 | The examples and perspective in this article may not represent a worldwide view of the subject.(October 2014) |
A house call is medical consultation performed by a doctor or other healthcare professionals visiting the home of a patient or client, [1] instead of the patient visiting the doctor's clinic or hospital. In some locations, families used to pay dues to a particular practice to underwrite house calls. [2]
In the early 1930s, house calls by doctors were 40% of doctor-patient meetings. By 1980, it was only 0.6%. [3] Reasons include increased specialization and technology. In the 1990s, team home care, including physician visits, was a small but growing field in health care, for frail older people with chronic illnesses.
The reasons for fewer house calls include concerns about providing low-overhead care in the home, time inefficiency, and inconvenience. Yet, there are more and more doctors who like the idea of no office overhead. Also, it can provide safe access to care by people who are ill. [4] Today, house calls may be making a revival among the wealthy through concierge telemedicine and mobile apps. [5] [6]
In 2012 as part of its Action Plan for Healthcare [7] the province of Ontario actively expanded funding for access to house calls with its primary focus being on seniors and those with physical limitations making it difficult for travel outside the home. [8] Residents of Ontario with valid Ontario Health Insurance Plan cards are able to take advantage of the house call system, and arrange for appointments with physicians at their home. Currently, this service is only available in Toronto. [9]
In the United States, leadership such as George Washington were known to receive house calls. Upon his deathbed in 1799, President Washington received a house call prior to his passing. [10] Presently, the United States' leadership retain a Physician to the President on staff. [11]
The US rate of out-of-hospital birth has remained steady at 1% of all births since 1989, with data from 2007 showing that 27.3% of the home births since 1989 took place in a free-standing birth center and 65.4% in a residence.
A 2007 randomized trial of in-home palliative care demonstrated increased patient satistifaction and decreased costs. [12] [13]
In the Soviet Union the national government established a nationwide free outpatient polyclinic system, where each health center covered a part of a city, a neighbourhood, and this system has been preserved in post-Soviet times. Each general practitioner (therapeut) out of some 10 to 20 working in each state outpatient health centre serves his patients on weekdays both in his room during his 3–4 reception hours and spends another 3–4 hours on house visits (which become most numerous during flu and colds epidemics and can reach 40 per day) on his assigned block of streets with a standard number of residents. Unlike Soviet times, however, each patient now has to produce apart from his citizen ID (pasport with place of residence stamp showing his registration on the clinic's precinct) a now uniform medical insurance policy of obligatory medical insurance provided by a number of medical insurance companies through either financing by employers for working people or by the state – for children as well as old age and disability pensioners through regional funds of medical insurance.
The purpose of such visit is primary diagnostics and prescription of treatment and mode of conduct as well as prescribing blood, urine and other tests to be carried out at the polyclinic. The doctor also supplies the patient with a sick leave from work or study for a number of days and the leave is to be closed by the same doctor or his/her substitute and sealed at the clinic on the patient's recovery and checkout. If need be, the GP may arrange a visit to the sick person from one of specialist physicians from his/her clinic and of his/her nurse for giving injections.
There are two identical state systems of outpatient clinics running parallel – for adults and for children.
With the rise of private enterprise since 1990, city dwellers may place a phone order for a house call from a private medical facility (to be paid for out of patient's own money).
Medicare is an unofficial designation used to refer to the publicly funded single-payer healthcare system of Canada. Canada's health care system consists of 13 provincial and territorial health insurance plans, which provide universal healthcare coverage to Canadian citizens, permanent residents, and depending on the province or territory, certain temporary residents. The systems are individually administered on a provincial or territorial basis, within guidelines set by the federal government. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories.
Ambulatory care or outpatient care is medical care provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care can include advanced medical technology and procedures even when provided outside of hospitals.
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider.
Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care that the patient may need. Patients commonly receive primary care from professionals such as a primary care physician, a physician assistant, a physical therapist, or a nurse practitioner. In some localities, such a professional may be a registered nurse, a pharmacist, a clinical officer, or an Ayurvedic or other traditional medicine professional. Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care.
