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GP contact with patients after treatment for hip fracture: frequency and determinants

Lookup NU author(s): Dr Matthew Thomas, Dr Mark Shirley, Stephen Aldridge, Paul Fearon, Professor David Deehan

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Abstract

Background Patients with hip fracture have complex medical issues, both at the time of admission and after discharge from hospital. We have observed a surge in patient-initiated and carer-initiated contacts with general physicians (GPs) for periods longer than those usually reported, in a series of patients sustaining fractures from July 2008 to September 2013.Objectives To establish (1) the frequency of contact with GPs (primary outcome) and (2) the factors influencing the frequency of different modes of contact.Methods Ten GP practices in West Northumberland were asked to retrospectively identify patients sustaining hip fractures, and to provide data on the number of GP contacts (patient visits to GP, telephone consultations, GP visits to patient's home) up to 1year before and 1year after fracture. Generalised linear models (GLM) were constructed using number of postfracture GP contacts as response variable; age, gender, residential status, number of prefracture contacts and days to contact postfracture were covariates.Results Each patient recorded cumulative 8.4 GP contacts before and 10.79 contacts after fracture. There were significantly more telephone contacts with GPs and GP home visits, but significantly fewer patient visits to GP clinics. In the GLM analysis, patient age and number of prefracture GP contacts predicted all types of postfracture contacts, while gender was not. Patients discharged home visited their GPs five times more frequently than those discharged to institutional care.Conclusions After hip fractures, telephone contacts and GP visits to patients' homes increase, but patient visits to GP clinics decrease, influenced by age and residential status.


Publication metadata

Author(s): Thomas M, Khan SK, Phipps N, Shirley MDF, Aldridge S, Fearon PV, Deehan DJ

Publication type: Article

Publication status: Published

Journal: Postgraduate Medical Journal

Year: 2016

Volume: 92

Issue: 1092

Pages: 587-591

Print publication date: 01/10/2016

Online publication date: 15/03/2016

Acceptance date: 11/02/2016

ISSN (print): 0032-5473

ISSN (electronic): 1469-0756

Publisher: BMJ Publishing Group

URL: http://dx.doi.org/10.1136/postgradmedj-2015-13356

DOI: 10.1136/postgradmedj-2015-133568


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