title: The 30-day prognosis of chronic-disease patients after contact with the out-of-hours service in primary healthcare.
abstract: OBJECTIVE
  Little is known about the prognosis of patients with chronic disease who contact the out-of-hours (OOH) service in primary care. The characteristics of contacts with the Danish out-of-hours service and daytime general practice, hospitalization, and death were studied during a 30-day follow-up period in patients with chronic heart diseases.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  The study was based on data from 11 897 adults aged 18 + years from a Danish survey of OOH contacts, including information on consultation type. Reason for encounter (RFE) was categorized by OOH GPs at triage as either "exacerbation" or "new health problem". Registry data were used to identify eligible patients, and the cohort was followed for 30 days after OOH contact through nationwide registries on healthcare use and mortality.
  
  
  METHODS
  The 30-day prognosis of chronic-disease patients after OOH contact.
  
  
  RESULTS
  Included patients with chronic disease had a higher risk of new OOH contact, daytime GP contact, and hospitalization than other patients during the 30-day follow-up period. OOH use was particularly high among patients with severe mental illness. A strong association was seen between chronic disease and risk of dying during follow-up.
  
  
  CONCLUSIONS
  Patients with chronic disease used both daytime general practice and the out-of-hours service more often than others during the 30-day follow-up period; they were more often hospitalized and had higher risk of dying. The findings call for a proactive approach to future preventive day care and closer follow-up of this group, especially patients with psychiatric disease.
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University , Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Flarup
authors.forename: Anders Helles
authors.initials: AH
authors.lastname: Carlsen
authors.forename: Grete
authors.initials: G
authors.lastname: Moth
authors.forename: Morten Bondo
authors.initials: MB
authors.lastname: Christensen
authors.forename: Mogens
authors.initials: M
authors.lastname: Vestergaard
authors.forename: Frede
authors.initials: F
authors.lastname: Olesen
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000401:mortality*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D055815:Young Adult
keywords: Chronic disease; Denmark; OOH; general practice; out-of-hours service; primary healthcare; reasons for encounter