Increased attendance rate: BMI matters, lifestyles don't. Results from the Dutch SMILE study

Abstract

Introduction. A small group of frequent attenders is responsible for a disproportional large percentage of all daytime consultations in general practice. High attendance rates are related to demographic and psychological characteristics. Differences in attendance rates are only partly explained by chronic diseases. Furthermore, lifestyles might be relevant too. The aim of this study was to examine the effect of lifestyle on attendance rates.Method. This study is part of the Study of Medical Information and Lifestyles in Eindhoven, the Netherlands (SMILE). Generalized estimated equations were used to determine the relation between attendance rate and the different lifestyle factors (N = 4444). Results. A higher body mass index was related to increased attendance rate in both male [relative risk (RR) 1.02; 95% confidence interval (CI) 1.01-1.03] and female patients (RR 1.01; 95% CI 1.01-1.02). Lifestyles were not related to the attendance rate, except for a sedentary lifestyle in women (RR 1.08; 95% CI 1.04-1.12). Discussion. Since half of the Dutch population suffers from overweight or obesity and this number is still increasing, attendance rates will rise further. In order to relieve the GPs, nurse practitioners could play a more prominent role in lifestyle interventions concerning overweight and obesity and its related diseases.

Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort

“…Surprisingly, GP visits were weakly inversely associated with alcohol consumption, which contradicts results by van Steenkiste et al. [ 6 ] Inconsistencies may be explained by differences in the Danish and Dutch study populations, general drinking habits, and definition of alcohol consumption. The inverse association between drinking alcohol and visits to GP was marginally stronger in women than men in the present study.…”

“…Body mass index (BMI) has previously been linked to increased GP use, whereas other lifestyle factors such as diet, physical activity, smoking and alcohol consumption did not influence attendance rates in the Dutch population. [ 6 ] This contradicts results from another Dutch study examining risk behaviors and use of GP services related to gender,[ 7 ] where no association between BMI and GP use was found. Finally, Vos et al.…”

Clinically important body weight gain following total hip arthroplasty: a cohort study with 5-year follow-up

“…In the US, adult obesity rates (BMI ≥ 30) are 36% 45 while in the Netherlands, approximately 12% of Dutch adults are obese. 46 In addition, in the Netherlands walking and bicycling are preferred modes of transportation for adults in contrast to the US. 12 These data suggest that activity levels are generally higher in Dutch populations and this increased mobility may be contributing to the differential effects of THA on post-surgical weight gain for overweight and obese patients in the US and in the Netherlands.…”

Frequent attenders in primary health care: A concept analysis

“…In the literature, the typical term was "frequent attender" but they were also called several other similar terms. These included "high attender" (Carney et al, 2001;Little et al, 2001;van Steenkiste et al, 2010), "high utilizer" (Bergh et al, 2005;Savegeau et al, 2006;Jatic and Jatic, 2008;Dinkel et al, 2016), "high user" (Jatic and Jatic, 2008), "high consulter" (Bergh et al, 2005), "high consumer" (Bergh et al, 2005), "frequent user" (Gomes et al, 2013;Kaattari et al, 2015), "heavy user" Smits et al, 2013;Nyman and Jäppinen, 2015) or "constant attender" (Jatic and Jatic, 2008). Although these terms were cited less frequently in the studies than the term "frequent attender," they were found to share the same characteristics.…”

“…Term that describe frequent attenders Other search terms that describe primary health care "frequent attend*" AND "primary health care" (MH "Primary Health Care") or "general practise (MH "General Practise") or "family practise (MH "Family Practise" or "physicians, family" (MH "Physicians, family")  Lower perceived quality of life (Kersnik et al, 2001;van Steenkiste et al, 2010;Rifel et al, 2013;Kaattari et al, 2015;Patel et al, 2015) Frequent visits to a primary health care provider  ≥1 consultation a month during six months (Menchetti et al, 2006)  ≥3 consultations in 12 months (Buja et al, 2015)  ≥5 consultations in 12 months (Little et al, 2001;Andersson et al, 2004)  ≥7 consultations in 12 months (den Boer-Wolters et al, 2009;Diaz et al, 2014;Nyman and Jäppinen, 2015)  ≥8 consultations in 12 months (Jyväsjärvi et al, 2001;Kersnik et al, 2001;Koskela et al, 2010;Kaattari et al, 2015;Dinkel et al, 2016)  ≥10 consultations in 12 months (Neal et al, 2001)  ≥12 consultations in 12 months (Scaife et al, 2000;Carney et al, 2001;Al-Kandari et al, 2008;Robles et al, 2009;Gili et al, 2011)  ≥13 consultations in 12 months (Stewart and O'Dowd, 2002)  ≥24 consultations in 12 months (Hauswaldt et al, 2013)  ≥15 consultations in 30 months (Savageau et al, 2006)  ≥15 consultations in 36 months (Schilte et al, 2001;Glaser et al, 2006)  ≥30 consultations in 24 months (Patel et al, 2015)  The top 3 % of attenders in 12 months (Howe et al, 2002;Pickvance et al, 2004;Smits et al, 2008)  The top 3 % of attenders in 41 months (Neal et al, 2000a)  The top 10% of attenders in 6 months…”