Background
Methods
Study population
Characteristics of the contacts
Analysis
Ethics
Results
Number of chronic conditions | ||||||
---|---|---|---|---|---|---|
0 n (%) | 1 n (%) | 2 n (%) | 3+ n (%) | p‒value | ||
Overall no of contacts | n = 2,791 | n = 2,849 | n = 1,530 | n = 1,066 | ||
Type of contact | Consultation | 1,501 (53.8) | 1,577 (60.7) | 860 (56.2) | 582 (54.6) | P < 0.001 |
Telephone | 1,033 (37.0) | 1,085 (33.1) | 550 (36.0) | 379 (35.6) | ||
Home visit | 34 (1.2) | 65 (2.1) | 61 (4.0) | 59 (3.5) | ||
E‒mail | 211 (7.6) | 113 (3.4) | 50 (3.3) | 40 (3.8) | ||
Missing | 12 (0.4) | 9 (0.7) | 9 (0.6) | 6 (0.6) | ||
Gender | Male | 991 (35.5) | 1,127 (39.5) | 616 (40.3) | 406 (38.1) | P < 0.072 |
Female | 1,653 (59.2) | 1,663 (58.4) | 890 (58.2) | 649 (60.9) | ||
Missing | 147 (5.3) | 59 (2.1) | 24 (1.6) | 11 (1.0) | ||
Age groups | 40–49 | 927 (33.2) | 552 (19.4) | 201 (13.1) | 83 (7.8) | P < 0.001 |
50–59 | 667 (23.9) | 638 (22.4) | 241 (15.8) | 159 (14.9) | ||
60–69 | 539 (19.3) | 682 (23.9) | 419 (27.4) | 249 (23.4) | ||
70+ | 508 (18.2) | 918 (32.2) | 645 (42.2) | 564 (52.9) | ||
Missing | 150 (5.4) | 59 (2.1) | 24 (1.6) | 11 (1.0) | ||
New episode or follow‒up | New episode | 1,226 (43.9) | 922 (32.4) | 454 (29.7) | 337 (31.6) | P < 0.001 |
Follow‒up | 1,112 (39.8) | 1.628 (57.1) | 912 (59.6) | 655 (61.4) | ||
Missing | 453 (16.2) | 299 (10.5) | 164 (10.7) | 74 (6.9) |
Number of chronic conditions | ||||||
---|---|---|---|---|---|---|
0 n (%) | 1 n (%) | 2 n (%) | 3+ n (%) | p‒value | ||
Characteristics of the contacts
| n = 1,229 | n = 1,315 | n = 731 | n = 528 | ||
Additional psychosocial problems | Yes | 110 (9.0) | 225 (17.1) | 161 (22.0) | 118 (22.4) | P < 0.001 |
No | 1,119 (91.0) | 1,090 (82.9) | 570 (78.0) | 410 (77.7) | ||
No inf. | 0 (0.0) | 0 (0,0) | 0 (0,0) | 0 (0,0) | ||
Time consumption of the consultation | <5 min. | 165 (13.4) | 128 (9.7) | 60 (8.2) | 36 (6.8) | P < 0.001 |
6–15 min. | 810 (65.9) | 876 (66.6) | 470 (64.3) | 334 (63.2) | ||
16–30 min. | 205 (16.9) | 280 (21.3) | 173 (23.7) | 141 (26.7) | ||
>30 min. | 24 (2.0) | 18 (1.4) | 13 (1.8) | 12 (2.3) | ||
No inf. | 25 (2.0) | 13 (1.0) | 15 (2.1) | 5 (1.0) | ||
The GP‒experienced burden of the consultation | Easy | 740 (60.2) | 738 (56.1) | 344 (47.1) | 231 (43.7) | P < 0.001 |
Medium | 277 (22.5) | 297 (22.6) | 213 (29.1) | 130 (24.6) | ||
Heavy | 261 (19.9) | 162 (22.2) | 163 (30.9) | |||
No inf. | 41 (3.3) | 19 (1.4) | 12 (1.6) | 4 (0.8) | ||
Referrals | Primary care specialist | 77 (6.3) | 56 (4.3) | 30 (4.1) | 18 (3.4) | P = 0.098 |
Outpatient clinics | 75 (6.1) | 64 (4.9) | 38 (5.2) | 41 (7.8) | ||
Hospital admission | 15 (1.2) | 14 (1.1) | 19 (2.6) | 8 (1.5) | ||
Substitution by staff possible | Yes | 144 (11.7) | 231 (17.6) | 111 (15.2) | 83 (15.7) | P = 0.001 |
No | 988 (80.4) | 1,003 (76.3) | 568 (77.7) | 416 (78.8) | ||
No inf. | 97 (7.9) | 81 (6.2) | 52 (7.1) | 29 (5.5) |
Chronic conditions | n (%) |
