Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Home-based primary care can reduce hospital and long-term care admissions, and days in care, and improve quality of life and satisfaction with care

Stall N, Nowaczynski M, Sinha SK  Systematic review of outcomes from home-based primary care programs for homebound older adults  Journal of the American Geriatric Society. 2014;62(12):2243-51.

Review question

Do home-based primary care programs lead to positive health outcomes among home-bound older adults, their caregivers and the healthcare system more broadly?


Home-bound older adults have complex and often interrelated medical and social problems that can leave them frail and marginalized.

Office-based primary care isn’t always the best way for home-bound older adults with multiple complex health conditions to access care. Compromised access can result in emergency department visits and hospitalization.

Home-based primary care, which involves primary care delivered in the home by the person’s ongoing primary care provider, is a promising alternative.

How the review was done

A detailed search of a number of electronic databases for all years up to and including March 2014,was conducted and studies that focused on home-based primary care and its influence on number of hospitalizations, days in hospital care, emergency department visits and days in long-term care beds, were included.

A total of 357 studies were identified in searches, and nine were included in the review after assessments for eligibility.

The authors did not acknowledge any funding sources for this review.

What the researchers found

Most of the home-based primary care studies included in the review found that such care reduced at least one of the following outcomes among home-bound older adults: emergency department visits, hospitalizations, days in hospital care, long-term care admissions and days in long-term care.

The review also found that home-based primary care also positively affected patient and caregiver quality of life, satisfaction with care, engagement in end-of-life decisions, and screening and vaccination rates.

At the system level, home-based primary care may also result in cost savings, although more research is needed to confirm this.  


This review found that specifically designed home-based primary care for home-bound older adults can reduce hospital and long-term care admissions, and overall days spent in institutional care, while improving patient and caregiver quality of life and satisfaction of care. More evidence is needed to confirm possible financial benefits of this model of care.

Related Web Resources

  • Dementia in long-term care

    Canadian Institute for Health Information
    Older adults with dementia may need to move into long-term care homes if they can no longer stay at home. These people have higher risk of getting physically restrained or given antipsychotic medication. Changes to policy and education have made these things happen less often.
  • Policy Brief: The Impact of COVID-19 on older persons

    United Nations
    COVID-19 has had a great impact on older adults around the world. This policy brief by the United Nations highlights some of the issues facing older adults on a systems and individual level. These concerns require policy change and collaboration to overcome. Read this resource to learn more.
  • During the COVID-19 pandemic, should I go to live with family/friend or stay in my retirement/assisted living home?

    COVID-19 poses significant health risks for seniors and those with compromised immune systems. For those living in assisted living and retirement homes, the decision to move back home with friends and family can be difficult to make. Use this decision aid to help you consider your options.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use