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Published in: BMC Primary Care 1/2006

Open Access 01-12-2006 | Research article

Characteristics and trends in required home care by GPs in Austria: diseases and functional status of patients

Authors: Gustav Kamenski, Waltraud Fink, Manfred Maier, Ingrid Pichler, Sonja Zehetmayer

Published in: BMC Primary Care | Issue 1/2006

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Abstract

Background

Almost all societies carry responsibility towards patients who require continuous medical care at home. In many health systems the general practitioner cooperates with community based services of home care and coordinates all medical and non medical activities. In Austria the general practitioner together and in cooperation with relatives of the patient and professional organisations usually takes on this task by visiting his patients.
This study was carried out to identify diseases that need home care and to describe the functional profile of home care patients in eastern Austria.

Methods

Cross sectional observational study with 17 GP practices participating during 2 study periods in 1997 and in 2004 in eastern Austria. Each GP identified patients requiring home care and assessed their underlying diseases and functional status by filling in a questionnaire personally after an encounter. Patients in nursing homes were excluded. Statistical tests used were t-tests, contingency tables, nonparametric Wilcoxon signed rank sum test and Fisher-combination test.

Results

Patients with degenerative diseases of the central nervous system (65%) caused by Alzheimer's disease and cerebrovascular occlusive disease and patients with degenerative diseases of the skeletal system (53%) were the largest groups among the 198 (1997) and 261 (2004) home care cases of the 11 (1997) and 13 (2004) practices. Malignant diseases in a terminal state constituted only 5% of the cases. More than two thirds of all cases were female with an average age of 80 years. Slightly more than 70% of the patients were at least partially mobile.

