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Home visits - central to primary care, tradition or an obligation? A qualitative study
BACKGROUND: Home visits are claimed to be a central element of primary care. However, the frequency with which home visits are made is declining both internationally and in Germany despite the increase in the number of chronically ill elderly patients. Given this, the question arises as to how to en...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2011
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098781/ https://www.ncbi.nlm.nih.gov/pubmed/21513534 http://dx.doi.org/10.1186/1471-2296-12-24 |
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author | Theile, Gudrun Kruschinski, Carsten Buck, Marlene Müller, Christiane A Hummers-Pradier, Eva |
author_facet | Theile, Gudrun Kruschinski, Carsten Buck, Marlene Müller, Christiane A Hummers-Pradier, Eva |
author_sort | Theile, Gudrun |
collection | PubMed |
description | BACKGROUND: Home visits are claimed to be a central element of primary care. However, the frequency with which home visits are made is declining both internationally and in Germany despite the increase in the number of chronically ill elderly patients. Given this, the question arises as to how to ensure sufficient primary health care for this vulnerable patient group. The aim of this study was to explore German general practitioners' (GPs) attitudes with regard to the feasibility, burden and outlook of continued home visits in German primary care. METHODS: Qualitative semi-structured interviews were carried out with 24 GPs from the city of Hannover, Germany, and its rural surroundings. Data was analysed using qualitative content analysis. RESULTS: The GPs indicated that they frequently conduct home visits, but not all of them were convinced of their benefit. Most were not really motivated to undertake home visits but some felt obliged to. The basic conditions covering home visits were described as unsatisfactory, in particular with respect to reimbursement and time constraints. House calls for vulnerable, elderly people remained undisputed, whereas visits of a social nature were mostly deleted. Urgent house calls were increasingly delegated to the emergency services. Visits to nursing homes were portrayed as being emotionally distressing. GPs considered good cooperation with nursing staff the key factor to ensure a successful nursing home visit. The GPs wanted to ease their work load while still ensuring quality home care but were unable to suggest how this might be achieved. Better financial compensation was proposed most often. The involvement of specially trained nurses was considered possible, but viewed with resentment. CONCLUSIONS: Home visits are still an integral aspect of primary care in Germany and impose a considerable workload on many practices. Though the existing situation was generally perceived as unsatisfactory, German GPs could not envisage alternatives if asked to consider whether the current arrangements were sustainable in the future. To guarantee an unaltered quality of primary home care, German GPs and health care policy makers should actively initiate a debate on the need for and nature of home visits in the future. |
format | Text |
id | pubmed-3098781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-30987812011-05-21 Home visits - central to primary care, tradition or an obligation? A qualitative study Theile, Gudrun Kruschinski, Carsten Buck, Marlene Müller, Christiane A Hummers-Pradier, Eva BMC Fam Pract Research Article BACKGROUND: Home visits are claimed to be a central element of primary care. However, the frequency with which home visits are made is declining both internationally and in Germany despite the increase in the number of chronically ill elderly patients. Given this, the question arises as to how to ensure sufficient primary health care for this vulnerable patient group. The aim of this study was to explore German general practitioners' (GPs) attitudes with regard to the feasibility, burden and outlook of continued home visits in German primary care. METHODS: Qualitative semi-structured interviews were carried out with 24 GPs from the city of Hannover, Germany, and its rural surroundings. Data was analysed using qualitative content analysis. RESULTS: The GPs indicated that they frequently conduct home visits, but not all of them were convinced of their benefit. Most were not really motivated to undertake home visits but some felt obliged to. The basic conditions covering home visits were described as unsatisfactory, in particular with respect to reimbursement and time constraints. House calls for vulnerable, elderly people remained undisputed, whereas visits of a social nature were mostly deleted. Urgent house calls were increasingly delegated to the emergency services. Visits to nursing homes were portrayed as being emotionally distressing. GPs considered good cooperation with nursing staff the key factor to ensure a successful nursing home visit. The GPs wanted to ease their work load while still ensuring quality home care but were unable to suggest how this might be achieved. Better financial compensation was proposed most often. The involvement of specially trained nurses was considered possible, but viewed with resentment. CONCLUSIONS: Home visits are still an integral aspect of primary care in Germany and impose a considerable workload on many practices. Though the existing situation was generally perceived as unsatisfactory, German GPs could not envisage alternatives if asked to consider whether the current arrangements were sustainable in the future. To guarantee an unaltered quality of primary home care, German GPs and health care policy makers should actively initiate a debate on the need for and nature of home visits in the future. BioMed Central 2011-04-22 /pmc/articles/PMC3098781/ /pubmed/21513534 http://dx.doi.org/10.1186/1471-2296-12-24 Text en Copyright ©2011 Theile et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Theile, Gudrun Kruschinski, Carsten Buck, Marlene Müller, Christiane A Hummers-Pradier, Eva Home visits - central to primary care, tradition or an obligation? A qualitative study |
title | Home visits - central to primary care, tradition or an obligation? A qualitative study |
title_full | Home visits - central to primary care, tradition or an obligation? A qualitative study |
title_fullStr | Home visits - central to primary care, tradition or an obligation? A qualitative study |
title_full_unstemmed | Home visits - central to primary care, tradition or an obligation? A qualitative study |
title_short | Home visits - central to primary care, tradition or an obligation? A qualitative study |
title_sort | home visits - central to primary care, tradition or an obligation? a qualitative study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098781/ https://www.ncbi.nlm.nih.gov/pubmed/21513534 http://dx.doi.org/10.1186/1471-2296-12-24 |
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