If the problem here is an aging, chronically ill America, one solution is health care at home. But before we can leap ahead, we have to take a few baby steps. The medical community, including physicians, medical schools and hospital administrators, will need to better define health care at home -- exactly what it does, why it matters and how it makes a difference -- in order to make it real and bring it to life for patients and family caregivers.
For example, health care at home is widely perceived, mistakenly, to be merely custodial, almost a matter of hand-holding and baby-sitting. In fact, home health is a multi-dimensional, multi-disciplinary provider of superior post-acute clinical service. The profession is increasingly adopting an innovative new model and getting more directly involved in patient care than ever before.
Plainly put, home health-care professionals routinely manage medications (our average patient takes 12 different kinds), change bandages, clean surgical wounds, administer essential therapy -- sometimes in the form of injections and intravenous fluids -- and do so compassionately, empowering patients (ours average 81 years of age) to live with dignity.
That kind of highly focused, deeply intimate attention, one-to-one and day-by-day, yields concrete rewards. Thanks to such services, according to the Centers for Medicare and Medicaid, patients under home health care sometimes move better, eat better, breathe better, suffer less pain, and generally function better.
In the best of scenarios, those unable to walk can once again climb to the top of the stairs. The man who lost the power of speech can once again tell his wife he loves her. We receive thousands of letters from grateful patients and families telling us as much.
Big picture, evidence is mounting that health care delivered at home may enable patients to live longer lives and, equally important, better ones. It can shorten hospital length of stay and lower readmissions. In the process, it is proving to do exactly what most needs to be done -- namely, raise quality of care, improve patient outcomes and drive down costs.
As such, then, home health care is emerging as a microcosm of what the health-care system should be doing across the board. It gets us where we live. After all, true health-care reform should always start at home.
Robie practices family medicine with Nitro Primary Care. He is a regional medical director for Amedisys Home Health and Hospice.