Understanding Significance, Challenges and Barriers in Home-Based Medical Care – A Thematic Review of Literature

Year : 2024 | Volume :14 | Issue : 01 | Page : 66-71

Shalini Raman Vig

Anil Dewan

  1. Consultant Architect, Visiting Faculty and Research Scholar Department of Architecture School of Planning and Architecture New Delhi India
  2. Professor and Dean , Department of Architecture, School of Planning and Architecture New Delhi India


Home-based medical care (HBMC) is emerging as a cornerstone of modern healthcare, offering a pragmatic solution to the evolving needs of patients. This form of care, which delivers personalized and patient-centric services, catering to individual needs within the familiar environment of their homes, is gaining traction for its ability to improve patient outcomes while simultaneously reducing healthcare costs. This thematic review of literature aims to shed light on the significance, challenges and barriers in HBMC.
The importance of HBMC in meeting the needs of patients, particularly those with chronic illnesses, disabilities, or advanced age, is highlighted in this paper through analysis of existing research. However, the widespread implementation and effective delivery of HBMC encounters a myriad of challenges. Financial constraints often limit the availability of resources necessary to sustain and expand HBMC programs. Moreover, navigating the regulatory landscape can be daunting, requiring careful adherence to complex standards and guidelines. In addition to financial and regulatory hurdles, inadequacies in infrastructure present a formidable challenge to the adoption of HBMC, since a robust infrastructure is essential to its success.
Continued research is needed to identify environmental factors that impact health outcomes in home-based settings, to evolve best practices for enhancing the quality and accessibility of care. By bridging these research gaps and implementing evidence-based strategies, we can ensure that HBMC continues to evolve as a vital component of the healthcare system. This paper concludes with recommendations for policymakers, healthcare providers, and researchers to overcome challenges hindering the optimization of Home-Based medical Care delivery.

Keywords: Home-based medical care, Home-based healthcare, Patient outcomes, Healthcare accessibility, Space design factors

[This article belongs to Research & Reviews : A Journal of Life Sciences(rrjols)]

How to cite this article: Shalini Raman Vig, Anil Dewan. Understanding Significance, Challenges and Barriers in Home-Based Medical Care – A Thematic Review of Literature. Research & Reviews : A Journal of Life Sciences. 2024; 14(01):66-71.
How to cite this URL: Shalini Raman Vig, Anil Dewan. Understanding Significance, Challenges and Barriers in Home-Based Medical Care – A Thematic Review of Literature. Research & Reviews : A Journal of Life Sciences. 2024; 14(01):66-71. Available from: https://journals.stmjournals.com/rrjols/article=2024/view=144721


