Background
Methods
Design and setting
Study population
Data
National registries in Denmark | Variables | |
---|---|---|
Heart disease
| Danish National Registry of Patients | ICD-10: I20, I21 |
Lung disease
| Danish National Registry of Patients | ICD-10: J40-J47, or J96 |
Danish National Health Service Register | Service codes: 7113, 7121 (spirometries) | |
Danish National Prescription Registry | ATC codes: R03AC, R03AK, R03BA, R03BB, R03CC, R03DA, R03DC, V03AN01 (oxygen) | |
Diabetes
| Danish National Diabetes Register | Civil registration numbers (CPR) corresponding registry data |
Psychiatric disease
| Danish Psychiatric Central Registry | ICD-10: F20, F25, F30, F31 |
Cancer
| Danish Cancer Registry | ICD-10: C00-C97 (excl. C44) |
0101 | Clinical consultation |
0106 | Preventive consultation (from 1 April 2011 included in 0101) |
0107 | Annual follow-up, annual follow-up-consultation for diabetes |
0411-0461, 0491 | Home visit |
2304 | Preventive consultation as annual follow-up (from 1 April 2011 included in 0120) |
2305 | Home visit regarding status of resources and need for care for elderly patients |
0120 | Preventive annual medical care consultation (from 1 April 2011) |
0121 | Annual medical care consultation for elderly patients (from 1 April 2011) |
6101 | Conversational therapy |
Statistical analyses
Ethics approvals
Results
Heart disease N = 494 (100%) | Lung disease N = 210 (100%) | Diabetes N = 1,527 (100%) | Psychiatric disease N = 355(100%) | Cancer N = 1,491 (100%) | 2+ diagnosed N = 673 (100%) | Remaining population N = 8,554 (100%) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Exacerbation (n (%)) | n = 152 (30.8) | n = 83 (39.5) | n = 381 (25.0) | n = 131 (36.9) | n = 336 (22.5) | n = 205 (30.5) | n = 1,213 (14.2) | |||||||
Gender (n (%2)) | ||||||||||||||
Men | 77 | (46.3) | 34 | (48.9) | 182 | (47.8) | 59 | (50.0) | 142 | (39.9) | 96 | (50.0) | 537 | (42.4) |
Women | 75 | (53.7) | 49 | (51.1) | 199 | (52.2) | 72 | (50.0) | 194 | (60.1) | 109 | (50.0) | 676 | (57.6) |
Total | 152 | (100.0) | 83 | (100.0) | (100.0) | 131 | (100.0) | 336 | (100.0) | 205 | (100.0) | 1,213 | (100.0) | |
Age groups in years (n (%2)) | ||||||||||||||
18-40 | 3 | (6.7) | 1 | (0.5) | 14 | (6.6) | 43 | (27.0) | 21 | (11.6) | 3 | (0.5) | 394 | (44.1) |
41-60 | 29 | (20.5) | 15 | (26.4) | 98 | (29.6) | 56 | (44.0) | 67 | (24.5) | 48 | (26.0) | 364 | (29.9) |
61-75 | 54 | (36.4) | 32 | (39.0) | 132 | (34.0) | 30 | (28.5) | 112 | (34.0) | 75 | (28.4) | 233 | (13.4) |
+75 | 66 | (36.4) | 35 | (34.1) | 137 | (29.8) | 2 | (0.4) | 136 | (29.9) | 79 | (35.0) | 222 | (12.7) |
Total | 152 | (100.0) | 83 | (100.0) | 381 | (100.0) | 131 | (100.0) | 336 | (100.0) | 205 | (100.0) | 1,213 | (100.0) |
New health problem (n (%)) | n = 342 (69.2) | n = 127 (60.5) | n = 1,146 (75.0) | n = 224 (63.1) | n = 1,155 (77.5) | n = 468 (69.5) | n = 7,341 (82.6) | |||||||
Gender (n (%2)) | ||||||||||||||
Men | 202 | (44.1) | 60 | (47.5) | 588 | (50.1) | 93 | (40.7) | 436 | (31.9) | 222 | (43.7) | 3,317 | (43.0) |
Women | 140 | (55.9) | 67 | (51.5) | 558 | (49.9) | 131 | (59.3) | 719 | (68.1) | 246 | (56.3) | 4,024 | (57.0) |
