Present and future of Home Care by GPs in the Province of Modena (Italy): a descriptive study with a qualitative insert, the MAGMA Home Study.

Background: The increase in life expectancy, in disabilities and in the number of elderly living alone represent a challenge for healthcare services and in particular for GPs as an increasing number of patients require Home Care (HC). Rumors spread among the population claiming that “GPs no longer make house calls'' while Italian GPs’ perceive an increasing workload for HC. At present, we are not aware of any study performed in Italy describing the HC activity of GPs and their perceptions about. Research questions: How is HC actually organized in the Province of Modena and how many home visits do GPs perform each year, to which patients and with what outcomes? What do physicians, nurses, patients and caregivers think about the HC service? Method: We'll conduct a retrospective descriptive study from the GP’s EMR-data through a SQL extraction in Modena Province (Italy), led by GPs-investigators in collaboration with the Local Health Authority and the University Department of Public Health. The variables will characterize both GPs and patients (socio-demographic data, comorbidities and socio-economic status), the volume and type of HC delivered, and their outcomes. A collection of qualitative data regarding experience and reflection of GPs, nurses, patients and caregivers will be performed through Focus Groups. The inclusion in the retrospective descriptive study will be on a voluntary basis, and all GPs will be asked to participate. Based on previous studies, we expect to include at least 10% of GPs. For participating in the Focus Group, GPs, nurses, patients and caregivers will be randomly extracted from the HC lists and asked to take part. The main outcomes will be the number and type of HC performed by each GPs and hospitalizations, deaths and ED access rates. The descriptive data will be