The role of periodic mortality case review sessions in a primary care teaching clinic.
BACKGROUND There is little information on general practitioner (GP) involvement in terminal care. Aim This study explores general practice experience of the care of dying patients. METHODS One hundred and forty-two GPs offered to participate in a study of consecutive deaths during three months, to a maximum of five cases per practice. Data were collected on patient characteristics, cause and place of death, terminal care and GP notification of deaths. RESULTS One hundred and three GPs (73%) completed data collection. Participating GPs were younger and more likely to be in group practice. There were 297 deaths reported: 34% of practices had five deaths or more but 20% had no death. Seventy-five per cent of patients had one GP consultation in the final three months, 60% had at least one hospital admission and 38.8% of deaths occurred at home. Mean home visit, surgery consultation and phone consultation rates were 5.4, 1.8 and 3.6 respectively. In 88% of cases, the GP was informed of the death within one week. CONCLUSIONS GPs are notified rapidly of deaths in all groups and causes. In the majority, the GP has had recent clinical contact and has often been heavily involved in care. Most deaths and care occur outside the cancer-related sphere.