TY - JOUR

T1 - Health care utilization related to the introduction of designated GPs at care homes in Denmark

T2 - a register-based study

AU - Christensen, Line Due

AU - Vestergaard, Claus Høstrup

AU - Christensen, Morten Bondo

AU - Huibers, Linda

PY - 2022

Y1 - 2022

N2 - Objective: To investigate the correlation between having designated general practitioners (GPs) in residential care homes and the residents’ number of contacts with primary care, number of hospital admissions and mortality. Design: A retrospective register-based longitudinal study. Setting: Forty-two care homes in Aarhus Municipality, Denmark. Subjects: A total of 2376 care home residents in the period from 1 September 2016 to 31 December 2018. Main outcome measures: We used two models to calculate the incidence risk ratio (IRR) for primary care contacts, hospital admission or dying. Model 1 compared the residents’ risk time before with their risk time after implementation of the designated GP model. Model 2 included only risk time after implementation and was based on calculations of successful (rate ≥60%) implementation. Results: Weighted by time at risk, the proportion of females across the two models ranged from 64% to 68%. The largest group was aged ‘85-94’ years. In Model 1, the mere implementation of the model did not correlate with changes in primary care contacts, hospital admissions, or mortality. Contrarily, in Model 2, residents living in care homes with successful implementation had fewer email contacts (IRR = 0.81, 95%CI: 0.68;0.96), fewer telephone contacts (IRR = 0.78, 95%CI: 0.68;0.90) and fewer hospital admissions (IRR = 0.85, 95%CI: 0.73;0.99), but more home visits (IRR = 1.70, 95%CI: 1.29;2.25) than residents living in care homes with lower implementation rates. Conclusion: The designated GP model seems promising, as a high implementation degree of the model correlated with a reduced the number of acute admissions, short-term admissions and readmissions. Future studies should focus on gaining deeper insight into the mechanisms of the designated GP model to further optimize the model.Key points A new care model was introduced in Denmark in 2017, designating dedicated GPs to residential care homes for the elderly. Successful implementation correlated with significantly fewer hospital admissions, specifically for acute admissions, but also with fewer short-term admissions and readmissions. The implementation of the model correlated significantly with fewer e-mail and telephone contacts and with more home visits. Future studies should gain more insight into the mechanisms of the designated GP model to further optimize the model.

AB - Objective: To investigate the correlation between having designated general practitioners (GPs) in residential care homes and the residents’ number of contacts with primary care, number of hospital admissions and mortality. Design: A retrospective register-based longitudinal study. Setting: Forty-two care homes in Aarhus Municipality, Denmark. Subjects: A total of 2376 care home residents in the period from 1 September 2016 to 31 December 2018. Main outcome measures: We used two models to calculate the incidence risk ratio (IRR) for primary care contacts, hospital admission or dying. Model 1 compared the residents’ risk time before with their risk time after implementation of the designated GP model. Model 2 included only risk time after implementation and was based on calculations of successful (rate ≥60%) implementation. Results: Weighted by time at risk, the proportion of females across the two models ranged from 64% to 68%. The largest group was aged ‘85-94’ years. In Model 1, the mere implementation of the model did not correlate with changes in primary care contacts, hospital admissions, or mortality. Contrarily, in Model 2, residents living in care homes with successful implementation had fewer email contacts (IRR = 0.81, 95%CI: 0.68;0.96), fewer telephone contacts (IRR = 0.78, 95%CI: 0.68;0.90) and fewer hospital admissions (IRR = 0.85, 95%CI: 0.73;0.99), but more home visits (IRR = 1.70, 95%CI: 1.29;2.25) than residents living in care homes with lower implementation rates. Conclusion: The designated GP model seems promising, as a high implementation degree of the model correlated with a reduced the number of acute admissions, short-term admissions and readmissions. Future studies should focus on gaining deeper insight into the mechanisms of the designated GP model to further optimize the model.Key points A new care model was introduced in Denmark in 2017, designating dedicated GPs to residential care homes for the elderly. Successful implementation correlated with significantly fewer hospital admissions, specifically for acute admissions, but also with fewer short-term admissions and readmissions. The implementation of the model correlated significantly with fewer e-mail and telephone contacts and with more home visits. Future studies should gain more insight into the mechanisms of the designated GP model to further optimize the model.

KW - aged

KW - caregivers

KW - Denmark

KW - general practitioners

KW - health services for the aged

KW - Home for the aged

KW - registries

UR - http://www.scopus.com/inward/record.url?scp=85129135339&partnerID=8YFLogxK

U2 - 10.1080/02813432.2022.2057031

DO - 10.1080/02813432.2022.2057031

M3 - Journal article

C2 - 35361055

AN - SCOPUS:85129135339

VL - 40

SP - 115

EP - 122

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

SN - 0281-3432

IS - 1

ER -