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    Many Elderly Prefer Hospital to Home for Acute Care


    "What reinforces that idea is that when we asked people if their doctors were to make house calls or see them at home, then a good proportion -- a quarter of the people who said they wanted to be taken care of in the hospital -- switched their preference to home care," Fried tells WebMD. "Clearly having the doctor see the patient at home, would have to be the key service. It didn't really matter if you gave them more nursing time or nursing assistant time."

    The movement to develop home care came about in part because frail, elderly patients often don't do well in a hospital environment. And home care may prove to be less costly for some conditions. But the shift in thinking about such treatment will have to come from the medical community first, says Fried, before patients will accept it.

    "Even more than doctors going to the home, the doctor's opinion [of best treatment place] was one of the most persuasive factors. So, I think the conclusion from that is if doctors believe in home care as a better alternative for their patient, then their patients may well be more accepting of that alternative," Fried says.

    Fried adds "if you interviewed people who had really active home care in the community, with doctors making house calls, etc., then I think you might find different responses in terms of higher preference for home care."

    James S. Goodwin, MD, tells WebMD, "There's a certain level of anxiety when you're sick. In our society, where we don't have a big history of home care, I think there would be a resistance -- [a thinking that] maybe if they stayed at home they wouldn't get optimal care." Goodwin is director of the Sealy Center on Aging at the University of Texas/Galveston.

    But that is starting to change, slowly, and studies like this one are important, Goodwin tells WebMD. "What I think has been interesting over the past couple of years, is that there are now studies which suggest that home care is as good as hospital care. ... Particularly with the very old, for whom hospitalization can be such a threat and a burden, we're beginning to do these studies of these trials of treating at home compared to treating at a hospital."

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