Dutch ICU survivors have more consultations with general practitioners before and after ICU admission compared to a matched control group from the general population

PLoS One. 2019 May 23;14(5):e0217225. doi: 10.1371/journal.pone.0217225. eCollection 2019.


Background: General Practitioners (GPs) play a key role in the healthcare trajectory of patients. If the patient experiences problems that are typically non-life-threatening, such as the symptoms of post-intensive-care syndrome, the GP will be the first healthcare professional they consult. The primary aim of this study is to gain insight in the frequency of GP consultations during the year before hospital admission and the year after discharge for ICU survivors and a matched control group from the general population. The secondary aim of this study is to gain insight into differences between subgroups of the ICU population with respect to the frequency of GP consultations.

Methods: We conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry for ICUs. Clinical data of patients admitted to an ICU in 2013 were enriched with claims data from the years 2012, 2013 and 2014. Poisson regression was used to assess the differences in frequency of GP consultations between the ICU population and the control group.

Results: ICU patients have more consultations with GPs during the year before and after admission than individuals in the control group. In the last four weeks before admission, ICU patients have 3.58 (CI 3.37; 3.80) times more GP consultations than the control group, and during the first four weeks after discharge they have 4.98 (CI 4.74; 5.23) times more GP consultations. In the year after hospital discharge ICU survivors have an increased GP consultation rate compared to the year before their hospital admission.

Conclusions: Close to hospital admission and shortly after hospital discharge, the frequency of GP consultations substantially increases in the population of ICU survivors. Even a year after hospital discharge, ICU survivors have increased GP consultation rates. Therefore, GPs should be well informed about the problems ICU patients suffer after discharge, in order to provide suitable follow-up care.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • General Practitioners / statistics & numerical data*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Netherlands
  • Patient Discharge
  • Physician-Patient Relations
  • Quality of Life*
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Survivors / statistics & numerical data*
  • Young Adult

Grants and funding

The National Intensive Care Evaluation (NICE) foundation pays the department of Medical Informatics for processing, checking and maintaining the Dutch quality registry. Drs. van Beusekom, Dr. Bakhshi-Raiez, Professor de Keizer and Dr. Termorshuizen are employees of the department of medical informatics and work for the NICE registry. Professor de Keizer and Dr. Dongelmans are members of the NICE board. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.