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GP contact with patients after treatment for hip fracture: frequency and determinants
  1. Matthew Thomas1,
  2. Sameer K Khan2,
  3. Norah Phipps3,
  4. Mark D F Shirley4,
  5. Stephen Aldridge2,
  6. Paul V Fearon2,
  7. David J Deehan2
  1. 1Ponteland Medical Group, Hadrian Primary Care Alliance, Newcastle upon Tyne, UK
  2. 2Department of Trauma & Orthopaedics, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  3. 3Prudhoe Medical Group, Hadrian Primary Care Alliance, Newcastle upon Tyne, UK
  4. 4School of Biology, Ridley Building, University of Newcastle, Newcastle upon Tyne, UK
  1. Correspondence to Dr Sameer K Khan, Apartment 509, The Bar, St James Gate, Newcastle upon Tyne NE1 4BA, UK; Sameer.khan{at}doctors.net.uk

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 1 year before and 1 year 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.

  • GERIATRIC MEDICINE

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