The 30-day prognosis of chronic-disease patients after contact with the out-of-hours service in
primary healthcare
Sammanfattning
Objective. Little is known about the prognosis of patients with chronic disease who contact the
out-of-hours (OOH) service in primary care. The characteristics of contacts with the Danish out-of-
hours service and daytime general practice, hospitalization, and death were studied during a 30-day
follow-up period in patients with chronic heart diseases. Design. Cohort study. Setting and subjects.
The study was based on data from 11 897 adults aged 18 + years from a Danish survey of OOH
contacts, including information on consultation type. Reason for encounter (RFE) was categorized by
OOH GPs at triage as either "exacerbation" or "new health problem". Registry data were used to
identify eligible patients, and the cohort was followed for 30 days after OOH contact through
nationwide registries on healthcare use and mortality. Main outcome measures. The 30-day
prognosis of chronic-disease patients after OOH contact. Results. Included patients with chronic
disease had a higher risk of new OOH contact, daytime GP contact, and hospitalization than other
patients during the 30-day follow-up period. OOH use was particularly high among patients with
severe mental illness. A strong association was seen between chronic disease and risk of dying
during follow-up. Conclusion. Patients with chronic disease used both daytime general practice and
the out-of-hours service more often than others during the 30-day follow-up period; they were more
often hospitalized and had higher risk of dying. The findings call for a proactive approach to future
preventive day care and closer follow-up of this group, especially patients with psychiatric disease.