CONSULTATION RATES AND INCIDENCE OF INTERCURRENT MORBIDITY AMONG PATIENTS WITH CHRONIC DISEASE IN GENERAL-PRACTICE

Background Information on frequency of consultation and presented morb idity among patients with chronic disease is relevant to the managemen t of these patients in view of the increasing prevalence of chronic di seases. Aim. This study set out to examine consultation rates and inci dence of intercurrent morbidity in general practice in cohorts of pati ents with five common chronic diseases: hypertension, chronic ischaemi c heart disease, diabetes mellitus, chronic respiratory.disease and os teoarthritis. Method In seven practices with 15 general practitioners the records of all patients were screened for inclusion in the study. The data used for analysis were from 962 patients, whose diagnoses wer e made in agreement with diagnostic criteria, who were not under speci alist care, and who were followed up for 21 months. A distinction was made between patients with one, or two or more of the five chronic dis eases studied. For the single disease subgroups of patients with hyper tension or diabetes two reference groups of people without a chronic d isease, standardized for age and sex, were identified from the populat ion in the same practices. Results. Consultation rates were higher for patients with comorbidity than for patients with a single disease. In tercurrent diseases were presented more frequently to the general prac titioner by patients with comorbidity than by patients with a single d isease. Most intercurrent morbidity consisted of acute common diseases such as myalgia, upper respiratory tract infection and urinary tract infection. Patients with only hypertension or only diabetes had higher consultation rates than the corresponding reference group but did not have higher total incidence rates of intercurrent morbidity. Conclusi on. Patients with chronic disease consult their general practitioner f requently, and patients with more than one chronic disease consult eve n more frequently. The general practitioner has to deal with chronic d isease and intercurrent acute disease in a single patient.