Frequent attenders in primary health care: A concept analysis

Kivelä, Kirsi; Elo, Satu; Kääriäinen, Maria

doi:10.1016/j.ijnurstu.2018.06.003

Cited by 26 publications

(36 citation statements)

References 61 publications

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“…The cause of higher first visit costs in FAs remained unclear and requires multi-year studies to clarify it. Similar findings regarding the cost of prescriptions for FAs have also been reported in Poland and Finland [2,20].…”

Section: Discussionsupporting

confidence: 82%

Characteristics of Frequent Attenders Compared with Non-Frequent Attenders in Primary Care: Study of Remote Communities in Taiwan

et al. 2020

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Frequent attenders (FAs) have an impact on the medical resources and the quality of care. In Taiwan, the characteristics of FAs remain unclear in primary care. Outpatient data were screened from a central clinic within six surrounding fishing villages in northeastern Taiwan in 2017. FAs were defined as those who made >18 visits in one year, and those who made ≤18 visits were defined as non-frequent attenders (NFAs). Data of FAs and NFAs were collected and compared. The major diagnoses were reported using International Classifications of Diseases, Tenth Edition (ICD-10) codes. A total of 1586 subjects and 9077 visits were enrolled, including 119 FAs and 1467 NFAs. FAs had a more advanced age compared to NFAs. Both FAs and NFAs had more visits in summer. FAs had consumed high prescriptions and related costs. FAs also had higher therapeutic and first visit costs than NFAs. Comparing with age- sex-matched NFAs, FAs were positively associated with musculoskeletal diseases (M00-M99), hematological diseases (D50-D89), endocrine diseases (E00-E90), and mental disorders (F00-F99). Large-scale local datasets and suitable definitions of FAs for Taiwanese subjects are needed.

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Section: Discussionsupporting

confidence: 82%

Characteristics of Frequent Attenders Compared with Non-Frequent Attenders in Primary Care: Study of Remote Communities in Taiwan

et al. 2020

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“…This suggests that the push from the HIV clinics to encourage registration with, and disclosure of status to, GP services has been effective. Similar to the general population, 15 those with comorbidities and poor selfrated health status were more likely to report GP use, as were older adults and those of lower SES and financial insecurity. Nearly two-thirds of the sample reported satisfaction in the four GP PREMs.…”

Section: Discussionmentioning

confidence: 80%

Experience of primary care for people with HIV: a mixed-method analysis

et al. 2019

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BackgroundAdvances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs.AimTo explore the experience of people living with HIV (PLHIV) regarding consulting their GPs.Design & settingA mixed-method analysis using data from two sources: a nationally-representative survey of PLHIV and a qualitative study with London-based PLHIV.MethodUnivariate logistic regression was used for quantitative data and framework analysis for qualitative data.ResultsThe survey had 4422 participants; the qualitative study included 52 participants. In both studies, registration with a GP and HIV status disclosure were high. Similar to general population trends, recent GP use was associated with poor self-rated health status, comorbidities, older age, and lower socioeconomic status. Two-thirds reported a good experience with GPs; a lower proportion felt comfortable asking HIV-related questions. Actual or perceived HIV stigma were consistently associated with poor satisfaction. In the interviews, participants with additional LTCs valued sensitive and consistent support from GPs. Some anticipated, and sometimes experienced, problems relating to HIV status, as well as GPs’ limited experience and time to manage their complex needs. Sometimes they took their own initiative to facilitate coordination and communication. For PLHIV, a ‘good’ GP offered continuity and took time to know and accept them without judgment.ConclusionThe authors suggest clarification of roles and provision of relevant support to build the confidence of PLHIV in GPs and primary care staff to care for them. As the PLHIV population ages, there is a strong need to develop trusting patient–GP relationships and HIV-friendly GP practices.

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“…1 As the authors reported, there is indeed limited literature on how to best serve those meeting the criteria of FA in the community and within our health systems. 2 Compassion and caring for others with integrity and respect must be at the core of what we do as health care providers. There is no one more deserving of compassionate care than those most vulnerable, including patients with high health system utilization and the families and friends who care for them at home.…”

Section: Editorialmentioning

confidence: 99%

“…Speaking from a primary care perspective, all providers have a panel of patients and each includes a certain few who have high needs and meet the criteria of FA. 2,3 In managing these medically complex, socially at-risk patients, there is a point when one realizes that all their needs cannot be met effectively, as some of the needs expand beyond the capabilities of the clinic office environment. This experience can trigger emotions of hopelessness and frustration that, over time, can lead to provider apathy and burnout.…”

Section: Editorialmentioning

confidence: 99%