An October 20 article in the New England Journal of Medicine states that, “ultimately, health care organizations that do not adapt to the home care imperative risk becoming irrelevant. It seems inevitable that health care is going home.”
The article describes the demographic, clinical, economic, and technological forces that are making home-based care an “imperative” for healthcare. The article, by Steven H. Landers, M.D., of the Cleveland Clinic, cites oxygen as an example of advances in portable medical technology, and cites parenteral nutrition and infusion as examples of care that are both cheaper than and as equally effective as institutional care.
Landers notes that in 20 years, there may be more than 70 million Americans age 65 and older. “Many of these older adults will have limitations on their activities, including difficulty walking and transferring from bed to chair, that make leaving their homes difficult. Bringing care to the home improves access for such people, especially those living in older homes with hard-to-negotiate entryways and those with limited resources for transportation. Older adults are particularly prone to complications of confinement in hospitals, such as delirium, skin conditions, and falls. Treating people at home may be one way to avoid such complications.”
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