Conclusion

Home care and home visits for patients with degenerative diseases of the central nervous and skeletal system are important elements of GP's work. Further research should therefore focus on effective methods of training and rehabilitation to better the mental and physical status of patients living in their private homes.
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Literature
1.
go back to reference Report on the Aged 4th report on the situation of the older generation in the Federal Republic of Germany: Risks, quality of life and care of people advanced in years under special consideration of demential disorders. 2002, DZA 12101 Berlin Report on the Aged 4th report on the situation of the older generation in the Federal Republic of Germany: Risks, quality of life and care of people advanced in years under special consideration of demential disorders. 2002, DZA 12101 Berlin
2.
go back to reference Avery AJ, Groom LM, Brown KP, Thornhill K, Boot D: The impact of nursing home patients on prescribing costs in general practice. J Clin Pharm Ther. 1999, 24: 357-363. 10.1046/j.1365-2710.1999.00235.x.CrossRefPubMed Avery AJ, Groom LM, Brown KP, Thornhill K, Boot D: The impact of nursing home patients on prescribing costs in general practice. J Clin Pharm Ther. 1999, 24: 357-363. 10.1046/j.1365-2710.1999.00235.x.CrossRefPubMed
3.
go back to reference Schick B, Dohner H: Interdisciplinary cooperation in the primary care of elderly patients-results with consequences for general practice. Gesundheitswesen. 1996, 58: 126-131.PubMed Schick B, Dohner H: Interdisciplinary cooperation in the primary care of elderly patients-results with consequences for general practice. Gesundheitswesen. 1996, 58: 126-131.PubMed
4.
go back to reference Westert GP, Satariano WA, Schellevis FG, van den Bos GA: Patterns of comorbidity and the use of health services in the Dutch population. Eur J Public Health. 2001, 11: 365-372. 10.1093/eurpub/11.4.365.CrossRefPubMed Westert GP, Satariano WA, Schellevis FG, van den Bos GA: Patterns of comorbidity and the use of health services in the Dutch population. Eur J Public Health. 2001, 11: 365-372. 10.1093/eurpub/11.4.365.CrossRefPubMed
5.
go back to reference Bergeron R, Laberge A, Vezina L, Aubin M: Which physicians make home visits and why? A survey. CMAJ. 1999, 161: 369-373.PubMedPubMedCentral Bergeron R, Laberge A, Vezina L, Aubin M: Which physicians make home visits and why? A survey. CMAJ. 1999, 161: 369-373.PubMedPubMedCentral
6.
go back to reference Keenan JM, Bland CJ, Webster L, Myers S: The home care practice and attitudes of Minnesota family physicians. J Am Geriatr Soc. 1991, 39: 1100-1104.CrossRefPubMed Keenan JM, Bland CJ, Webster L, Myers S: The home care practice and attitudes of Minnesota family physicians. J Am Geriatr Soc. 1991, 39: 1100-1104.CrossRefPubMed
7.
go back to reference Madigan E, Neff DF: Care of patients with long-term indwelling urinary catheters. Online J Issues Nurs. 2003, 8: 7-PubMed Madigan E, Neff DF: Care of patients with long-term indwelling urinary catheters. Online J Issues Nurs. 2003, 8: 7-PubMed
8.
go back to reference Modin S, Furhoff AK: Care by general practitioners and district nurses of patients receiving home nursing: a study from suburban Stockholm. Scand J Prim Health Care. 2002, 20: 208-212. 10.1080/028134302321004854.CrossRefPubMed Modin S, Furhoff AK: Care by general practitioners and district nurses of patients receiving home nursing: a study from suburban Stockholm. Scand J Prim Health Care. 2002, 20: 208-212. 10.1080/028134302321004854.CrossRefPubMed
9.
go back to reference Scott A, Wordsworth S: The effects of shifts in the balance of care on general practice workload. Fam Pract. 1999, 16: 12-17. 10.1093/fampra/16.1.12.CrossRefPubMed Scott A, Wordsworth S: The effects of shifts in the balance of care on general practice workload. Fam Pract. 1999, 16: 12-17. 10.1093/fampra/16.1.12.CrossRefPubMed
10.
go back to reference Hofmarcher Maria , Rack Herta : Health Care Systems in Transition: Austria. The European Observatory on Health Care systems. 2001 Hofmarcher Maria , Rack Herta : Health Care Systems in Transition: Austria. The European Observatory on Health Care systems. 2001
11.
go back to reference Bauer P, Koehne K: Evaluation of experiments with adaptive interim analysis. Biometrics. 1994, 50: 1029-1041. 10.2307/2533441.CrossRefPubMed Bauer P, Koehne K: Evaluation of experiments with adaptive interim analysis. Biometrics. 1994, 50: 1029-1041. 10.2307/2533441.CrossRefPubMed
12.
13.
go back to reference Statistics Austria general and Population Preliminary death tables. Vienna; 2002. Publication series of Ministry of Social Security. 2006 Statistics Austria general and Population Preliminary death tables. Vienna; 2002. Publication series of Ministry of Social Security. 2006
14.
go back to reference Vass M, Avlund K, Kvist K, Hendriksen C, Andersen CK, Keiding N: Structured home visits to older people. are they only of benefit for women? A randomised controlled trial. Scand J Prim Health Care. 2004, 22: 106-11. 10.1080/02813430410005829.CrossRefPubMed Vass M, Avlund K, Kvist K, Hendriksen C, Andersen CK, Keiding N: Structured home visits to older people. are they only of benefit for women? A randomised controlled trial. Scand J Prim Health Care. 2004, 22: 106-11. 10.1080/02813430410005829.CrossRefPubMed
