title: GP contact with patients after treatment for hip fracture: frequency and determinants.
abstract: BACKGROUND
  Patients with hip fracture have complex medical issues, both at the time of admission and after discharge from hospital. We have observed a surge in patient-initiated and carer-initiated contacts with general physicians (GPs) for periods longer than those usually reported, in a series of patients sustaining fractures from July 2008 to September 2013.
  
  
  OBJECTIVE
  To establish (1) the frequency of contact with GPs (primary outcome) and (2) the factors influencing the frequency of different modes of contact.
  
  
  METHODS
  Ten GP practices in West Northumberland were asked to retrospectively identify patients sustaining hip fractures, and to provide data on the number of GP contacts (patient visits to GP, telephone consultations, GP visits to patient's home) up to 1 year before and 1 year after fracture. Generalised linear models (GLM) were constructed using number of postfracture GP contacts as response variable; age, gender, residential status, number of prefracture contacts and days to contact postfracture were covariates.
  
  
  RESULTS
  Each patient recorded cumulative 8.4 GP contacts before and 10.79 contacts after fracture. There were significantly more telephone contacts with GPs and GP home visits, but significantly fewer patient visits to GP clinics. In the GLM analysis, patient age and number of prefracture GP contacts predicted all types of postfracture contacts, while gender was not. Patients discharged home visited their GPs five times more frequently than those discharged to institutional care.
  
  
  CONCLUSIONS
  After hip fractures, telephone contacts and GP visits to patients' homes increase, but patient visits to GP clinics decrease, influenced by age and residential status.
authors.affiliation: Ponteland Medical Group, Hadrian Primary Care Alliance, Newcastle upon Tyne, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Department of Trauma & Orthopaedics, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Sameer K
authors.identifier: http://orcid.org/0000-0003-4086-6047
authors.initials: SK
authors.lastname: Khan
authors.affiliation: Prudhoe Medical Group, Hadrian Primary Care Alliance, Newcastle upon Tyne, UK.
authors.forename: Norah
authors.initials: N
authors.lastname: Phipps
authors.affiliation: School of Biology, Ridley Building, University of Newcastle, Newcastle upon Tyne, UK.
authors.forename: Mark D F
authors.initials: MD
authors.lastname: Shirley
authors.affiliation: Department of Trauma & Orthopaedics, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Aldridge
authors.affiliation: Department of Trauma & Orthopaedics, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Paul V
authors.initials: PV
authors.lastname: Fearon
authors.affiliation: Department of Trauma & Orthopaedics, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Deehan
mesh_terms: D000359:Aftercare / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D058005:General Practitioners / Q000706:statistics & numerical data*; D006620:Hip Fractures; D006760:Hospitalization; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D010351:Patient Discharge; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013689:Telephone
keywords: GERIATRIC MEDICINE