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A multidisciplinary program for delivering primary care to the underserved urban homebound: looking back, moving
Kristofer L Smith1, Katherine Ornstein, Theresa Soriano
1John F. Kennedy School of Government, Harvard University, Cambridge, Massachusetts, USA.
Journal of the American Geriatrics Society
|August 18, 2006
Summary
Home-based primary care (HBPC) programs offer multidisciplinary support for a growing number of homebound adults. The Mount Sinai Visiting Doctors program demonstrates a successful model for expanding HBPC services and improving patient outcomes.
Area of Science:
- Geriatrics
- Health Services Research
- Primary Care Medicine
Background:
- The number of homebound adults with multiple chronic conditions is increasing, necessitating coordinated care.
- Traditional home-based primary care (HBPC) programs face challenges due to limited institutional support for expansion.
- Multidisciplinary care teams are essential for managing complex health needs in homebound populations.
Purpose of the Study:
- To detail the development and growth of the Mount Sinai Visiting Doctors (MSVD) program, a successful HBPC initiative.
- To present the MSVD program as a replicable model for other institutions seeking to establish or expand HBPC services.
- To highlight strategies employed by MSVD to achieve program growth and sustainability.
Main Methods:
- The article describes the establishment and evolution of the MSVD program since its inception in 1995.
- It outlines the program's approach to delivering multidisciplinary primary care to homebound patients in East Harlem, New York.
- Key factors contributing to program growth, including securing institutional support and fulfilling teaching responsibilities, are discussed.
Main Results:
- The MSVD program has grown to include 12 primary care providers serving over 1,000 patients annually.
- The program has successfully enabled patients to live and die at home, reduced caregiver burden, and established a training experience.
- MSVD has become a leader in home-based primary care research and demonstrated a positive cost-benefit profile.
Conclusions:
- The MSVD program's success is attributed to high-quality care, demonstrated cost-effectiveness, and integration of teaching responsibilities.
- The program's growth offers a viable model for faculty and institutions interested in developing or expanding HBPC programs.
- Effective HBPC programs require strong institutional support and a focus on patient-centered, multidisciplinary care.
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