Biery, Nyann, MS

Frutos, Brenda, MPH, CHES

Sheth, Akash, MS

Wilson, Lynn M., DO

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of Family MedicineTargeting the Complex Needs of Community-Dwelling Older Adults through MultidisciplinaryHome Visit Teams in Primary CareBrenda Frutos MPH, CHESLehigh Valley Health Network, Brenda.Frutos@lvhn.orgNyann Biery MSLehigh Valley Health Network, nyann.biery@lvhn.orgAkash Sheth MSLehigh Valley Health Network, Akash.Sheth@lvhn.orgLynn M. Wilson DOLehigh Valley Health Network, lynn_m.wilson@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/family-medicineThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtFrutos, B. Biery, N. Sheth, A. Wilson, L. (2018, October 18-20). Targeting the Complex Needs of Community-Dwelling Older Adultsthrough Multidisciplinary Home Visit Teams in Primary Care. Poster Presented at: The Collaborative Family Healthcare Association(CFHA), 2018 Conference, Rochester, NY.© 2018 Lehigh Valley Health NetworkTargeting the Complex Needs of Community-Dwelling Older Adults through Multidisciplinary Home Visit Teams in Primary CareBrenda Frutos, MPH, Nyann Biery, MS, Akash Sheth, MS, and Lynn Wilson, DOLehigh Valley Health Network, Allentown, Pa.INTRODUCTION•  Home visit teams consisting of a RN, Community Health Worker (CHW), and Clinical Pharmacist were embedded into 6 primary care offices to respond to the unique needs of older adult patients (aged 60 or older).•  Home visit teams performed  patient outreach activities,  including care coordination,  facilitating linkages to commu nity resources, and medication management for older adult  patients.•  This evaluation sought to measure health care utilization before and after initial patient outreach performed by the home visit teams.ACKNOWLEDGMENTS AND DISCLAIMERThis demonstration project is funded by the Geriatrics Workforce Enhancement Program grant awarded by the U.S. Department of Health and Human Services (USDHHS), Health Resources and Services Administration (HRSA). The views, opinions, and content expressed in this presentation do not necessarily reflect the views, opinions, or policies of HRSA, or the USDHHS.DISCUSSION•  Multidisciplinary home visit teams may be a solution for improving the delivery of primary care for older adults. •  Early findings show short-term reduction in ED visits and hospital admissions, but an increase in primary care visits. Further investigations are needed to support the redesign of primary care for older adults.RESULTSTABLE 1.  Mean Number of Primary Care Visits Per Older Adult PatientTABLE 2.  Mean Number of ED Visits Per Older Adult PatientTABLE 3.  Mean Number of Hospital Admissions Per Older Adult Patient2.352.402.452.502.552.602.652.702.75Prior 6 monthsSD=1.819After6 monthsSD=2.241Prior12 monthsSD=1.794After 12 monthsSD=2.465Number of Visits2.542.472.532.710.00.20.40.60.81.01.21.41.6Prior 6 monthsSD=1.582After6 monthsSD=1.707Prior12 monthsSD=2.457After 12 monthsSD=3.369Number of ED Visits0.610.731.21.390.00.10.20.30.40.50.6Prior 6 monthsSD=0.845After6 monthsSD=0.887Prior12 monthsSD=1.352After 12 monthsSD=1.468Number of Hospital Admissions0.260.290.470.49METHODS•  One-group pretest-posttest design evaluation of older adult patients’ health care utilization.•  Older adult patients who were en rolled at least 6 months (n = 475) and  12 months (n = 294).•  Mean numbers of primary care visits, ED visits, and hospital admissions  per patient were calculated for both pre/post 6 months and 12 months.N06666_BrendaFrutos__Poster.indd   1 10/10/18   1:08 PM

Targeting the Complex Needs of Community-Dwelling Older Adults through Multidisciplinary Home Visit Teams in Primary Care

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Targeting the Complex Needs of Community-Dwelling Older Adults through Multidisciplinary Home Visit Teams in Primary Care

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