Consultation frequency patterns for older patients in Danish general practice: a nationwide register-based cohort study.

Abstract

Background: There may be distinctly different ways for general practices to serve the growing population of older patients, providing them different combinations of face-to-face, telephone, and email consultations; home visits; and chronic care reviews.

Aim: To identify latent general practice profiles of frequency and combination of consultation types for older patients and relate them to practice characteristics.

Design & setting: Register-based cohort study of all Danish citizens aged ≥75 years.

Method: For each of the years 2017-2021, a latent profile analysis was conducted on the practices' frequencies of consultation types, adjusting for patient population characteristics.

Results: We identified a 'Majority' and the following three temporary latent profiles of provision of consultation services to older patients: the 'Phone heavy' profile (9%-10% of practices, 2017-2019), which provided nearly double the telephone consultations as the 'Majority' profile and was associated with the GPs being older and working single-handed; the 'High frequency' profile (12%-14% of practices, 2017-2018), which provided higher levels of face-to-face, telephone, and email consultations than the 'Majority' profile; and the 'Phone and email heavy' profile (7% of practices, 2020), which provided more email than face-to-face consultations, and more of each consultation than the 'Majority' profile. The number of profiles decreased from three in 2017 to only the 'Majority' profile in 2021.

Conclusion: There is a trend towards a more uniform pattern of consultations for older patients in general practice. It is unknown whether high provision of certain types of consultations in general practice has downstream effects such as decreased need for hospital and out-of-hours services.