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A Canadian Provider’s Handbook to Home-Based Primary Care

Posted: August 2, 2016    Format: PDF
A Canadian Provider’s Handbook to Home-Based Primary Care

By: ,


Category(s): Care of the Elderly, Clinical (by topic), Population Health, Social Responsibility
Topic(s): Home Care


This handbook has been developed for those with an interest in providing home-based primary care to their patients. While considered an old-fashioned solution to an emerging problem, modern home- based primary care models must be distinguished from the traditional house call:

Home-based primary care (HBPC) specifically targets individuals with complex chronic disabling disease, with the goal of maximizing the independence of the patient and reducing preventable emergency room visits and hospitalizations. HBPC programs provide comprehensive longitudinal primary care by an interdisciplinary team in the homes of patients with complex chronic disease, who are not effectively managed by routine clinic- based care. HBPC is very different from and complementary to standard skilled home care services, in population, processes and outcomes. HBPC targets persons with advanced chronic disease, rather than remediable conditions. HBPC provides comprehensive care of multiple co-morbidities, rather than problem-focused care. HBPC is delivered by an interdisciplinary team, rather than one or two independent providers.

– Veteran’s Affairs Home Based Primary Care, 2009

We hope readers will find the ideas and practices outlined in this handbook useful especially to those starting to explore providing this type of care for their patients, and more experienced providers looking to further evolve their existing practices.

Wherever possible, we cite the evidence that exists to support what is contained in this handbook, otherwise, the rest of what is here is based on the consensus best practice experience of this handbook’s authors who are committed providers of home-based primary and specialty care.