15.
go back to reference Brodaty H, Green A: Who cares for the carer? The often forgotten patient. Aust Fam Physician. 2002, 31: 833-836.PubMed Brodaty H, Green A: Who cares for the carer? The often forgotten patient. Aust Fam Physician. 2002, 31: 833-836.PubMed
16.
go back to reference Huston PG: Family care of the elderly and caregiver stress. Am Fam Physician. 1990, 42: 671-676.PubMed Huston PG: Family care of the elderly and caregiver stress. Am Fam Physician. 1990, 42: 671-676.PubMed
17.
go back to reference Kramer BJ: Husbands caring for wives with dementia: a longitudinal study of continuity and change. Health Soc Work. 2000, 25: 97-107.CrossRefPubMed Kramer BJ: Husbands caring for wives with dementia: a longitudinal study of continuity and change. Health Soc Work. 2000, 25: 97-107.CrossRefPubMed
18.
go back to reference Ward S, Opie J, O'Connor DW: Family carer's responses to behavioural and psychological symptoms of dementia. Int J Geriatr Psychiatry. 2003, 18: 1007-1012. 10.1002/gps.1005.CrossRefPubMed Ward S, Opie J, O'Connor DW: Family carer's responses to behavioural and psychological symptoms of dementia. Int J Geriatr Psychiatry. 2003, 18: 1007-1012. 10.1002/gps.1005.CrossRefPubMed
19.
go back to reference Thomas E, Wilkie R, Peat G, Hill S, Dziedzic K, Croft P: The North Straffordshire Osteoarthritis Project – 1 NORSTOP: prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults. BMC Musculoskelet Disord. 2004, 5: 2-10.1186/1471-2474-5-2.CrossRefPubMedPubMedCentral Thomas E, Wilkie R, Peat G, Hill S, Dziedzic K, Croft P: The North Straffordshire Osteoarthritis Project – 1 NORSTOP: prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults. BMC Musculoskelet Disord. 2004, 5: 2-10.1186/1471-2474-5-2.CrossRefPubMedPubMedCentral
20.
21.
go back to reference Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD: Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in US adults: The third National Health and Nutrition Examination Survey 1988–1999. Diabetes Care. 1998, 21: 518-524.CrossRefPubMed Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD: Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in US adults: The third National Health and Nutrition Examination Survey 1988–1999. Diabetes Care. 1998, 21: 518-524.CrossRefPubMed
22.
go back to reference World Health Organisation (WHO): Nutrition, diet and the prevention of chronic diseases. Report of a joint WHO/FAO expert consultation. Technical report series 916. Geneva. 2003 World Health Organisation (WHO): Nutrition, diet and the prevention of chronic diseases. Report of a joint WHO/FAO expert consultation. Technical report series 916. Geneva. 2003
23.
go back to reference Walsh D, Regan J: Terminal care in the home- the general practice perspective. Ir med J. 2001, 94: 9-11.CrossRefPubMed Walsh D, Regan J: Terminal care in the home- the general practice perspective. Ir med J. 2001, 94: 9-11.CrossRefPubMed
24.
go back to reference Beaver K, Luker KA, Woods S: Primary care services received during terminal illness. Int J Palliat Nurs. 2000, 6: 220-227.CrossRefPubMed Beaver K, Luker KA, Woods S: Primary care services received during terminal illness. Int J Palliat Nurs. 2000, 6: 220-227.CrossRefPubMed
25.
go back to reference Kevin Yuen, Margaret Behrndt, Jacklyn C, Mitchell GK: Palliative care at home: general practitioners working with palliative care teams. MJA. 2003, 38-40. Suppl 6 Kevin Yuen, Margaret Behrndt, Jacklyn C, Mitchell GK: Palliative care at home: general practitioners working with palliative care teams. MJA. 2003, 38-40. Suppl 6
26.
go back to reference Zepetella G: How do terminal ill patients at home take their medication?. Palliat Med. 1999, 13: 469-75. 10.1191/026921699675653923.CrossRef Zepetella G: How do terminal ill patients at home take their medication?. Palliat Med. 1999, 13: 469-75. 10.1191/026921699675653923.CrossRef
27.
go back to reference Saletti A, Johansson L, Yifter-Lindgren E, Wissing U, Osterberg K, Cederholm T: Nutritional status and a 3-year follow-up in elderly receiving support at home. Gerontology. 2005, 51 (3): 192-8. 10.1159/000083993.CrossRefPubMed Saletti A, Johansson L, Yifter-Lindgren E, Wissing U, Osterberg K, Cederholm T: Nutritional status and a 3-year follow-up in elderly receiving support at home. Gerontology. 2005, 51 (3): 192-8. 10.1159/000083993.CrossRefPubMed
28.
go back to reference Guigoz Y, Lauque S, Vellas BJ: Identifying the elderly at risk for malnutrition: The Mini Nutritional assessment. Clin Geriatr Med. 2002, 18 (4): 737-57. 10.1016/S0749-0690(02)00059-9.CrossRefPubMed Guigoz Y, Lauque S, Vellas BJ: Identifying the elderly at risk for malnutrition: The Mini Nutritional assessment. Clin Geriatr Med. 2002, 18 (4): 737-57. 10.1016/S0749-0690(02)00059-9.CrossRefPubMed
Metadata
Title
Characteristics and trends in required home care by GPs in Austria: diseases and functional status of patients
Authors
Gustav Kamenski
Waltraud Fink
Manfred Maier
Ingrid Pichler
Sonja Zehetmayer
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2006
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-7-55

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