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.Study design: 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. © The Author 2012. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.