As the population ages, and more patients with chronic pulmonary diseases become frail and functionally impaired, the prevalence of homebound patients grows. Homebound patients have higher disease burden, inpatient utilization rates, and mortality than non- homebound patients. Vulnerable homebound patients with pulmonary disease benefit from pulmonary expertise to evaluate and optimize their complex medication regimens, evaluate equipment such as nebulizers, home oxygen, ventilators and suction machines, and coordinate services. We review the need and benefits of house calls for these patients, and illustrate these needs with cases. We also explore the logistics of making house calls part of pulmonary practice, including supplies needed, safety in the home, and reimbursement. Reimbursement has grown for house calls, we review how to bill for visits, for advance care planning, and for the care management that is often required when caring for patients with advanced illness. In addition, house calls can often be beneficial for patients who may be identified as high risk and are part of value based agreements with payers.

中文翻译：

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上门服务在肺病患者护理中的作用

随着人口老龄化，越来越多的慢性肺病患者变得虚弱和功能受损，居家患者的患病率增加。居家患者比非居家患者具有更高的疾病负担、住院使用率和死亡率。脆弱的居家肺病患者受益于肺部专业知识，以评估和优化其复杂的药物治疗方案，评估雾化器、家用氧气、呼吸机和抽吸机等设备，并协调服务。我们回顾了这些患者上门拜访的需求和好处，并通过案例说明了这些需求。我们还探索了使上门服务成为肺部实践的一部分的后勤工作，包括所需的用品、家中的安全和报销。上门服务的报销有所增加，我们审查了如何为就诊、预先护理计划以及护理晚期疾病患者时通常需要的护理管理开具账单。此外，上门服务通常对可能被确定为高风险的患者有益，并且是与付款人达成的基于价值的协议的一部分。