TOPLINE:

Consultation frequencies for older adults in Denmark showed notable variation, with the proportion of practices showing systematic variation increasing from nearly 4% in 2017-2020 to 9% in 2021.

METHODOLOGY:

• Researchers conducted a nationwide register-based cohort study in Denmark from 2017 to 2021, focusing on residents aged 75 years or older to assess variation in consultation frequencies.
• GPs in Denmark reported services electronically for remuneration, covering various consultation types such as face-to-face visits, telephone consultations, email, and home visits.
• Annual chronic care reviews and preventive home visits were performed for older patients with frailty who had multiple chronic diseases.
• Associations between practice-level factors and systematic variation in consultation frequency were assessed. Observed vs expected consultation frequencies were evaluated, with the expected frequencies analysed on the basis of zero-inflated Poisson regression.
• A total of 569,457 older adults (mean age, 80.3 years; 43.8% men) listed with 1596 general practices were included in 2021.

TAKEAWAY:

• In 2021, the average consultation frequency for older adults was 10 per person, comprising 3.7 face-to-face consultations, 3.3 telephone consultations, 2.2 email consultations, 0.61 home visits, and 0.38 chronic care reviews.
• From 2017 to 2021, a decline in total consultations per person per year was observed, mainly in face-to-face and telephone consultations, whereas the average annual number of home visits increased.
• In 2021, 9% of practices showed systematic variation in consultation frequency after adjusting for patient factors, with most providing more consultations than expected. The proportion of practices showing systematic variation was higher in 2021 than in 2017-2020 (3.6%-4.0%).
• No significant association was found between practice-level factors and the number of consultations provided.

IN PRACTICE:

"Few general practices showed lower-than-expected consultation frequencies, suggesting that a baseline access to primary healthcare, likely driven by the gatekeeper role of general practice and minimum care requirements. The asymmetry indicates that practice-level variation primarily exists as increased rather than decreased consultation provision," the authors wrote. "General practices with significantly higher consultation frequencies than expected based on their patient population should evaluate whether their care approach optimally balances patient needs with resources," they added.

SOURCE:

This study was led by Jonas Korsholm Olsen, Department of Public Health, University of Southern Denmark, Odense, Denmark. It was published online on February 03, 2026, in BJGP Open.

LIMITATIONS:

The study did not employ mixed-effects modelling to examine patient- vs practice-level variance. Regional variations in workforce availability may have existed, and an ongoing shortage of GPs may have affected consultation patterns.

DISCLOSURES:

This study was supported by grants from Helsefonden, University of Southern Denmark, Fonden for Almen Praksis, and the Danish Regions. The authors reported having no relevant competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.