How Do German General Practitioners Assess Medical Specialist Care Needs of Nursing Home Residents? Results of a Postal Survey in North-Western Germany.

Ove Spreckelsen,Falk Hoffmann,Guido Schmiemann,Michael Hermann Freitag,Alexander Maximilian Fassmer,Bettina Engel

doi:10.3390/ijerph17197126

Abstract

The frequency of contacts of nursing home residents with medical specialists is lower compared to the general population of the same age group in Germany. The aim of this study was to assess general practitioners’ (GPs) views on specialist care needs of nursing home residents, on questions of qualification and care coordination. A cross-sectional study was conducted with a postal questionnaire among a representative sample of 1121 GPs in north-western Germany in 2018. The perceptions of GPs about the relative importance of the type of specialist care that is required in nursing homes was assessed on a five-point Likert scale (0 = very low to 4 = very high). A total of 375 GPs (response 33.5%; mean age 54.4 years; 57.6% male) participated in the survey. GPs assessed care needs as highest for neurologists and psychiatrists (68.7%) and lowest for gynecologists (6.5%). Almost all respondents (96.2%) strongly agreed that medical care for nursing home residents should be coordinated by GPs and that GPs should initiate the referral for further specialist care when required (87.5%). A minority (25.7%) agreed that quality of medical care would improve when care for a nursing home was provided by only one GP practice. GPs perceive the needs of nursing home residents for specialist care as high only in relation to care by neurologists and psychiatrists. GPs consider their own coordination function for medical care in nursing homes as very important.

Highlights

The provision of health care for people living in long-term care facilities is a challenge for health systems
While a poor health status corresponds with high demands of medical care, in health research and policy it is subject to discussion as to whether this demand is adequately met by ambulatory
The main finding of this study is that neurologists and psychiatrists are the only medical specialists for which German general practitioners’ (GPs) perceive the care needs of nursing home residents as high

Summary

Introduction

The provision of health care for people living in long-term care facilities is a challenge for health systems. In Germany, there are currently about 818,000 residents living in 11,200 nursing homes [1]. The average health status of nursing home residents is worse than the non-institutionalized counterparts of the same age with a high proportion of cognitive deficits, mobility constraints, and an overall high disease burden [2,3,4,5,6]. While a poor health status corresponds with high demands of medical care, in health research and policy it is subject to discussion as to whether this demand is adequately met by ambulatory. Res. Public Health 2020, 17, 7126; doi:10.3390/ijerph17197126 www.mdpi.com/journal/ijerph

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