Bone Abstracts

Background: It is inadequate to use the patient’s age and sex alone to estimate physicians’ workload in the primary setting. The extent to which the morbidity burden of osteoporosis patients would account of the utilization of primary care services has not been examined.

Aim: We analyzed the number of face-to-face visits of osteoporosis patients visiting Danish GP clinics and aimed to assess what proportion of primary care services variation are explained by patient morbidity and GP clinic characteristics.

Methods and data: We use patient morbidity characteristics such as diagnostic markers and multi-morbidity casemix adjustment based on adjusted clinical groups (ACGs) and face-to-face visits for a sample of primary care patients for the year 2010. Our sample included 2057 patients in 59 general practices. We applied a multi-level approach.

Results (preliminary): The average number of annual face-to-face visits for osteoporosis patients in general practice was about 7.12 visits per patient. Much of the variation in the utilization of primary care services was driven by multi-morbidity characteristics rather than age and gender. The number of face-to-face visits increased progressively with the degree of multi-morbidity. In addition, the number of face-to-face visits was higher for patients who suffered from diagnostic makers based on ICPC-2 (body systems and/or components such as infections and symptoms). Nevertheless, 16–19% of the variation in face-to-face visits was related to the clinic in which the osteoporosis patient was cared for.

Conclusion (preliminary): Patients’ illness burden and GP clinic characteristics are significant in determining the utilization of primary care service in osteoporosis care. Thus, it may be relevant to introduce differentiated remuneration of GPs according to morbidity status.