Are frequent callers to family physicians high utilizers?
OBJECTIVE
Our objective was to describe patients who telephone frequently after hours to physicians (frequent callers) and categorize their medical problems and resource utilization.


METHODS
Charts of frequent callers were reviewed and compared with those of a systematically selected group from the same family medicine residency practice (control group). Data collected included demographic and clinical information, as well as information on utilization of office, emergency department, and hospital services. In addition, 4 family physicians reviewed the patient information and identified the primary diagnosis for frequent callers.


RESULTS
Frequent callers were predominately female; had 3 times as many office visits, diagnoses, and medications; and had 8 times as many hospital admissions as the control group. The most common primary diagnostic categories were psychiatric disorders (36%), pain (21%), chronic illnesses (16%), pregnancy (13%), and common problems of childhood (9%).


CONCLUSIONS
Frequent callers represent a unique group of patients with high utilization of health care services. Better targeted patient education and referral to other support services may decrease the number of calls and utilization of health services. Alternatively, among high utilizers, frequent telephone calls may be a substitute for other forms of care.
Hildebrandt
David E
DE
Department of Family Medicine, University of Colorado Health Sciences Center at Fitzsimons, Aurora, CO, USA.
Westfall
John M
JM
Nicholas
Richard A
RA
Smith
Peter C
PC
Stern
Jacqueline
J
D000553:Ambulatory Care; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010045:Outpatients; D010821:Physicians, Family; D013689:Telephone