[Patients who initiate frequent attendance in family practice].
The aim of this study was to estimate the loads of general practice by very frequent attenders to general practitioner consultations. The area of study covers one town in West Pomeranian province, where per capita financing of the primary health care includes also the basic medical diagnostics but excludes specialistic medical consultations. The cohort of patients included all patients (1700 persons) who declared an affiliation with Family Practice (NZOZ) before 1st March 1999. During observation period (from 1st March 1999 to 31st March 2002) 24,338 questionnaires about medical consultations were gathered. For the cohort, based on 3-year observation, we define average indicator of general practitioner consultations per year (x = 4.64, sd = 4.36). We define persons who fall beyond the average value from cohort increased in 2 standard deviation interval as the very frequent attenders (VFAs) of general practitioner service. The VFAs constituted 4.4% of the cohort; men = 2.5%, women 5.9% of the entire group respectively. These percentages represent 19 men and 56 women for VFAs. This group was significantly elder. VFAs represent about 16% of the entire population of medical consultations and 30% of all diagnostic services. They were also the reason for 17% of the volume of hospitalizations, over 17% specialist consultations and over 18% of the entire rehabilitation services.


CONCLUSIONS
This study confirmed the usefulness of the proposed criterion for separating the group of VFAs. The VFAs ought to be covered by very careful diagnostics services and particularly considerate general practitioner's care. The statistical results of this study suggest that the frequent attendance by the VFAs might be caused by real health and psychosocial problems.
Pracowni Organizacji i Ekonomiki Ochrony Zdrowia Zakładu Higieny i Epidemiologii Pomorskiej Akademii Medycznej w Szczecinie. pracorg@sci.pam.szczecin.pl
Jarosław W
JW
Szydłowski
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011044:Poland; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires