Table 2.
Association between GP contacts, continuity of care score, identification of palliative care needs, and multiple hospital admissions
| Multiple hospital admissions in the last 90 days | |||||||||
|---|---|---|---|---|---|---|---|---|---|
|
| |||||||||
| No (n = 31 820) | Yes (n = 1894) | IRRa | 95% CI | P-value | |||||
|
| |||||||||
| Events, n | Days in community, n | IR × 30 days | Events, n | Days in community, n | IR × 30 days | ||||
| GP contact rate (12–4 months before death) | 313 501 | 8 395 512 | 1.12 | 21 259 | 488 090 | 1.31 | 1.08 | (1.05 to 1.11) | <0.001 |
|
| |||||||||
| Mean | SD | IMD | Mean | SD | |||||
|
| |||||||||
| Continuity of care score (12–4 months before death) | 0.41 | 0.30 | 0.38 | 0.28 | 0.79 | (0.68 to 0.92) | 0.003 | ||
|
| |||||||||
| Freq | % | Freq | % | ||||||
|
| |||||||||
| Palliative care QoF any time before last 90 days | |||||||||
| No | 28 782 | 90.5 | 1763 | 93.1 | |||||
| Yes | 3038 | 9.5 | 131 | 6.9 | 0.66 | (0.56 to 0.78) | 0.001 | ||
a
Multilevel Poisson model with a random intercept for region and GP practice, adjusted by age, number of QoF comorbidities, sex, IMD, rurality, living in a care home, cause of death, and year of death. The model includes only participants with at least two contacts with the GP during the exposure period. The full model is available in Supplementary Table S7. CI = confidence interval. IR = incidence rate. IRR = incidence risk ratio. IMD = Index of Multiple Deprivation. QoF = Quality and Outcomes Framework. SD = standard deviation.