The 30-day prognosis of chronic-disease patients after contact with the out-of-hours service in primary healthcare |
| |
| Authors: | Lone Flarup Anders Helles Carlsen Grete Moth Morten Bondo Christensen Mogens Vestergaard Frede Olesen Peter Vedsted |
| |
| Institution: | 1.Research Unit for General Practice, Department of Public Health, Aarhus University, Denmark;2.Danish Research Centre for Cancer Diagnosis in Primary Care (CaP), Department of Public Health, Aarhus University, Denmark;3.Section for General Medical Practice, Department of Public Health, Aarhus University, Denmark |
| |
| Abstract: | Objective. Little is known about the prognosis of patients with chronic disease who contact the out-of-hours (OOH) service in primary care. The characteristics of contacts with the Danish out-of-hours service and daytime general practice, hospitalization, and death were studied during a 30-day follow-up period in patients with chronic heart diseases. Design. Cohort study. Setting and subjects. The study was based on data from 11 897 adults aged 18 + years from a Danish survey of OOH contacts, including information on consultation type. Reason for encounter (RFE) was categorized by OOH GPs at triage as either “exacerbation” or “new health problem”. Registry data were used to identify eligible patients, and the cohort was followed for 30 days after OOH contact through nationwide registries on healthcare use and mortality. Main outcome measures. The 30-day prognosis of chronic-disease patients after OOH contact. Results. Included patients with chronic disease had a higher risk of new OOH contact, daytime GP contact, and hospitalization than other patients during the 30-day follow-up period. OOH use was particularly high among patients with severe mental illness. A strong association was seen between chronic disease and risk of dying during follow-up. Conclusion. Patients with chronic disease used both daytime general practice and the out-of-hours service more often than others during the 30-day follow-up period; they were more often hospitalized and had higher risk of dying. The findings call for a proactive approach to future preventive day care and closer follow-up of this group, especially patients with psychiatric disease.Key Words: Chronic disease, Denmark, general practice, OOH, out-of-hours service, primary healthcare, reasons for encounter- Limited knowledge exists on the prognosis of patients with chronic disease who attend out-of-hours (OOH) primary care.
- Patients with at least one out of five selected chronic diseases had higher OOH and GP use and also increased risk of hospitalization than other patients during the 30-day follow-up period.
- Patients with chronic disease in combination with OOH contact were at high risk of dying.
- The findings mandate more proactive approaches to future preventive day care and follow-up of patients with chronic disease.
|
| |
| Keywords: | |
|
|
