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Table 1 Comparison of home-based primary care (HBPC) and home care (HC) services, eligibility, and referral source in Vancouver, Canada, 2008-2013

From: A before-after study of hospital use in two frail populations receiving different home-based services over the same time in Vancouver, Canada

Home-Based Primary Care (HBPC)

Home Care (HC)

Service description

 Longitudinal primary care by physician and nurse practitioners through regular house calls

“Usual” primary care, physician may or may not make house calls

 Integrated team of registered nurses, and allieda health professional working with family physicians and nurse practitioners

Home care nursing and alliedahealth professional services delivered through separate home health services program, communicating with family physician as needed

 Regular team face to face meetings between physicians, nurse practitioners, and other team members, easy ad hoc communication amongst team members

No regular team meetings between physicians and HC team by fax or phone call

 Team shares common electronic medical record across disciplines

Separate electronic record for physician and HC team with no interoperability

 Dedicated 24/7 physician/nurse practitioner and capacity for responsive same-day/night care

Variation in 24/7 physician coverage, no capacity for responsive same-day/night care

 Home support delivered by contracted out service through home and community care system

Home support delivered by contracted out service through home and community care system

Population Service Use Characteristics and Eligibility Criteria

 Already requiring and receiving regular assistance for personal care (HC services)

New onset of need for regular assistance for personal care (washing, meal preparation, feeding, medication management)

 Unable to access usual primary care due to advanced frailty (homebound)

Able to access usual primary care

Referral sourceb

 Usual family physician, case manager at health unit of geographic catchment in which patient resides

Self-referral, physician, hospital

  1. aIncludes physiotherapy and occupational therapy
  2. bReferral criteria have changed since completion of the study