There are approximately 2 million chronically at-home patients in the United States, defined as those who simply cannot leave their homes. Half remain at home because of old age and frailty. The other half suffer from chronic and debilitating illness.
New York is particularly struck by homebound patients thanks to the abundance of walkup apartment buildings. These structures make travel unmanageable for many people who understandably didn't have the foresight to move to a wheelchair-accessible home in the first place. The poor are especially disadvantaged because they have fewer means to move or afford quality care to stave off illness.
Visiting doctors are today able to supply high-level care at home, with portable X-rays and blood tests, hospital-quality treatment for pneumonia and heart failure, wound care, IV fluids, and minor medical operations.
One sign that visiting care from doctors is necessary is when individuals find it necessary to schedule medical visits further and further apart. This will happen to patients who find it a burden to leave the house. Many of these patients eventually run out of medication and "coast" without them until an emergency strikes and they have to be rushed to the emergency room, which incurs even greater costs.
Falls are a common reason for the house call. Recent studies have shown that such home care is decidedly less expensive than is emergency hospital care.