Dutch ICU survivors have more consultations with general practitioners before and after ICU admission compared to a matched control group from the general population
Dutch ICU survivors have more consultations with general practitioners before and after ICU admission compared to a matched control group from the general population
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DOI：
10.1371/journal.pone.0217225
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发表时间：
2019-05-23
期刊：
影响因子：
3.7
通讯作者：
Dongelmans, Dave A.
中科院分区：
文献类型：
--
作者：
van Beusekom, Ilse;Bakhshi-Raiez, Ferishta;Dongelmans, Dave A.
背景全科医生（GP）在患者的医疗保健轨迹中发挥着关键作用。如果患者遇到通常不危及生命的问题，例如重症监护后综合征的症状，全科医生将是他们咨询的第一位医疗保健专业人员。本研究的主要目的是了解ICU幸存者和普通人群中匹配的对照组在入院前一年和出院后一年的GP咨询频率。本研究的第二个目的是深入了解ICU人群的亚组之间的差异，就GP consultation.MethodsWe的频率进行了一项回顾性队列研究，结合国家健康保险索赔数据库和国家质量注册ICU。2013年入住ICU的患者的临床数据使用2012年、2013年和2014年的索赔数据进行了丰富。Poisson回归被用来评估ICU人口和对照组之间的GP磋商的频率的差异。ResultsICU患者有更多的咨询与GP在一年前和入院后比个人在对照组。在入院前的最后4周，ICU患者的GP咨询次数是对照组的3.58倍（CI 3.37; 3.80），在出院后的前4周，他们的GP咨询次数是对照组的4.98倍（CI 4.74; 5.23）。在出院后的一年ICU幸存者有增加GP咨询率比前一年他们hospitalacceptance.ConclusionsClose入院后不久出院，GP咨询的频率大大增加ICU幸存者的人口。即使在出院一年后，ICU幸存者也增加了GP咨询率。因此，全科医生应充分了解ICU患者出院后遇到的问题，以便提供适当的后续护理。
BackgroundGeneral Practitioners (GPs) play a key role in the healthcare trajectory of patients. If the patient experiences problems that are typically non-life-threatening, such as the symptoms of post-intensive-care syndrome, the GP will be the first healthcare professional they consult. The primary aim of this study is to gain insight in the frequency of GP consultations during the year before hospital admission and the year after discharge for ICU survivors and a matched control group from the general population. The secondary aim of this study is to gain insight into differences between subgroups of the ICU population with respect to the frequency of GP consultations.MethodsWe conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry for ICUs. Clinical data of patients admitted to an ICU in 2013 were enriched with claims data from the years 2012, 2013 and 2014. Poisson regression was used to assess the differences in frequency of GP consultations between the ICU population and the control group.ResultsICU patients have more consultations with GPs during the year before and after admission than individuals in the control group. In the last four weeks before admission, ICU patients have 3.58 (CI 3.37; 3.80) times more GP consultations than the control group, and during the first four weeks after discharge they have 4.98 (CI 4.74; 5.23) times more GP consultations. In the year after hospital discharge ICU survivors have an increased GP consultation rate compared to the year before their hospital admission.ConclusionsClose to hospital admission and shortly after hospital discharge, the frequency of GP consultations substantially increases in the population of ICU survivors. Even a year after hospital discharge, ICU survivors have increased GP consultation rates. Therefore, GPs should be well informed about the problems ICU patients suffer after discharge, in order to provide suitable follow-up care.