Determinants of Frequent Attendance in Primary Care. A Systematic Review of Longitudinal Studies

Hajek, André; Kretzler, Benedikt; König, Hans‐Helmut

doi:10.3389/fmed.2021.595674

Cited by 12 publications

(25 citation statements)

References 58 publications

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“…Hence, in this current work we used a HCU tool originally developed by Stuhldreher et al [18] and refined by Hohls et al [19]. Additional details are provided by Hajek et al [20]. It was also used in previous research (e.g., [17,19]).…”

Section: Quality Assessmentmentioning

confidence: 99%

Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review

Hajek

Kretzler

König

2021

IJERPH

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Background: A systematic review synthesizing studies examining the determinants of dental service use drawing on the (extended) Andersen model is lacking. Hence, our purpose was to fill this knowledge gap; Methods: Three established electronic databases (PubMed, PsycInfo, as well as CINAHL) were searched. Observational studies focusing on the determinants of dental service use drawing on the Andersen model were included; Results: In sum, 41 studies have been included (ten studies investigating children/adolescents and 31 studies investigating adults). Among children, particularly higher age (predisposing characteristic), higher income (enabling resource) and more oral health problems (need factor) were associated with increased dental service use. Among adults, findings are, in general, less consistent. However, it should be noted that one half of the studies found an association between increased education (predisposing characteristic) and increased dental service. In general, study quality was rather high. However, it should be noted that most studies did not report how they dealt with missing data; Conclusions: Our systematic review revealed that all components (i.e., predisposing characteristics, enabling resources and need factors) of the Andersen model tend to be associated with dental service use among children, whereas the findings are more mixed among adults. In conclusion, beyond need factors, dental service use also tend to be driven by other factors. This may indicate over—or, more likely—underuse of dental services and could enrich the inequality discussion in dental services research.

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Section: Quality Assessmentmentioning

confidence: 99%

Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review

Hajek

Kretzler

König

2021

IJERPH

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“…This difference might have resulted from the different healthcare contexts of different countries. China reviewed its medical and health policies in 2009 to provide equal basic medical and health services to all citizens [ 1 ]. In 2011, the family doctor contract program was introduced nationwide to encourage residents to prioritize the services provided by community health service centers when visiting a doctor.…”

Section: Discussionmentioning

confidence: 99%

“…Frequent attendance at community health service centers has resulted in a huge burden on the healthcare system, thus attracting increasing scientific attention in recent years [ 1 ]. Approximately 10% of the attending population has been reported to account for 40% of the total number of visits to general practitioners [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for the frequent attendance of older patients at community health service centers in China: a cross-sectional study based on stratified sampling

Shou

2021

BMC Fam Pract

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Background This study aimed to investigate the characteristics of frequent attenders (FAs) among older patients in Shanghai, China, and explore the associated factors. Methods This cross-sectional study was conducted in six community health service centers in Shanghai, China, from August to December 2018 based on stratified sampling. On the basis of our preliminary study, FAs were defined as those attending at least four consultations in a month. A self-administered questionnaire was used to collect the clinicodemographic data of the participants. Social support, pain severity, depression, and anxiety were evaluated using the Social Support Revalued Scale, six-point Behavioral Rating Scale, Patient Health Questionnaire–9, and Generalized Anxiety Disorder Scale, respectively. Results This study included 619 patients aged > 60 years. Among these patients, 155 (25%) were FAs to a community health service center, 366 (59.1%) had 1 or 2 chronic diseases, 179 (28.9%) had ≥3 chronic diseases, 313 (50.4%) opted for a family doctor service, and 537 (86.8%) chose a community health service center for the first consultation. The following were identified as independent risk factors for frequent attendance: widowed status, unmarried status, the presence of > 3 chronic diseases, first consultation at a community health service center, high medical expenses, frequent attendance of the spouses, long-term medication, the use of both traditional Chinese and Western medicine services, and depression. Conclusions This study summarizes the characteristics of older FAs to community health service centers in China and identifies 10 risk factors significantly associated with frequent attendance.

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“…In this study, we used a tool developed by Stuhldreher et al [9] and refined by Hohls et al [10]. For further details, please see Table 2 in a study conducted by Hajek et al [11]. Having a place to go for health care was related to increased levels of ambulatory office visits (ß = 0.32, p < 0.001) and community support (ß = 0.10, p < 0.05).…”

Section: Quality Assessmentmentioning

confidence: 99%

Determinants of Healthcare Use Based on the Andersen Model: A Systematic Review of Longitudinal Studies

2021

Self Cite

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The aim was to give an overview of longitudinal observational studies investigating the determinants of healthcare use explicitly using the Andersen model. To this end, three electronic databases (Medline, PsycINFO and CINAHL) were searched (and an additional hand search was performed). Longitudinal observational studies examining the determinants of healthcare use (outpatient physician services and hospital stays) based on the Andersen model were included, whereas disease-specific samples were excluded. Study quality was evaluated. The selection of studies, extraction of data and assessment of the studies were conducted by two reviewers. The following determinants of healthcare use were displayed based on the (extended) Andersen model: predisposing characteristics, enabling resources, need factors and psychosocial factors. In sum, n = 10 longitudinal studies have been included in our systematic review. The included studies particularly showed a longitudinal association between increased needs and higher healthcare use. Study quality was rather high. However, several studies did not conduct robustness checks or clarify the handling of missing data. In conclusion, this systematic review adds to our current understanding of the factors associated with healthcare use (mainly based on cross-sectional studies). It showed mixed evidence with regard to the association between predisposing characteristics, enabling resources and healthcare use longitudinally. In contrast, increased need factors (in particular, self-rated health and chronic conditions) were almost consistently associated with increased healthcare use. This knowledge may assist in managing healthcare use. Since most of the studies were conducted in North America or Europe, future longitudinal studies from other regions are urgently required.

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Determinants of Frequent Attendance in Primary Care. A Systematic Review of Longitudinal Studies

Cited by 12 publications

References 58 publications

Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review

Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review

Risk factors for the frequent attendance of older patients at community health service centers in China: a cross-sectional study based on stratified sampling

Determinants of Healthcare Use Based on the Andersen Model: A Systematic Review of Longitudinal Studies

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