COVID Challenges and Adaptations Among Home-Based Primary Care Practices: Lessons for an Ongoing Pandemic from a National Survey.
Christine S Ritchie, Naomi Gallopyn, Orla C Sheehan and 7 others
PMID 34111388WHAT IT FOUND
Most home-based primary care practices reported strain, PPE and supply shortages, and shifts to telephone or video visits.
Patient access was harder because of fear, dementia, hearing needs, and unfamiliar technology.
Key findings
01Of 62 practices answering the strain question, 22.6% reported severe strain or impact and 64.5% reported some strain or impact.
02Among practices reporting patient shortages, they described shortages in access to home health aides (74.5%), home nursing (42.6%), durable medical equipment (27.7%), Meals on Wheels (23.4%), hospice care (17.0%), and medications (10.6%).
03Most practices (91.1%) described multiple adaptations, including telemedicine (95.8%), reducing physical visits (81.9%), staff training (52.8%), and bringing resources such as groceries and medications (52.8%).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The listservs were person-based, not practice-based, so the number of distinct practices invited and the practice response rate could not be calculated. Respondents came from two home-based care organizations and were primarily physicians and nurse practitioners, so other home-based care models and disciplines may be underrepresented. Practices with more than 500 patients were more represented, and few practices had most patients in assisted living, so the sample may not reflect all home-based primary care. Responses were self-reported practice perceptions, not audited records or patient outcomes. The survey was in mid-2020, and only up to 66 practices (84.0%) answered most open-ended questions, so themes may not represent all practices or later pandemic phases.
The easy way to misread this
Do not read these adaptations as evidence that telemedicine or driveway visits improved patient outcomes. The survey reports what practices said they did in mid-2020, not patient results, and it studied practices rather than patients.