This systematic review demonstrates the potential of home-based primary care (HBPC) interventions for improving heath, cost, and patient experience outcomes for adults with multiple chronic conditions and serious disabilities.
HBPC programs serve individuals with complex chronic conditions and functional limitations by delivering primary care in home settings for medical conditions with intensive care coordination, which may include coordinating or delivering long-term services and supports. This review evaluates the strength of evidence and the specific elements of studied HBPC programs.
This review found evidence that HBPC programs lead to reduced hospitalizations and hospital days (with a moderate strength of evidence) as well as reduced emergency and specialty visits, and lower total health care costs (with less strong evidence). HBPC participation also results in improved clinical outcomes, patient and caregiver experience, and quality of life, though the strength of evidence was low. There is also moderate evidence that higher-risk patients who are more frail and have more complex medical conditions experience the greatest benefit from HBPC programs. Programs employ varied services to supplement HBPC, such as caregiver supports, palliative care, and transitional care, but there is limited evidence on the specific impacts of these services for different populations.
While the body of evidence on HBPC programs was still becoming established when this systematic review was published in 2016, this review showed positive evidence on a range of outcomes that shows the benefits of HBPC for adults with complex health and functional needs.