  1. The Value Initiative Issue Brief: Creating Value by Bringing Hospital Care Home | AHA [Internet]. American Hospital Association. 2022. Available from: https://www.aha.org/issue-brief/2020-12-03-value-initiative-issue-brief-creating-value-bringing-hospital-care-home
  2. Caplan GA, Ward JA, Brennan NJ, Coconis J, Board N, Brown A. Hospital in the home: a randomised controlled trial. Medical Journal of Australia. 1999 Feb;170(4):156-60.
  3. Healing at Home: Hospital-at-Home Model Takes Care to Patients [Internet]. Cardiovascular Business. 2022. Available from: https://cardiovascularbusiness.com/topics/healthcare-management/healthcare-economics/healing-home-hospital-home-model-takes-care
  4. Centers for Medicare & Medicaid Services (CMS), HHS. Medicare and Medicaid programs; regulatory provisions to promote program efficiency, transparency, and burden reduction; Part II. Federal register. 2014 May 12;79(91):27105-57.
  5. Choi YK, Thompson HJ, Demiris G. Use of an internet-of-things smart home system for healthy aging in older adults in residential settings: pilot feasibility study. JMIR aging. 2020 Nov 10;3(2):e21964.
  6. Dalai HM, Taylor RS, Wingham J, Greaves C, Jolly K, Lang C, Davis RC, Smith KM, Doherty PJ, Miles J, Van Lingen R. A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT. Programme Grants for Applied Research. 2021 Feb 1;9(1):i-99.
  7. Federman AD, Soones T, DeCherrie LV, Leff B, Siu AL. Association of a bundled hospital-at-home and 30-day postacute transitional care program with clinical outcomes and patient experiences. JAMA internal medicine. 2018 Aug 1;178(8):1033-40.
  8. Goodridge D, Rogers M, Klassen L, Jeffery B, Knox K, Rohatinsky N, Linassi G. Access to health and support services: perspectives of people living with a long-term traumatic spinal cord injury in rural and urban areas. Disability and rehabilitation. 2015 Jul 31;37(16):1401-10.
  9. Hughes SL, Weaver FM, Giobbie-Hurder A, Manheim L, Henderson W, Kubal JD, Ulasevich A, Cummings J, Department of Veterans Affairs Cooperative Study Group on Home-Based Primary Care, Department of Veterans Affairs Cooperative Study Group on Home-Based Primary Care. Effectiveness of team-managed home-based primary care: a randomized multicenter trial. Jama. 2000 Dec 13;284(22):2877-85.
  10. Irgens I, Hoff JM, Sørli H, Haugland H, Stanghelle JK, Rekand T. Hospital based care at home; study protocol for a mixed epidemiological and randomized controlled trial. Trials. 2019 Dec;20:1-2.
  11. Reckrey JM, Yang M, Kinosian B, Bollens-Lund E, Leff B, Ritchie C, Ornstein K. Receipt Of Home-Based Medical Care Among Older Beneficiaries Enrolled In Fee-For-Service Medicare: Study examines receipt of home-based medical care among community-dwelling, fee-for-service Medicare beneficiaries age sixty-five or older. Health Affairs. 2020 Aug 1;39(8):1289-96.
  12. Levine DM, Ouchi K, Blanchfield B, Saenz A, Burke K, Paz M, Diamond K, Pu CT, Schnipper JL. Hospital-level care at home for acutely ill adults: a randomized controlled trial. Annals of internal medicine. 2020 Jan 21;172(2):77-85.
  13. Patel HY, West Jr DJ. Hospital at home: an evolving model for comprehensive healthcare. Global Journal on Quality and Safety in Healthcare. 2021 Nov 1;4(4):141-6.
  14. Reinhard S. Home alone revisited: Family caregivers providing complex care. Innovation in aging. 2019 Nov;3(Suppl 1):S747.
  15. Cousins S. Rethink: How will Covid-19 affect healthcare design? [Internet]. Ribaj.com. RIBA Journal; 2020. Available from: https://www.ribaj.com/intelligence/future-of-healthcare-design-in-post-pandemic-world
  16. Shepperd S, Doll H, Angus RM, Clarke MJ, Iliffe S, Kalra L, Ricauda NA, Tibaldi V, Wilson AD. Avoiding hospital admission through provision of hospital care at home: a systematic review and meta-analysis of individual patient data. Cmaj. 2009 Jan 20;180(2):175-82.
  17. Cochrane Effective Practice and Organisation of Care Group, Edgar K, Iliffe S, Doll HA, Clarke MJ, Gonçalves-Bradley DC, Wong E, Shepperd S. Admission avoidance hospital at home. Cochrane database of systematic reviews. 1996 Sep 1;2024(3).
  18. Uma Educational and Technical Society – Provision of Home-Based Rehabilitation (uetsindia.org)
  19. https://www.cdc.gov/nchs/data/icd/icfoverview_finalforwho10sept.pdf
  20. Desheng WU, Xiulan ZH, Zhang S. Effect of home-based rehabilitation for hip fracture: A meta-analysis of randomized controlled trials. Journal of Rehabilitation Medicine (Stiftelsen Rehabiliteringsinformation). 2018 Jul 1;50(6).
  21. Yao X, Paulson M, Maniaci MJ, Dunn AN, Nelson CR, Behnken EM, Hart MS, Sangaralingham LR, Inselman SA, Lampman MA, Dunlay SM. Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial. Trials. 2022 Jun 16;23(1):503.

Regular Issue Subscription Review Article
Volume 14
Issue 01
Received March 15, 2024
Accepted April 5, 2024
Published April 30, 2024