Table 1

Distinguishing home-based primary care from other home-care models

FEATURE	MODEL
FEATURE	HOME-BASED PRIMARY CARE	OUTREACH HOME VISITS	HOSPITAL-AT-HOME	TRANSITIONAL HOME CARE	SKILLED HOME CARE
Functional model	Ongoing comprehensive primary care in the home¹⁴	Home-based multidimensional geriatric assessments	Acute medical care in the home¹⁶	Medical care after hospital discharge	Targeted nursing, allied health, and social care services
Care focus	Complex and interrelated chronic disease management and social care issues	Needs assessments	Acute illness or chronic disease exacerbation	Often disease specific (eg, heart failure¹⁷ or chronic obstructive pulmonary disease¹⁸)	Remediable conditions¹⁴ and supporting independent living
Time course	Ongoing	Consultation with possible limited follow-up	Time-limited to the end of an acute episode	Time-limited to a designated period after discharge	Time-limited to ongoing
Personnel	Primary care provider–led interprofessional teams	Varied, but typically nursing and allied health professionals	General practitioners, specialists, nurses, and allied health professionals	General practitioners, specialists, nurses, and allied health professionals	Nursing and allied health professionals only
Goals of care	Improve access to primary care Maximize independence and function Reduce emergency department, hospital, and long-term care admissions Enhance patient safety and quality of life Link with supportive home-care services^14,15	Assess needs and develop care plan (to be implemented by office-based primary care provider or specialist)	Serve as a substitute for acute hospital care Reduce iatrogenic events (nosocomial infections, functional decline, pressure sores, delirium, falls, etc)¹⁶ Reduce overall costs	Prevent adverse outcomes after discharge from hospital (improve coordination and continuity of care, reduce readmissions)¹⁹ Reduce overall costs	Support independent living