Objective To describe, using data from the Newcastle 85+ cohort study, the use of primary care and other healthcare services by 85-year-olds as they age.
Design Longitudinal population-based cohort study.
Setting Newcastle on Tyne and North Tyneside, UK.
Participants Community dwelling and institutionalised men and women recruited through general practices (n=845, 319 men and 526 women).
Results Contact was established with 97% (n=1409/1459) of eligible 85-year-olds, consent obtained from 74% (n=1042/1409) and 851 agreed to undergo the multidimensional health assessment and a general practice medical records review. A total of 845 participants had complete data at baseline for this study (319 male, 526 female), with 344 (118 male, 226 female) reinterviewed at 60 months. After adjusting for confounders, all consultations significantly increased over the 5 years (incidence rate ratio, IRR=1.03, 95% CI 1.01 to 1.05, P=0.001) as did general practitioner (GP) consultations (IRR=1.03, 95% CI 1.01 to 1.05, P=0.006). Significant increases were also observed in inpatient and day hospital use over time, though these disappeared after adjustment for confounders.
Conclusions Our study of primary, secondary and community care use by the very old reveals that, between the ages of 85 and 90 years, older people are much more likely to consult their GP than any other primary healthcare team members. With a rapidly ageing society, it is essential that both current and future GPs are appropriately skilled, and adequately supported by specialist colleagues, as the main healthcare provider for a population with complex and challenging needs.
- primary care
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Statistics from Altmetric.com
Contributors LR conceived the study, obtained project funding and drafting of the paper. MEY, CJ and TF were responsible for data analysis and drafting of the paper. RD, BH and SP contributed to drafting of the paper. All authors approved the final manuscript.
Funding This work was supported by UK MRC and BBSRC (G0500997), Dunhill Medical Trust (R124/0509); Newcastle Healthcare Charity; NIHR Newcastle Biomedical Research Centre. This paper presents independent research funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR), project number SPCR 303. LR is funded by a National Institute for Health Research Professorship (NIHR-RP-011-043).
Disclaimer The views expressed are those of the author(s) and not necessarily those of the NIHR, the National Health Service or the Department of Health.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Newcastle and North Tyneside 1 Research Ethics Committee (reference number 06/Q0905/2)
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Newcastle 85+ study data may be obtained by agreement from the Data Guardians Group on submission of a data request form (available at: https://research.ncl.ac.uk/85plus/datarequests).
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.