HOSPITALIZATION AND PLACE-OF-DEATH AMONG HOMEBOUND OLDER ADULTS IN A HOME-BASED PRIMARY CARE PROGRAM

Frail and homebound older adults are poorly served by existing primary care models. Home-based primary care (HBPC) can improve access-to-care and postpone adverse events. We completed a retrospective electronic chart review of a single-centre multidisciplinary HBPC program for homebound older adults. Patients with a preceding index acute care hospitalization who were subsequently active in the program for >30 days from October 2009 – April 2013 were enrolled. Hospital utilization one-year pre and post enrolment were compared. Patients active in the program for >90 days (n=94), had a 13.54 day (67.01%) annual reduction in days in hospital (p< 0.005) and 0.56 (52.51%) fewer hospital admissions per year (p = 0.027). Among patients active for 30 – 90 days (n=24), 16 expired (66.6%) with 8 deaths at home. HBPC as a post-discharge intervention for homebound older adults can significantly reduce future acute care hospital use and allow patients to die at home.