title: General practitioners' contribution to the management of community-acquired pneumonia in the Netherlands: a retrospective analysis of primary care, hospital, and national mortality databases with individual data linkage.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) is an important cause of hospital admission and death, but the extent of the problem of CAP at the primary healthcare level is largely unknown.
  
  
  OBJECTIVE
  To investigate the contribution of general practitioners (GPs) to the management of patients with CAP in the Netherlands.
  
  
  METHODS
  The study population consisted of all people enlisted in a GP network. We obtained information on CAP episodes from GP electronic records (using ICPC code R81) during the years 2002-2009. CAP registrations were also obtained from national hospital discharge data (ICD-9 codes) and cause of death statistics (ICD-10 codes). The three registration systems were linked at the individual level. We used descriptive analyses to estimate the annual number of CAP episodes (i.e. defined as a CAP diagnosis within 30 days).
  
  
  RESULTS
  From 2002 to 2009 the mean annual size of the study population was 395,039. For this population, 3,700 (0.9%) CAP episodes per year were registered in at least one of the registration systems, 2,933 (79%) of which were in the GP system only. Recovery within 30 days occurred on average in 95% (2,791/2,933) of the CAP episodes annually registered by a GP, while 2.3% (67/2,933) of patients with a GP-registered CAP episode were admitted to hospital within 30 days and 1% (26/2,933) had a fatal outcome within 30 days.
  
  
  CONCLUSIONS
  The vast majority of CAP episodes registered in the Netherlands are managed successfully at the GP level without hospitalisation.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Bianca
authors.initials: B
authors.lastname: Snijders
authors.forename: Wim
authors.initials: W
authors.lastname: van der Hoek
authors.forename: Irina
authors.initials: I
authors.lastname: Stirbu
authors.forename: Marianne A B
authors.initials: MA
authors.lastname: van der Sande
authors.forename: Arianne B
authors.initials: AB
authors.lastname: van Gageldonk-Lafeber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000628:therapy*; D016208:Databases, Factual; D019468:Disease Management; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011014:Pneumonia / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult
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