---|---|
Hypertension
| 871 (22.9) |
Type2 diabetes
| 315 (8.3) |
Depression
| 254 (6.7) |
Lipid disorder
| 175 (4.6) |
COPD
| 185 (4.9) |
Isch. heart disease
| 164 (4.3) |
Atrial fibrillation
| 122 (3.2) |
Obesity/Overweight
| 109 (2.9) |
Asthma
| 95 (2.5) |
Dementia
| 53 (1.4) |
All contacts
| 3,803 (100) |
Chronic disease | No | Additional psychosocial problems present n (%) | Time consumption Minutes n (%) | The GP-experienced burden n (%) | Nurse substitution possible n (%) | ||
---|---|---|---|---|---|---|---|
<16 | >15 | Very easy-medium | Heavy or very heavy | ||||
Hypertension
| 304 | 36 (11.9) | 267 (9.9) | 37 (12.2) | 266 (87.8) | 37 (12.2) | 91 (32.0) |
Type2-diabetes
| 72 | 8 (11.1) | 60 (15.3) | 12 (16.7) | 55 (77.5) | 16 (22.5) | 20 (29.0) |
Depression
| 84 | 27 (32.1) | 37 (6.0) | 47 (56.0) | 52 (61.9) | 32 (38.1) | 6 (7.6) |
Lipid disorder
| 27 | 1 (3.7) | 23 (14.8) | 4 (14.8) | 20 (80.0) | 5 (20.0) | 8 (30.8) |
COPD
| 50 | 8 (16.0) | 36 (6.0) | 14 (28.0) | 36 (73.5) | 13 (26.5) | 4 (8.3) |
Isch. heart disease
| 33 | 3 (9.1) | 28 (12.1) | 5 (15.2) | 31 (93.9) | 2 (6.1) | 6 (20.0) |
Atrial fibrillation
| 27 | 3 (11.1) | 25 (14.8) | 2 (7.4) | 23 (88.5) | 3 (11.5) | 6 (24.0) |
Obesity/overweight
| 19 | 4 (21.1) | 15 (0.0) | 4 (21.1) | 14 (73.7) | 5 (26.3) | 3 (16.7) |
Asthma
| 27 | 2 (7.4) | 20 (7.4) | 7 (25.9) | 26 (96.3) | 1 (3.7) | 4 (15.4) |
Dementia
| 17 | 0 (0.0) | 10 (11.8) | 7 (41.2) | 11 (64.7) | 6 (35.3) | 2 (11.8) |
P-values
| P<0.001 | P<0.001 | P<0.001 | P<0.001 |
GP experienced workload as heavy/very heavy | P-values | |||||
---|---|---|---|---|---|---|
Prevalence (N) | Prevalence difference (95% CI) | Prevalence ratio (95% CI) | Adj. prevalence ratio (95% CI) | |||
Chronic disease
|
Hypertension
| 0.12 (37) | ref | 1 | 1 | |
Type2-diabetes
| 0.22 (16) | 0.10 (-0.001-0.21) | 1.85 (1.09-3-12) | 1.62 (0.94-2.8) | 0.085 | |
Depression
| 0.38 (32) | 0.26 (0.15-0.37) | 3.12 (2.1-4.69) | 1.41 (0.93-2.13) | 0.107 | |
Lipid disorder
| 0.20 (5) | 0.08 (-0.08-0.24) | 1.64 (0.71-3.79) | 1.81 (0.92-3.54) | 0.085 | |
COPD
| 0.26 (13) | 0.14 (0.01-0.27) | 2.17 (1.25-3.79) | 1.59 (0.94-2.68) | 0.084 | |
Isch. heart disease
| 0.06 (2) | -0.06 (-0.15-0.23) | 0.5 (0.13-1.97) | 0.50 (0.13-1.90) | 0.308 | |
Atrial fibrillation
| 0.115 (3) | 0.005 (-0.13-0.12) | 0.95 (0.31-2.86) | 1.10 (0.39-3.09) | 0.852 | |
Obesity/overweight
| 0.26 (5) | 0.14 (-0.06-0.34) | 2.15 (0.96-4.85) | 1.64 (0.73-3.67) | 0.232 | |
Asthma
| 0.04 (1) | -0.08 (-0.17-0.005) | 0.30 (0.04-2.13) | 0.25 (0.04-1.64) | 0.149 | |
Dementia
| 0.35 (6) | 0.23 (0.001-0.46) | 2.92 (1.42-5.88) | 2.00 (0.98-3.94) | 0.056 | |
Additional psychosocial problems
|
No
| 0.41 (82) | ref | 1 | 1 | |
Yes
| 0.14 (38) | 0.27 (0.16-0.37) | 2.8 (2.07-3.88) | 1.72 (1.23-2.40) | 0.002 | |
Time consumption
|
< 16 minutes
| 0.10 (51) | ref | 1 | 1 | |
>15 minutes
| 0.50 (69) | 0.40 (0.32-0.49) | 5.11 (3.75-7.00) | 4.06 (2.80-5.89) | <0.001 |