title: [Follow-up of elderly patients in their homes by general practitioners after discharge from hospital].
abstract: The present project which is part of a more extensive coordination project has had the goal of carrying out and assessing the proposals about follow up home visits by the general practitioner after discharge from hospital made by "The coordinating committee for the health services". General practitioners in the municipality of Roskilde made a total of 210 visits to elderly patients aged 75 years or over who had been discharged to their homes after hospitalization for at least three days. During these visits, the practitioners discovered newly developed problems in 49% of the visits while adjustment of medication proved necessary at 52% of the visits. This investigation is concerned with the risk situation, viz discharge of elderly patients from hospital but it also attempts to identify the risk groups which obtain most benefit from follow up. The majority of problems were found among the oldest patients aged 85 years and over who had been hospitalized for more than seven days. In addition, the general practitioners found that significantly more elderly patients aged 85 years and over (less than or equal to 0.05) and elderly patients who had been hospitalized for over seven days should be followed up by home visits. It is emphasized that the model outlined here would not stress the individual general practitioner's daily routine to any great extent.
authors.affiliation: Amtssygehuset i Roskilde, langtidsmedicinsk afdeling.
authors.forename: F R
authors.initials: FR
authors.lastname: Hansen
authors.forename: A
authors.initials: A
authors.lastname: Ziebell
authors.forename: K
authors.initials: K
authors.lastname: Spedtsberg
authors.forename: M
authors.initials: M
authors.lastname: Schroll
mesh_terms: D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D005500:Follow-Up Studies; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D010351:Patient Discharge; D010821:Physicians, Family; D000078329:Workforce
vernacular_title: Praktiserende laegers opfølgning i aeldres hjem efter hospitalsindlaeggelse.