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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Family Practice 1/2014

Gaining information about home visits in primary care: methodological issues from a feasibility study

Zeitschrift:
BMC Family Practice > Ausgabe 1/2014
Autoren:
Karen Voigt, Stephanie Taché, Andreas Klement, Thomas Fankhaenel, Stefan Bojanowski, Antje Bergmann
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2296-15-87) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests. KV, AK, SB and AB are members of Saxon and German College of General Practitioners and Family Physicians (SGAM and DEGAM).

Authors’ contributions

KV and AB developed the conception and design for the feasibility study. KV, ST and AB were involved in drafting the manuscript. AK, TF and SB revised the manuscript critically. All authors read and gave final approval of the final manuscript. Acquisition and analysis of the data was done by KV in cooperation with AK and TF.

Abstract

Background

Home visits are part of general practice work in Germany. Within the context of an expanding elderly population and a decreasing number of general practitioner (GPs), open questions regarding the organisation and adequacy of GPs’ care in immobile patients remain. To answer these questions, we will conduct a representative primary data collection concerning contents and organisation of GPs’ home visits in 2014. Because this study will require considerable efforts for documentation and thus substantial involvement by participating GPs, we conducted a pilot study to see whether such a study design was feasible.

Methods

We used a mixed methods design with two study arms in a sample of teaching GPs of the University Halle. The quantitative arm evaluates participating GPs and documentation of home visits. The qualitative arm focuses on reasons for non-participation for GPs who declined to take part in the pilot study.

Results

Our study confirms previously observed reasons for non-response of GPs in the particular setting of home visits including lack of time and/or interest. In contrast to previous findings, monetary incentives were not crucial for GPs participation. Several factors influenced the documentation rate of home visits and resulted in a discrepancy between the numbers of home visits documented versus those actually conducted. The most frequently reported problem was related to obtaining patient consent, especially when patients were unable to provide informed consent due to cognitive deficits.

Conclusions

The results of our feasibility study provide evidence for improvement of the study design and study instruments to effectively conduct a documentation-intensive study of GPs doing home visits. Improvement of instructions and questionnaire regarding time variables and assessment of the need for home visits will be carried out to increase the reliability of future data. One particularly important methodological issue yet to be resolved is how to increase the representativeness of home visit care by including the homebound patient population that is unable to provide informed consent.
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