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House call practices: a comparison by specialty

A M Adelman1, L Fredman, A L Knight

  • 1Department of Family and Community Medicine, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey 17033-0805.

The Journal of Family Practice
|July 1, 1994
PubMed
Summary
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Family physicians make house calls significantly more often than internists or pediatricians. This national survey highlights practice patterns and physician attitudes toward house calls in primary care.

Area of Science:

  • Primary Care Medicine
  • Health Services Research
  • Physician Practice Patterns

Background:

  • No national survey of physician house calls since 1980.
  • Lack of recent data on pediatric house calls.
  • Need to compare house call practices across primary care specialties.

Purpose of the Study:

  • To compare house call practices among family physicians, general internists, and general pediatricians.
  • To identify factors associated with physicians making house calls.
  • To explore physician attitudes towards house calls.

Main Methods:

  • National mail survey of 1500 primary care physicians (500 each in family medicine, internal medicine, pediatrics).
  • Random selection from the American Medical Association Physician Master File.

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  • Analysis of 906 returned questionnaires (59% response rate).

    • Main Results:

    • Family physicians (63%) were significantly more likely to make house calls than internists (47%) or pediatricians (15%).
    • Factors associated with house calls included community prevalence, solo practice, male sex, and northeastern location.
    • Positive attitudes towards patient satisfaction, comprehensive care, and physician satisfaction correlated with making house calls.

    Conclusions:

    • Family physicians significantly outperform internists and pediatricians in providing house calls.
    • Physician attitudes and practice characteristics influence house call provision.
    • House calls remain an underutilized service in pediatrics and internal medicine.