Frequent Attenders with Chronic Respiratory Diseases in Primary Care Settings

Abstract

Governments struggle to fund health services and there is a growing interest in the cost, clinical characteristics, and interventions for high utilizers of care, such as persistent frequent attenders to primary care. The purpose of this study was to determine the components shaping the phenomenon of frequent attendance in patients with chronic respiratory diseases in primary care settings. We examined 200 adult patients with chronic diseases (median age 65, range 18-90) recruited from 126 general practitioners. We conclude that, in patients with chronic respiratory diseases, frequent attendance can be expected among those with a low level of satisfaction with their quality of health, a low level of QoL in the physical domain as much as QoL in the social relationships domain, making multiple visits to a doctor (more than 4 visits), taking more than five drugs, being treated for more than three chronic diseases, waiting at the doctor's office for no more than 30 min, receiving a greater number of primary care services, and requiring the assistance of a district nurse. Such patients may need social support interventions and monitoring of their clinical status.

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

“…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].…”

“…In Western countries that have public doctors and referral systems, this phenomenon has been widely discussed due to its impact on the distribution of medical resources and quality of care. Previous studies in Europe and the United Kingdom have reported certain risk factors and characteristics for FAs, including female predominance, psychological/somatoform disorders, chronic obstructive pulmonary diseases, diabetes mellitus, and cancer [1][2][3][4].…”