>Re (from Linda J. Smith): Home visits in early pp
>Dear Elizabeth Payton- Right on both counts. If computers and copiers can be
repaired on-site, so can mothers be helped in their homes. All it takes is
the societal will and sufficient recognition that this is important.

Hi Linda and Elizabeth:
   Let's face it, the bottom line is money. On site computer/copier repair
brings in big bucks--totally unrelated to "societal will and sufficient
recognition that this is important." If there wasn't money in it, these
repair services would go down the tube. Also, clients pay directly because
their options are limited. They've "come" to need their communications
equipment for whatever reason, and repair results are almost always very
tangible.
   We know mothers and babies can be cared for in their homes. We know the
results may be tangible, but often they are more abstract. (This is another
reason why "care plan" outcome objectives and documentation of their
achievement is so important.) We have data that non-physician care providers
with the appropriate training are as good or better than physicians at triage
and referring clients to other care providers p.r.n. We also know most
parents and other care providers believe other options are as good or almost
as good as a home visit consultation.
   It's hard to believe that providing a home visit is not a money-maker, but
if it was it would become common practice. Unfortunately (or fortunately
depending on the way you look at it), in office physician visits are much
more likely to be covered by third party payers than home visits. Having just
done a lit search on early discharge, I discovered several articles
recommending home visits, but not much in the way of stats demonstrating
their effectiveness. Without that, well...
   And on that gloomy note, I retreat...
Karen Gromada