Prevalence and characteristics of frequent attenders in a prepaid Canadian family practice.

Frequent attenders in family practice represent a small proportion of the total population, yet they consume a large amount of services. A description of their characteristics and problems is needed in order to design a therapeutic intervention tailored to meet these needs. A comparative analytic survey of 9,313 patients was done in order to isolate three cohorts: 200 zero users in the previous year, 200 modal (one to two times per year) users, and 200 frequent users (nine or more times per year). It was found that frequent attenders (who represented 4.5 percent of the practice, yet generated 21 percent of the annual visits) differ from infrequent attenders in that they have twice the probability of being single; are more physically, socially, emotionally distressed; suffer from problems of self-esteem; show a slightly greater degree of family dysfunction; tend to be unemployed, retired, or mothers of infants; are externally controlled or tend to rely on others for help; receive low incomes, retirement pensions, or family benefits; tend to be high users of other physician, social work, nursing, and laboratory services; consume a significantly greater number of pills than their infrequent user counterparts; and tend to present more emotional and gastrointestinal complaints than their modal user counterparts.