title: Proximity to death is associated with frequency of GP contacts in the oldest old: the Leiden 85-plus study.
abstract: BACKGROUND
  the relationship between proximity to death and the amount of care provided by general practitioners (GPs) is largely unknown.
  
  
  OBJECTIVE
  to examine the influence of the proximity to death on the frequency and length of GP contacts in the oldest old.
  
  
  METHODS
  this population-based follow-up study included 599 inhabitants of Leiden, the Netherlands. At ages 85-90 years, the frequency and length of GP contacts during the previous year were collected.
  
  
  METHODS
  the influence of age and proximity to death on contact frequency and time was analysed with linear mixed modelling.
  
  
  RESULTS
  in a model including 'age' alone, mean contact frequency during surviving years increased with 0.25 contacts/year [95% confidence interval (CI) 0.04-0.45, P = 0.019] and mean contact time with 11.04 min/year (95% CI: 5.42-16.67, P < 0.001). In a model including 'age' and 'proximity to death', those who died compared with those who survived had 11.94 contacts (95% CI: 10.86-13.01) more that year and 323 min (95% CI: 294-353, P < 0.001) more time, with no effect of 'age'.
  
  
  CONCLUSIONS
  the observed increase in utilisation of GP care of the oldest old depends more on the proximity to death and less on age alone. Being old only results in a small increase in the GP's workload.
authors.affiliation: Public Health and Primary Care, Leiden University Medical Center, PO Box 9600, Leiden 2300RC, Netherlands. j.w.blom@lumc.nl
authors.forename: Jeanet W
authors.initials: JW
authors.lastname: Blom
authors.forename: Steven P
authors.initials: SP
authors.lastname: Lemmens
authors.forename: Willem J J
authors.initials: WJ
authors.lastname: Assendelft
authors.forename: Just A H
authors.initials: JA
authors.lastname: Eekhof
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D009026:Mortality / Q000639:trends*; D009426:Netherlands; D009819:Office Visits / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D013997:Time Factors