Health Care Use and Outcomes Among Participants Enrolled in the Mayo Clinic Primary Care House Call Program: A Case-Control Study.

Abstract

House call programs provide care for homebound patients. We conducted a case-control study to compare hospitalization and/or emergency department (ED) use by patients enrolled in a primary care house call program versus ambulatory (community-dwelling) patients. Program enrollees (cases) were matched by age and self-reported gender to community-dwelling patients (controls). The primary exposure was the combination of hospitalization and/or ED visits for 1 year before the index date (October 1, 2024). We used unadjusted and adjusted conditional logistic regression to determine differences in health care use. We identified 26 cases (median [range] age, 84 [66-98] years; 16 [62%] female) and 130 controls. All cases had 4 or more chronic diseases, as compared with 87 (67%) of controls (<i>P</i> = .003). A higher proportion of cases than controls had previous hospitalization and/or ED visits (84.6% vs 27.7%; <i>P</i> < .001). After adjusting for the number of chronic illnesses, no differences in previous hospitalization and/or ED use were identified between groups. Cases had more chronic illnesses and more hospitalizations and/or ED visits than community-dwelling controls. The comorbid health burden of participants in the house call program drove greater health care use and justifies a higher level of care for this medically complex patient population.