丹麦全科医疗中老年患者护理的连续性与间断性：一项回顾性队列研究。

Continuity and discontinuity of care among older patients in Danish general practice: a retrospective cohort study.

作者信息

Olsen Jonas K, Kristensen Troels

机构信息

Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark

Danish Centre for Health Economics, University of Southern Denmark, Odense, Denmark.

出版信息

BJGP Open. 2023 Dec 19;7(4). doi: 10.3399/BJGPO.2023.0081. Print 2023 Dec.

DOI:10.3399/BJGPO.2023.0081

PMID:37336619

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11176696/

Abstract

BACKGROUND

Continuity of care (COC) for older adults has been associated with lower use of healthcare services, decreased risk of hospitalisation, and lower mortality. However, research on COC in older adults is limited by short time periods and small sample sizes. Long-term COC can only develop if the patient stays with the general practice for ≥10 years. Therefore, research that focuses on long duration and broader populations is needed.

AIM

To measure the extent of longitudinal site-level COC in general practice and listing duration of the patient-general practice relation for all older Danish citizens.

DESIGN & SETTING: Retrospective cohort study of all patients aged ≥65 years on 31 December 2021 listed with a Danish general practice ( = 1 144 941 persons).

METHOD

Individual-level register data were used on start and end dates for listing with a general practice to analyse site-level COC by number of changes and listing duration of the patient-general practice relation from January 2007-December 2021.

RESULTS

During the 15 years, 39.3% of older adults did not change general practice. Among the remaining 60.7%, who experienced discontinuity of care, 34.0% changed once, 16.3% changed twice, and 6.3% changed three times. Overall, <5% changed general practice >3 times. The duration of the patient-general practice relations were on average 9.5 years. Overall, 27.5% lasted 0-4 years, 33.7% lasted 5-9 years, and 38.8% lasted ≥10 years.

CONCLUSION

Danish general practice provides high levels of site-level COC for their older patients. On average, patients aged ≥65 years changed general practice once and had a patient-general practice relation length of 9.5 years.

摘要

背景

老年人的连续性护理（COC）与医疗服务使用减少、住院风险降低和死亡率降低相关。然而，关于老年人COC的研究受到时间段短和样本量小的限制。只有当患者在全科医疗中持续就诊≥10年时，长期COC才能得以发展。因此，需要关注长时间跨度和更广泛人群的研究。

目的

衡量丹麦所有老年公民在全科医疗中的纵向机构层面COC程度以及患者与全科医疗关系的登记持续时间。

设计与设置

对2021年12月31日在丹麦全科医疗登记的所有≥65岁患者（n = 1144941人）进行回顾性队列研究。

方法

使用个体层面的登记数据，记录在全科医疗登记的开始和结束日期，以分析2007年1月至2021年12月期间按变更次数和患者与全科医疗关系的登记持续时间衡量的机构层面COC。

结果

在这15年中，39.3%的老年人未更换全科医疗。在其余经历了护理中断的60.7%中，34.0%更换过一次，16.3%更换过两次，6.3%更换过三次。总体而言，<5%的人更换全科医疗超过3次。患者与全科医疗关系的持续时间平均为9.5年。总体而言，27.5%持续0 - 4年，33.7%持续5 - 9年，38.8%持续≥10年。