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Home Care Delivered by GPs in Modena (Italy):
A Descriptive Study
with an Exploratory Analysis of its Determinants
The rise in life expectancy, disabilities, and the number of elderly individuals living alone poses a challenge
for healthcare services, particularly for General Practitioners (GPs), as an increasing number of patients
require Home Care (HC). Italian GPs perceive an escalating workload for HC, while rumors circulating
among media suggest that "GPs no longer make house calls". Currently, there is no existing study in Italy
describing the HC activities of GPs and their perceptions.
How is HC organized and delivered in the Province of Modena, and how many programmed home
visits do GPs perform each year? What are the determinants influencing the HC activity of GPs?
Alice Serafini1,2, Lucia Palandri2, Giulia Ugolini1,2, Silvia Riccomi1,2, Davide Fornaciari1, Lucia Leonelli1, Elisa Stefani1,
Irene Bruschi1,2, Anna Franzelli1, Chiara Salvia1, Sara Fantini1, Maria Stella Padula2, Elena Righi2
1)Primary Care Department,Local Health Service of Modena, Italy; 2) Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
METHODS We conducted a retrospective descriptive
study using an anonymous survey directed to all GPs
in Modena Province (Italy). Collected variables
included GP characteristics, volume and type of HC
delivered and patients characteristics. For this
explorative analysis, we collected anonymous
administrative data.
RESULTS More than 84 GPs participated in the study
on a voluntary basis, corresponding to 21% of all the
GPs of the province of Modena. Participants
showed variability in age, gender, work experience in
GP, setting of work and volumes of HC delivered
(Table 1). A total of 1199 patients resulted to be
enrolled in a HC structured program in
PC,corresponding to the 8% of the population aged
more than 75 years old. In Figure 1, an exploratory
analysis of the relationship between the collected
variables is depicted.
CONCLUSION Relying only on administrative
aggregated data made difficult to characterize both
the clinical complexity of homebound patients, and
the HC activity of doctors, as they excluded the
unrecorded and unstructured HC activity. The n° of
integrated HC programmes seems positively
correlated with the n° of patients and the n° of
patients aged > 75 in the GP’s list, while the n° of
programmed HC programmes seem inversely
correlated with them; this could be explained to an
excess of workload that could impede a proactive
management of HC by the GP. Similarly, a
growing n° of patients is associated with a lower
n° of home visits paid per month.
Table 1. Descriptive data
PERSPECTIVES & POINTS FOR DISCUSSION
● A qualitative study is ongoing to deepen the understanding of HC
providers, patients and caregivers that have experienced HC
● A well designed, funded, prospective cohort study is necessary to
quantify the contribution of HC by GPs to health and QoL of patients
Figure. Variables plot