Self-employed GPs visit more patients at home than salaried GPs house calls are less frequent in health care systems where GPs act as gatekeepers and patient lists are maintained. Today in most European countries and the United States home visits are the exception and are no longer the standard method of health care delivery - although there is diversity between individual general practitioners (GPs) and different countries. Home visits are claimed to be a central element of general practice as this represented the primary mode of healthcare delivery by community physicians from the mid-20 th century. To guarantee an unaltered quality of primary home care, German GPs and health care policy makers should actively initiate a debate on the need for and nature of home visits in the future. Though the existing situation was generally perceived as unsatisfactory, German GPs could not envisage alternatives if asked to consider whether the current arrangements were sustainable in the future. Home visits are still an integral aspect of primary care in Germany and impose a considerable workload on many practices. The involvement of specially trained nurses was considered possible, but viewed with resentment. Better financial compensation was proposed most often. The GPs wanted to ease their work load while still ensuring quality home care but were unable to suggest how this might be achieved. GPs considered good cooperation with nursing staff the key factor to ensure a successful nursing home visit. Visits to nursing homes were portrayed as being emotionally distressing. Urgent house calls were increasingly delegated to the emergency services. House calls for vulnerable, elderly people remained undisputed, whereas visits of a social nature were mostly deleted. The basic conditions covering home visits were described as unsatisfactory, in particular with respect to reimbursement and time constraints. Most were not really motivated to undertake home visits but some felt obliged to. The GPs indicated that they frequently conduct home visits, but not all of them were convinced of their benefit. Data was analysed using qualitative content analysis. Qualitative semi-structured interviews were carried out with 24 GPs from the city of Hannover, Germany, and its rural surroundings. The aim of this study was to explore German general practitioners' (GPs) attitudes with regard to the feasibility, burden and outlook of continued home visits in German primary care.
Home visits by doctors how to#
Given this, the question arises as to how to ensure sufficient primary health care for this vulnerable patient group. However, the frequency with which home visits are made is declining both internationally and in Germany despite the increase in the number of chronically ill elderly patients. Home visits are claimed to be a central element of primary care.
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