General practitioners' home visit tendency and readmission-free survival after COPD hospitalisation

a Danish nationwide cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background:The tendency of general practitioners (GPs) to conduct home visits is considered an important aspect of practices' accessibility and quality of care.Aims:To investigate whether GPs' tendency to conduct home visits affects 30-day readmission or death after hospitalisation with chronic obstructive pulmonary disease.Methods:All Danish patients first-time hospitalised with COPD during the years 2006-2008 were identified. The association between the GP's tendency to conduct home visits and the time from hospital discharge until death or all-cause readmission was analysed by means of Cox regression adjusted for multiple patient and practice characteristics.Results:The study included 14,425 patients listed with 1,389 general practices. Approximately 31% of the patients received a home visit during the year preceding their first COPD hospitalisation, and within 30 days after discharge 19% had been readmitted and 1.6% had died without readmission. A U-shaped dose-response relationship was found between GP home visit tendency and readmission-free survival. The lowest adjusted risk of readmission or death was recorded among patients who were listed with a general practice in which >20-30% of other listed first-time COPD-hospitalised patients had received a home visit. The risk was higher if either 0% (hazard rate ratio 1.18 (1.01-1.37)) or >60% (hazard rate ratio 1.23 (1.04-1.44)) of the patients had been visited.Conclusion:A moderate GP tendency to conduct home visits is associated with the lowest 30-day risk of COPD readmission or death. A GP's tendency to conduct home visits should not be used as a unidirectional indicator of the ability to prevent COPD hospital readmissions.

OriginalsprogEngelsk
TidsskriftPrimary Care Respiratory Journal
Vol/bind24
Sider (fra-til)14100
ISSN1471-4418
DOI
StatusUdgivet - 2014

Fingeraftryk

House Calls
General Practitioners
Chronic Obstructive Pulmonary Disease
Cohort Studies
General Practice
Patient Readmission
Quality of Health Care

Citer dette

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title = "General practitioners' home visit tendency and readmission-free survival after COPD hospitalisation: a Danish nationwide cohort study",
abstract = "Background:The tendency of general practitioners (GPs) to conduct home visits is considered an important aspect of practices' accessibility and quality of care.Aims:To investigate whether GPs' tendency to conduct home visits affects 30-day readmission or death after hospitalisation with chronic obstructive pulmonary disease.Methods:All Danish patients first-time hospitalised with COPD during the years 2006-2008 were identified. The association between the GP's tendency to conduct home visits and the time from hospital discharge until death or all-cause readmission was analysed by means of Cox regression adjusted for multiple patient and practice characteristics.Results:The study included 14,425 patients listed with 1,389 general practices. Approximately 31{\%} of the patients received a home visit during the year preceding their first COPD hospitalisation, and within 30 days after discharge 19{\%} had been readmitted and 1.6{\%} had died without readmission. A U-shaped dose-response relationship was found between GP home visit tendency and readmission-free survival. The lowest adjusted risk of readmission or death was recorded among patients who were listed with a general practice in which >20-30{\%} of other listed first-time COPD-hospitalised patients had received a home visit. The risk was higher if either 0{\%} (hazard rate ratio 1.18 (1.01-1.37)) or >60{\%} (hazard rate ratio 1.23 (1.04-1.44)) of the patients had been visited.Conclusion:A moderate GP tendency to conduct home visits is associated with the lowest 30-day risk of COPD readmission or death. A GP's tendency to conduct home visits should not be used as a unidirectional indicator of the ability to prevent COPD hospital readmissions.",
author = "Jesper Lykkegaard and Larsen, {Pia V} and Paulsen, {Maja S} and Jens S{\o}ndergaard",
year = "2014",
doi = "10.1038/npjpcrm.2014.100",
language = "English",
volume = "24",
pages = "14100",
journal = "Primary Care Respiratory Journal",
issn = "1471-4418",
publisher = "Strategic Medical Publishing",

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TY - JOUR

T1 - General practitioners' home visit tendency and readmission-free survival after COPD hospitalisation

T2 - a Danish nationwide cohort study

AU - Lykkegaard, Jesper

AU - Larsen, Pia V

AU - Paulsen, Maja S

AU - Søndergaard, Jens

PY - 2014

Y1 - 2014

N2 - Background:The tendency of general practitioners (GPs) to conduct home visits is considered an important aspect of practices' accessibility and quality of care.Aims:To investigate whether GPs' tendency to conduct home visits affects 30-day readmission or death after hospitalisation with chronic obstructive pulmonary disease.Methods:All Danish patients first-time hospitalised with COPD during the years 2006-2008 were identified. The association between the GP's tendency to conduct home visits and the time from hospital discharge until death or all-cause readmission was analysed by means of Cox regression adjusted for multiple patient and practice characteristics.Results:The study included 14,425 patients listed with 1,389 general practices. Approximately 31% of the patients received a home visit during the year preceding their first COPD hospitalisation, and within 30 days after discharge 19% had been readmitted and 1.6% had died without readmission. A U-shaped dose-response relationship was found between GP home visit tendency and readmission-free survival. The lowest adjusted risk of readmission or death was recorded among patients who were listed with a general practice in which >20-30% of other listed first-time COPD-hospitalised patients had received a home visit. The risk was higher if either 0% (hazard rate ratio 1.18 (1.01-1.37)) or >60% (hazard rate ratio 1.23 (1.04-1.44)) of the patients had been visited.Conclusion:A moderate GP tendency to conduct home visits is associated with the lowest 30-day risk of COPD readmission or death. A GP's tendency to conduct home visits should not be used as a unidirectional indicator of the ability to prevent COPD hospital readmissions.

AB - Background:The tendency of general practitioners (GPs) to conduct home visits is considered an important aspect of practices' accessibility and quality of care.Aims:To investigate whether GPs' tendency to conduct home visits affects 30-day readmission or death after hospitalisation with chronic obstructive pulmonary disease.Methods:All Danish patients first-time hospitalised with COPD during the years 2006-2008 were identified. The association between the GP's tendency to conduct home visits and the time from hospital discharge until death or all-cause readmission was analysed by means of Cox regression adjusted for multiple patient and practice characteristics.Results:The study included 14,425 patients listed with 1,389 general practices. Approximately 31% of the patients received a home visit during the year preceding their first COPD hospitalisation, and within 30 days after discharge 19% had been readmitted and 1.6% had died without readmission. A U-shaped dose-response relationship was found between GP home visit tendency and readmission-free survival. The lowest adjusted risk of readmission or death was recorded among patients who were listed with a general practice in which >20-30% of other listed first-time COPD-hospitalised patients had received a home visit. The risk was higher if either 0% (hazard rate ratio 1.18 (1.01-1.37)) or >60% (hazard rate ratio 1.23 (1.04-1.44)) of the patients had been visited.Conclusion:A moderate GP tendency to conduct home visits is associated with the lowest 30-day risk of COPD readmission or death. A GP's tendency to conduct home visits should not be used as a unidirectional indicator of the ability to prevent COPD hospital readmissions.

U2 - 10.1038/npjpcrm.2014.100

DO - 10.1038/npjpcrm.2014.100

M3 - Journal article

VL - 24

SP - 14100

JO - Primary Care Respiratory Journal

JF - Primary Care Respiratory Journal

SN - 1471-4418

ER -