At many places around the country, different trial balloons are being tried for in-home care of acutely ill patients. Much of this seems to be happening as a result of The Independence at Home Act that was included as part of the Affordable Care Act passed recently. This sounds like something that is good for the older generations that will have difficulties making frequent trips to a doctors.
While this does not assure that all doctors are on board with this, some (hundreds) of U.S. Physicians are backing the home-based care. Most of these doctors are now members of the American Academy of Home Care Physicians. I am surprised that this organization had been around since 1984 and in some form has been serving acutely patients in their homes.
A new version of the black bag used by physicians in San Diego, California includes a mobile x-ray machine and a device that can preform over twenty lab tests at the point of care. Engineering and electronics companies are developing products for monitoring health at home.
The following factors are believed to be driving health care out of the hospitals and back into the home.
- the aging of the U.S. population,
- epidemics of chronic diseases,
- technological advances,
- health care consumerism,
- escalating health care costs.
Hospitals will not want this to happen, and many physician clinics will oppose in-home care. There will probably be some starts and stops, but once this gets traction, some medical practices and hospitals may well find that their doors must close permanently.
Almost all the abstract was available, but it has now been severely limited on NEMJ.