Urban Medical Receives Research Grant to Study House Calls

The Urban Medical Group (UMG) received a grant of $237,777 from the Jacob and Valeria Langeloth Foundation to conduct an evaluation of its House Calls program. UMG’s House Calls program is a unique home visiting program that involves a health care team that visits elders wherever they reside, follows them to hospital, other temporary facilities and back home again, to ensure continuity of care and a level of quality that results in reduced hospitalizations. Currently 325 individuals participate in this program.

The overall goal of the program evaluation is to promote increased funding and replication of the House Calls model.

The key research objectives are to:

1. Demonstrate that HC reduces overall costs associated with medical care among participants as compared to non-participants
2. Demonstrate that HC is effective at reducing hospital and nursing home admissions, an indicator of effective preventive care
3. Demonstrate that HC reduces the time until hospital and nursing home admissions, an indicator that patients remain in their homes longer
4. Understand and communicate how HC meets the needs of patients and caregivers
5. Understand and communicate how HC is a valuable program for housing providers

Key process objectives are to:

1. Disseminate findings to key constituents
2. Design data collection systems that will serve as building blocks for an on-going evaluation program at Urban Medical.

During the course of the evaluation UMG will collect and analyze data in several different ways including:

• Analysis of Medicare cost data: We will analyze Medicare claims data for people enrolled in House Calls, compared to an equivalent sample enrolled in Medicare, but not participating in House Calls.
• Health survey: The House Calls nurse practitioner will administer the “SF-12v2 Health Survey” to House Calls participants. This brief survey instrument will establish a baseline for the House Calls patients’ perceived general health. We will also administer the SF-12 to the same patients again after 5-7 months to detect any changes that may be attributable to the House Calls program.
• Patient and Family interviews: We will conduct interviews with a sample of House Calls enrollees and their family members. The interview will focus on satisfaction with care through the House Calls program. The interviews will be conducted by research assistants who will be trained by the project staff.
• Housing provider interview: We will interview key staff at 3-5 elder housing complexes where House Calls patients are residents. The purpose of the interviews is to determine the impact of the House Calls program on housing provider cost and staffing (e.g. possible reduced turnover of residents, reduced staff burden).

At the conclusion of the two-year evaluation UMG expects to have produced the following information:

1. An analysis of data comparing health care costs between House Calls patients and a comparable group of elders.
2. An analysis of perceived health of House Calls patients, pre and post enrollment in House Calls compared to findings in the literature.
3. An analysis of qualitative data regarding satisfaction of care among House Calls participants and their families.
4. An analysis of findings from a survey of housing providers on the impact of House Calls on staff time, stress and abilities to meet the needs of their residents, and on housing turnover.
5. Establishment of a data collection system for House Calls program data gathered in this study as a foundation for future studies.
6. Papers for publication in peer reviewed academic journals.
7. Collateral materials describing findings of evaluation for insurers and housing providers.
8. Meetings with insurers and housing providers regarding the demonstrated positive impact of house calls and how it can help achieve these constituents' goals.

The Principal Investigator for the evaluation is Dr. Fadi Badlissi, a staff physician at Urban Medical Group. Dr. Badlissi will work with a team of Boston University research consultants, Dr. Sara Bachman and Ms. Carol Tobias to conduct the evaluation.