample and to determine numbers of home visits and domiciliary visits in total and by physician specialty.
  
  
  METHODS
  Patient homes, nursing homes, and domiciliary care facilities.
  
  
  METHODS
  Direct patient care physicians (n = 22,186).
  
  
  METHODS
  Physician demographics, specialty, practice characteristics (practice type, geographic location), number of home visits, and domiciliary visits in 2006 and 2011.
  
  
  RESULTS
  We found a small increase (n = 63,501) in total number of home visits made to Medicare beneficiaries between 2006 and 2011 performed by a decreasing percentage of physicians (5.1%, n = 18,165 in 2006; 4.5%, n = 15,296 in 2011). There was substantial growth in domiciliary care visit numbers (n = 218,514) and a small increase in percentage of physicians delivering these services (2.0% in 2006, 2.3% in 2011). Physicians who performed home visits were more likely to be older, in rural locations, specialists in primary care, and more likely to provide nursing home and domiciliary care compared with physicians who did not make any home visits (P < .05).
  
  
  CONCLUSIONS
  Home visits and domiciliary visits to Medicare beneficiaries are increasing. General internal medicine physicians provided the highest number of home and domiciliary care visits in 2006, and family physicians did so in 2011. Such delivery models show promise in lowering medical costs while providing high-quality patient care.
authors.affiliation: University of Washington, Seattle, WA, USA sairenji@uw.edu.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sairenji
authors.affiliation: Robert Graham Center, Washington, DC, USA.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Jetty
authors.affiliation: American Board of Family Medicine, Lexington, KY, USA.
authors.forename: Lars E
authors.initials: LE
authors.lastname: Peterson
mesh_terms: D000328:Adult; D005260:Female; D017048:Health Care Costs; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006792:House Calls / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D011787:Quality of Health Care; D014481:United States
keywords: Medicare; domiciliary care visits; geriatrics; home visits; house calls