Healthcare in Canada is delivered through the provincial and territorial systems of publicly funded health care, informally called Medicare. It is guided by the provisions of the Canada Health Act of 1984, and is universal. The 2002 Royal Commission, known as the Romanow Report, revealed that Canadians consider universal access to publicly funded health services as a "fundamental value that ensures national health care insurance for everyone wherever they live in the country."
A clinic is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs of populations in local communities, in contrast to larger hospitals which offer more specialized treatments and admit inpatients for overnight stays.
Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.
Health care in Ireland is delivered through public and private healthcare. The public health care system is governed by the Health Act 2004, which established a new body to be responsible for providing health and personal social services to everyone living in Ireland – the Health Service Executive. The new national health service came into being officially on 1 January 2005; however the new structures are currently in the process of being established as the reform programme continues. In addition to the public-sector, there is also a large private healthcare market.
The health care system in Japan provides different types of services, including screening examinations, prenatal care and infectious disease control, with the patient accepting responsibility for 30% of these costs while the government pays the remaining 70%. Payment for personal medical services is offered by a universal health care insurance system that provides relative equality of access, with fees set by a government committee. All residents of Japan are required by the law to have health insurance coverage. People without insurance from employers can participate in a national health insurance program, administered by local governments. Patients are free to select physicians or facilities of their choice and cannot be denied coverage. Hospitals, by law, must be run as non-profits and be managed by physicians.
Singapore Health Services, commonly known as SingHealth, is Singapore's largest group of healthcare institutions. The group was formed in 2000 and consists of four public hospitals, three community hospitals, five national specialty centres and a network of eight polyclinics. The Singapore General Hospital is the largest hospital in the group and serves as the flagship hospital for the cluster.
The National Healthcare Group (NHG) is a group of healthcare institutions located in Singapore. The group was formed in 2000 and operates several hospitals, national specialty centers and polyclinics. Tan Tock Seng Hospital is the largest hospital in the group and serves as the flagship hospital for the cluster.
Healthcare in Algeria consists of an established network of hospitals, clinics, and dispensaries. The government provides universal health care.
Healthcare in Singapore is under the purview of the Ministry of Health of the Government of Singapore. It mainly consists of a government-run publicly funded universal healthcare system as well as a significant private healthcare sector. Financing of healthcare costs is done through a mixture of direct government subsidies, compulsory comprehensive savings, national healthcare insurance, and cost-sharing.
Geriatric medicine, as a speciality, was introduced in Egypt in 1982, and in 1984 a geriatrics and gerontology unit in Ain Shams University Faculty of Medicine was established.
Healthcare in Finland consists of a highly decentralized three-level publicly funded healthcare system and a much smaller private sector. Although the Ministry of Social Affairs and Health has the highest decision-making authority, specific healthcare precincts are responsible for providing healthcare to their residents as of 2023.
Healthcare in Ukraine is part of a universal health care system largely built up as a successor of the Soviet healthcare system otherwise dismantled in 1991. The Ministry of Healthcare implements the state policy in the country in the field of medicine and healthcare.
A healthcare center, health center, or community health center is one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area. Typical services covered are family practice and dental care, but some clinics have expanded greatly and can include internal medicine, pediatric, women’s care, family planning, pharmacy, optometry, laboratory testing, and more. In countries with universal healthcare, most people use the healthcare centers. In countries without universal healthcare, the clients include the uninsured, underinsured, low-income or those living in areas where little access to primary health care is available. In the Central and East Europe, bigger health centers are commonly called policlinics.
Healthcare in Belgium is composed of three parts. Firstly there is a primarily publicly funded healthcare and social security service run by the federal government, which organises and regulates healthcare; independent private/public practitioners, university/semi-private hospitals and care institutions. There are a few private hospitals. Secondly is the insurance coverage provided for patients. Finally, industry coverage; which covers the production and distribution of healthcare products for research and development. The primary aspect of this research is done in universities and hospitals.
Electronic consultation is an aspect of telemedicine which involves remote communication between patients and clinicians, or between clinicians and specialists.
Teladoc Health, Inc. is a multinational telemedicine and virtual healthcare company headquartered in the United States. Primary services include telehealth, medical opinions, AI and analytics, telehealth devices and licensable platform services. In particular, Teladoc Health uses telephone and videoconferencing software as well as mobile apps to provide on-demand remote medical care.
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