Declining number of home visits to older adults by GPs: an observational study using data from electronic health records in The Netherlands, 2017-2023.
Chantal J Leemrijse, Marianne J Heins, Bart J Knottnerus, Mariette Hooiveld, Judith N de Boer, Ron F Schipper, Joost W Vanhommerig
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Abstract
Background: Despite an ageing population that has higher care demands, home visits by GPs have been declining.
Aim: To analyse the number of GP home visits from 2017-2023 in The Netherlands, and to investigate whether this trend differed according to age, sex, multimorbidity, and neighbourhood deprivation. In addition, to discover the most common reasons for home visits between 2017 and 2023.
Design & setting: An observational study that used data derived from Nivel Primary Care Database (Nivel-PCD), which contained routinely recorded data from approximately 500 Dutch GP practices.
Method: The number of home visits was calculated by age, sex, multimorbidity, and neighbourhood deprivation. Visual inspection was used to investigate the relation between the trend in number of home visits and age, sex, multimorbidity, and neighbourhood deprivation of patients.
Results: A large decrease in the overall number of home visits was observed between 2017 and 2023 (-32%). The largest decrease was between 2019 and 2020 (-15%), but the downward trend continued in 2021 through 2023 (-5% per year). The most profound decline between 2023 and 2017 was found in the number of short home visits (-52%). The number of home visits for intensive GP care increased by 12% between 2017 and 2023.
Conclusion: We report a continuing decline in the number of home visits by GPs, comparing 2023 with 2017. Home visits for intensive GP care, often for patients at the end of life, increased since 2017. GPs may be forced to make choices owing to the increasing workload.
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