Total | 342 | (100.0) | 127 | (100.0) | 1,146 | (100.0) | 224 | (100.0) | 1,155 | (100.0) | 468 | (100.0) | 7,341 | (100.0) |
Age groups in years (n (%2)) | ||||||||||||||
18-40 | 6 | (4.0) | 4 | (4.2) | 117 | (17.2) | 83 | (43.8) | 114 | (18.5) | 21 | (0.9) | 3,683 | (57.6) |
41-60 | 55 | (22.1) | 20 | (17.8) | 262 | (28.7) | 93 | (40.1) | 214 | (24.1) | 80 | (26.1) | 1,851 | (25.1) |
61-75 | 105 | (31.2) | 46 | (40.9) | 351 | (28.9) | 35 | (14.0) | 335 | (28.1) | 157 | (32.1) | 851 | (8.0) |
+75 | 176 | (42.7) | 57 | (37.0) | 416 | (25.2) | 13 | (2.1) | 462 | (29.3) | 210 | (32.5) | 956 | (9.3) |
Total | 342 | (100.0) | 127 | (100.0) | 1,146 | (100.0) | 224 | (100.0) | 1,155 | (100.0) | (100.0) | 7,341 | (100.0) |
Heart disease N = 494 | Lung disease N = 210 | Diabetes N = 1,527 | Psychiatric disease N = 355 | Cancer N = 1,491 | 2+ diagnosed N = 673 | Remaining population N = 5,894 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Proportion of patients with a daytime face-to-face GP contact during 30 days prior to the index date (n (%3)) | ||||||||||||||
Exacerbation (index contact) | 115 | (31.2) | 55 | (38.9) | 273 | (25.9) | 74 | (33.0) | 234 | (23.9) | 148 | (30.4) | 692 | (14.6) |
New health problem (index contact) | 205 | (68.8) | 81 | (61.4) | 719 | (74.1) | 118 | (67.0) | 679 | (76.1) | 308 | (69.6) | 3,152 | (85.4) |
Total | 320 | (100.0) | 136 | (100.0) | 992 | (100.0) | 192 | (100.0) | 913 | (100.0) | 456 | (100.0) | 3,851 | (100.0) |
Proportion of patients provided an annual follow-up during the past 12 month (n (%3)) | ||||||||||||||
Exacerbation (index contact) | 32 | (23.1) | 12 | (27.7) | 97 | (23.7) | 16 | (21.0) | 56 | (20.1) | 51 | (20.4) | 140 | (17.5) |
New health problem | 68 | (76.9) | 25 | (72.3) | 305 | (76.3) | 22 | (79.0) | 182 | (79.9) | 113 | (79.6) | 486 | (82.5) |
Total | 100 | (100.0) | 37 | (100.0) | 402 | (100.0) | 38 | (100.0) | 238 | (100.0) | 164 | (100.0) | 626 | (100.0) |
Mean number of daytime face-to-face GP contacts according to time before index date (n (%)) | ||||||||||||||
Index contact due to exacerbation: | ||||||||||||||
1 month | 1.5 | (1.1;1.4) | 1.4 | (1.1;1.7) | 1.8 | (1.3;2.2) | 1.8 | (1.1;2.9) | 1.6 | (1.3;1.8) | 2.0 | (1.2;2.7) | 0.7 | (0.6;0.7) |
3 months | 3.7 | (3.1;4.4) | 3.6 | (2.9;4.3) | 4.7 | (3.5;5.8) | 5.3 | (3.0;7.7) | 3.4 | (3.0;3.8) | 5.0 | (3.1;7.0) | 2.5 | (2.3;2.8) |
6 months | 7.2 | (5.9;8.4) | 7.0 | (5.7;7.7) | 8.8 | (6.5;11.0) | 10.1 | (5.7;14.6) | 6.3 | (5.6;7.1) | 9.7 | (5.9;13.4) | 4.7 | (4.2;5.0) |
12 months | 13.1 | (10.9;15.4) | 12.5 | (10.0;15.0) | 16.5 | (12.2;20.8) | 18.9 | (10.3;27.6) | 11.1 | (9.8;12.4) | 18.5 | (10.9;26.1) | 8.6 | (7.8;9.3) |
Index contact due to new health problem: | ||||||||||||||
1 month | 0.8 | (0.5;0.8) | 0.8 | (0.7;0.9) | 0.7 | (0.6;0.8) | 0.8 | (0.7;0.9) | 0.7 | (0.7;0.8) | 1.4 | (1.2;1.7) | 0.8 | (0.7;0.8) |
3 months | 3.3 | (2.8;3.8) | 2.0 | (3.4;5.4) | 3.5 | (3.2;3.8) | 2.9 | (2.3;3.5) | 2.9 | (2.7;3.1) | 4.1 | (3.6;4.6) | 1.7 | (1.7;1.8) |
6 months | 6.1 | (5.2;7.0) | 8.4 | (6.7;10.0) | 6.6 | (6.1;7.1) | 5.6 | (4.7;6.5) | 5.3 | (4.9;5.6) | 7.3 | (6.5;8.1) | 3.2 | (3.1;3.3) |
