General practitioner follow-up after hospitalisation in Central and Eastern Sydney, Australia: access and impact on health services

Abstract

Objectives. General practitioner (GP) follow-up after a hospital admission is an important indicator of integrated care. We examined the characteristics of patients who saw a GP within 2 weeks of hospital discharge in the Central and Eastern Sydney (CES) region, Australia, and the relationship between GP follow-up and subsequent hospitalisation. Methods. This data linkage study used a cohort of 10 240 people from the 45 and Up Study who resided in CES and experienced an overnight hospitalisation in the 5 years following recruitment (2007-14). Characteristics of participants who saw a GP within 2 weeks of discharge were compared with those who did not using generalised linear models. Time to subsequent hospitalisation was compared for the two groups using Cox proportional hazards regression models stratified by prior frequency of GP use. Results. Within 2 weeks of discharge, 64.3% participants saw a GP. Seeing a GP within 2 weeks of discharge was associated with lower rates of rehospitalisation for infrequent GP users (i.e. ,8 visits in year before the index hospitalisation; hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.70-0.97) but not frequent GP users (i.e. 8 plus visits; HR 1.02; 95% CI 0.90-1.17). Conclusion. The effect of seeing a GP on subsequent hospitalisation was protective but differed depending on patient care needs. What is known about the topic? There is general consensus among healthcare providers that primary care is a significant source of ongoing health care provision. What does this paper add? This study explored the relationship between GP follow-up after an uncomplicated hospitalisation and its effect on rehospitalisation.

Culturally and linguistically diverse men's experiences of support following perinatal death: A qualitative study

“…The latter is supportive of previous research for men (e.g. O' Leary & Thorwick, 2006), and particularly, CALD men who may be isolated if they are from smaller communities or arrived as migrants (Barr et al, 2020). Similarly, religion and ritual were seen by some participants as a key source of support, while for others, this could be conflicted if the right sorts of religious support were not available.…”

“…In addition to the lack of access and uptake of more formal mental health or bereavement services and a tendency to minimise grief following perinatal death (Obst et al, 2020), men in general often also experience low levels of informal support options (Obst & Due, 2019;O'Leary & Thorwick, 2006) including support from family, friends and the broader community, as well as any religious groups if relevant. This may be particularly the case for people from CALD backgrounds who can experience higher rates of social isolation due to migration experiences, including separation from family and community elders and other issues such as language barriers (Barr et al, 2020).…”

General practice staff and patient experiences of a multicomponent intervention for people at high risk of poor health outcomes: a qualitative study

“…Providing timely (within 7 days) follow-up after patients experienced a hospital care episode was reported by practice staff as challenging. General practice follow-up after hospital care episodes involves complex dependencies between the patient, the GP and the hospital [ 19 ]. Practices rely on discharge information being sent to them from hospitals or patients independently notifying them of their hospital care episode.…”

“…The transition between hospital to home and GP care is associated with high risk for adverse events and avoidable hospital readmissions, particularly for older people with complex needs [ 16 – 18 ]. The extent to patients receive timely GP follow-up after hospital discharge depends on a set of complex factors relating to patient’s perceptions of the value of GP follow-up, GPs receiving notification of the hospitalisation and hospitals communicating the need for GP follow-up to both the patient and the GP [ 19 ]. From the limited Australian research available it appears that in the order of around one-third of patients discharged from hospital do not see a GP within 14 days [ 19 – 21 ].…”

Cohort Profile Update: The 45 and Up Study

“…Linked with other health data sets, the results from the surveys have been used extensively for epidemiological research into risk factors and incidence of chronic diseases such as cancer, 17 , 18 cardiovascular disease, 19 , 20 mental health 21 and dementia. 16 The Study has been used to quantify and characterize social determinants of health and wellbeing, 22 predictors, changes over time, inequalities of healthcare access and health outcomes 23 , 24 and inform prevention opportunities.…”