ANNUAL VISITS TO PATIENTS OVER THE AGE OF 75 - WHO IS MISSED

Background. In the UK, the GP contract requires annual consultations a nd offers of home visits to the elderly. However, as many as 50% of el derly people refuse the offer of a health screen. Objective. To descri be the characteristics of elderly people who declined the offer of an annual home visit. Method. All elderly people aged 75 years and over, registered with a general practice of 13 full time and 3 part time doc tors with a list size of 33,000 people, were offered a home visit. Dat a from this prospective cohort were linked with data from a community survey two years previously, which had achieved a 95% response rate. T he main outcome measures were perceived health status, perceived lonel iness, morale score, physical and mental disability, use of primary ca re and social services. Results. Thirty-six percent of all elderly peo ple registered with the practice declined to take up the offer of a ho me visit. Those refusing a visit had not recently joined the practice and had very similar distributions of all demographic and most health and wellbeing characteristics to those who took up the offer. However, those declining appeared to have higher levels of morale (P = 0.010) and less contact with the general practitioner (P 0.021) including an average of three weeks longer since last consultation with their gener al practitioner than those accepting the visit. Conclusions. There app ears little evidence in this population that elderly people who declin e a home visit are necessarily part of an 'iceberg' of unmet need.