12 months | 11.6 | (9.9;13.3) | 16.3 | (12.7;19.8) | 12.7 | (11.7;13.7) | 10.8 | (9.1;12.6) | 10.0 | (9.4;10.7) | 14.2 | (12.8;15.6) | 6.0 | (5.8;6.2) |
Odds Ratio (95%CI | ||||||||
---|---|---|---|---|---|---|---|---|
Contacts to GP | N (%) | Crude | Adjusted1
| Adjusted2
| ||||
Heart disease
|
152
|
(100%)
| ||||||
No GP contacts | 37 | (19.4%) | 1 | 1 | 1 | |||
1-2 GP contacts | 90 | (59.4%) | 2.19 | (1.08;4.46) | 2.22 | (1.08;4.59) | 2.21 | (1.47;3.83) |
>2 GP contacts | 25 | (21.2%) | 1.41 | (0.59;3.41) | 1.56 | (1.29;3.71) | 1.54 | (0.51;4.64) |
Lung disease
|
83
|
(100%)
| ||||||
No GP contacts | 28 | (24.6%) | 1 | 1 | 1 | |||
1-2 GP contacts | 41 | (52.9%) | 2.82 | (1.16;6.85) | 2.81 | (1.15;6.91) | 3.20 | (1.42;7.17) |
>2 GP contacts | 14 | (22.4%) | 1.34 | (0.42;4.26) | 1.34 | (0.42;4.25) | 1.49 | (1.08;2.05) |
Diabetes
|
381
|
(100%)
| ||||||
No GP contacts | 109 | (24.0%) | 1 | 1 | 1 | |||
1-2 GP contacts | 197 | (53.1%) | 1.60 | (1.06;2.43) | 1.55 | (1.03;2.36) | 1.51 | (0.99;2.30) |
>2 GP contacts | 75 | (22.9%) | 1.74 | (1.02;2.94) | 1.56 | (0.90;2.70) | 1.54 | (0.89;2.68) |
Psychiatric disease
|
131
|
(100%)
| ||||||
No GP contacts | 57 | (38.7%) | 1 | 1 | 1 | |||
1-2 GP contacts | 49 | (37.3%) | 0.99 | (0.49;1.99) | 0.96 | (0.48;1.97) | 0.98 | (0.48;2.01) |
>2 GP contacts | 25 | (24.0%) | 2.38 | (0.99;5.71) | 2.09 | (0.99;5.14) | 2.15 | (1.00;5.39) |
Cancer
|
336
|
(100%)
| ||||||
No GP contacts | 103 | (23.9%) | 1 | 1 | 1 | |||
1-2 GP contacts | 170 | (52.6%) | 1.65 | (1.07;2.54) | 1.61 | (1.04;2.50) | 1.56 | (1.01;2.43) |
>2 GP contacts | 63 | (22.2%) | 2.39 | (1.37;4.16) | 2.19 | (1.22;3.94) | 2.17 | (1.20;3.91) |
2 + diagnose
|
205
|
(100%)
| ||||||
No GP contacts | 58 | (25.4%) | 1 | 1 | 1 | |||
1-2 GP contacts | 104 | (52.8%) | 1.53 | (0.82;2.83) | 1.51 | (0.82;2.78) | 1.49 | (0.81;2.76) |
>2 GP contacts | 43 | (21.8%) | 1.78 | (0.84;3.75) | 1.63 | (0.75;3.54) | 1.63 | (0.75;3.56) |
Annual follow-up
|
Crude
|
Adjusted
1
|
Adjusted
2
| |||||
Heart disease
|
152
|
(100%)
| ||||||
No annual follow-up | 120 | (81.2%) | 1 | 1 | 1 | |||
Annual follow-up | 32 | (18.8%) | 0.82 | (0.39;1.73) | 0.84 | (0.40;1.78) | 0.83 | (0.39;1.75) |
Lung disease
|
83
|
(100%)
| ||||||
No annual follow-up | 71 | (80.7%) | 1 | 1 | 1 | |||
Annual follow-up | 12 | (19.3%) | 0.71 | (0.21;2.41) | 0.70 | (0.20;2.48) | 0.68 | (0.19;2.43) |
Diabetes
|
381
|
(100%)
| ||||||
No annual follow-up | 284 | (73.2%) | 1 | 1 | 1 | |||
Annual follow-up | 97 | (26.8%) | 1.07 | (0.71;1.62) | 1.0 | (0.65;1.51) | 0.98 | (0.66;1.55) |
Psychiatric disease
|
131
|
(100%)
| ||||||
No annual follow-up | 115 | (88.0%) | 1 | 1 | 1 | |||
Annual follow-up | 16 | (12.0%) | 0.59 | (0.20;1.74) | 0.48 | (0.17;1.40) | 0.42 | (0.14;1.25) |
Cancer
| 336 |
(100%)
| ||||||
No annual follow-up | 280 | (82.8%) | 1 | 1 | 1 | |||
Annual follow-up | 56 | (17.2%) | 1.00 | (0.58;1.71) | 0.92 | (0.53;1.58) | 0.91 | (0.52;1.58) |
2 + diagnose
|
205
|
(100%)
| ||||||
No annual follow-up | 154 | (78.9%) | 1 | 1 | 1 | |||
Annual follow-up | 51 | (21.1%) | 0.83 | (0.62;1.12) | 0.63 | (0.34;1.17) | 0.61 | (0.33;1.13) |