GP visits reduce risk of hospitalisation and death following heart attack
The important role GPs play in providing care for patients following heart attacks has been highlighted in a new report from the Australian Institute of Health and Welfare (AIHW).
The report also demonstrates the value of bringing together different sources of data to tell a more complete story.
The report, “Transition between hospital and community care for patients with coronary heart disease”, brings together de-identified data on public hospital admissions, GP and cardiologist visits, and deaths.
The study examined the health services used by more than 37,300 people with coronary heart disease (including heart attack or angina) who were discharged from a public hospital in New South Wales or Victoria between April 2012 and June 2013.
Eight in 10 (80%) patients hospitalised for coronary heart disease were aged over 55, and 3 in 10 (30%) were aged 65–74. More than two-thirds (68%) of all patients were men (25,400 compared with 12,000 women).
The study followed patients’ service use for 2 years after their discharge to establish the benefits of visiting a GP, a cardiologist, or one of a number of other community-based health care services, in terms of reducing a patient’s risk of being readmitted to hospital or dying.
The data show the likelihood of readmission to hospital is high, particularly in the first few months after discharge.
‘Overall, 1 in 4 patients had an emergency readmission relating to coronary heart disease within the 2 year period, with 40% of these people readmitted after their hospital stay within 90 days of being discharged from hospital,’ said AIHW spokesperson Dr Lynelle Moon.
However, the report also shows that regular contact with a GP after discharge has a positive impact.
‘The raw numbers show that among patients who did not follow up with their GP, nearly 5 in every 10 had an emergency readmission to hospital,’ Dr Moon said.
However, the likelihood of emergency readmission was more than halved if they followed up with a GP, with just 2 in 10 having an emergency readmission.
‘Our analysis allowed us to account for many other factors that may have influenced a person’s likelihood of having an emergency readmission to hospital, such as their age or the complexity of their condition, so we could single out the true impact of seeing a GP,’ Dr Moon said.
‘Even after accounting for all other factors, the data showed the risk of emergency readmission was significantly lower for people who visited a GP.’
The good news is that most patients did follow up with their GP—and generally, this was quite quickly after being discharged from hospital, with most patients continuing to do so regularly.
‘About 8 in 10 patients had a follow-up appointment with their GP within 30 days of being discharged, with 6 in 10 following up within the first week,’ Dr Moon said.
The study makes use of linked health data sets, allowing exploration of interactions between multiple health-care services. This has not previously been possible using single data collections.
13 January 2018.