BACKGROUND: The diversity of definitions of frequent attendance in the literature hampers comparison of their precision, validity, and associated factors. AIM: To examine different definitions of frequent attendance in order to identify the sociodemographic and clinical factors associated with frequent attendance in primary care, according to each definition. DESIGN OF STUDY: One-phase cross-sectional study. SETTING: Seventy-seven primary care centres in Catalonia, Spain. METHOD: A total of 3815 primary care patients were interviewed between October 2005 and March 2006. Three definitions of frequent attendance were tested: (1) frequent attenders as the top 25% and the top 10% consulting patients; (2) frequent attenders as the top 25% and the top 10% consulting patients stratified by age and sex; and (3) frequent attenders as the top 25% and the top 10% consulting patients stratified by the presence of physical/mental conditions (patients with only mental disorders, with only chronic physical conditions, with comorbid conditions, and with no condition). Multilevel logistic regressions were used. RESULTS: The following factors were systematically related to frequent attender status: being on sick leave, being born outside of Spain, reporting mental health problems as the main reason for consulting, and having arthritis/rheumatism, or bronchitis. Major depression was related to frequent attendance in two of the three definitions. The factor 'GP' was related to frequent attendance when the top decile cut-off point was used. The models with a 10% cut-off point were more discriminative than those with a 25% cut-off point: the area under the receiver operating characteristic curve for models with a 25% cut-off and a 10% cut-off ranged between 0.71 (95% confidence interval [CI] = 0.70 to 0.73) and 0.75 (95% CI = 0.74 to 0.77) and between 0.79 (95% CI = 0.78 to 0.81) and 0.85 (95% CI = 0.83 to 0.86), respectively. CONCLUSION: The way frequent attendance is defined is of crucial importance. It is recommended that a more discriminative definition of frequent attendance is used (the top 10%).
BACKGROUND: The diversity of definitions of frequent attendance in the literature hampers comparison of their precision, validity, and associated factors. AIM: To examine different definitions of frequent attendance in order to identify the sociodemographic and clinical factors associated with frequent attendance in primary care, according to each definition. DESIGN OF STUDY: One-phase cross-sectional study. SETTING: Seventy-seven primary care centres in Catalonia, Spain. METHOD: A total of 3815 primary care patients were interviewed between October 2005 and March 2006. Three definitions of frequent attendance were tested: (1) frequent attenders as the top 25% and the top 10% consulting patients; (2) frequent attenders as the top 25% and the top 10% consulting patients stratified by age and sex; and (3) frequent attenders as the top 25% and the top 10% consulting patients stratified by the presence of physical/mental conditions (patients with only mental disorders, with only chronic physical conditions, with comorbid conditions, and with no condition). Multilevel logistic regressions were used. RESULTS: The following factors were systematically related to frequent attender status: being on sick leave, being born outside of Spain, reporting mental health problems as the main reason for consulting, and having arthritis/rheumatism, or bronchitis. Major depression was related to frequent attendance in two of the three definitions. The factor 'GP' was related to frequent attendance when the top decile cut-off point was used. The models with a 10% cut-off point were more discriminative than those with a 25% cut-off point: the area under the receiver operating characteristic curve for models with a 25% cut-off and a 10% cut-off ranged between 0.71 (95% confidence interval [CI] = 0.70 to 0.73) and 0.75 (95% CI = 0.74 to 0.77) and between 0.79 (95% CI = 0.78 to 0.81) and 0.85 (95% CI = 0.83 to 0.86), respectively. CONCLUSION: The way frequent attendance is defined is of crucial importance. It is recommended that a more discriminative definition of frequent attendance is used (the top 10%).
Authors: Richard Morriss; Joe Kai; Christopher Atha; Anthony Avery; Sara Bayes; Matthew Franklin; Tracey George; Marilyn James; Samuel Malins; Ruth McDonald; Shireen Patel; Michelle Stubley; Min Yang Journal: BMC Fam Pract Date: 2012-07-06 Impact factor: 2.497
Authors: Will Whittaker; Matt Sutton; Margaret Maxwell; Rosalia Munoz-Arroyo; Sara Macdonald; Andrew Power; Michael Smith; Philip Wilson; Jill Morrison Journal: BMJ Date: 2010-08-17
Authors: Frans T Smits; Henk J Brouwer; Aeilko H Zwinderman; Jacob Mohrs; Hugo M Smeets; Judith E Bosmans; Aart H Schene; Henk C Van Weert; Gerben ter Riet Journal: BMC Fam Pract Date: 2013-09-17 Impact factor: 2.497
Authors: Hendrik van den Bussche; Hanna Kaduszkiewicz; Ingmar Schäfer; Daniela Koller; Heike Hansen; Martin Scherer; Gerhard Schön Journal: BMC Health Serv Res Date: 2016-04-14 Impact factor: 2.655