Recently enlisted patients in general practice use more health care resources.
BACKGROUND
The continuity of care is one of the cornerstones of general practice. General practitioners find personal relationships with their patients important as they enable them to provide a higher quality of care. A long-lasting relationship with patients is assumed to be a prior condition for attaining this high quality. We studied the differences in use of care between recently enlisted patients and those patients who have been enlisted for a longer period.


METHODS
104 general practices in the Netherlands participated the study. We performed a retrospective cohort study in which patients who have been enlisted for less than 1 year (n = 10,102) were matched for age, sex and health insurance with patients who have been enlisted for longer in the same general practice. The two cohorts were compared with regard to the number of contacts with the general practice, diagnoses, rate of prescribing, and the referral rate in a year. These variables were chosen as indicators of differences in the use of care.


RESULTS
In the year following their enlistment, a higher percentage of recently enlisted patients had at least one contact with the practice, received a prescription or was referred. They also had a higher probability of receiving a prescription for an antibiotic. Furthermore, they had a higher mean number of contacts and referrals, but not a higher mean number of prescriptions.


CONCLUSIONS
Recently enlisted patients used more health care resources in the first year after their enlistment compared to patients enlisted longer. This could not be explained by differences in health.
NIVEL (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, The Netherlands. l.jabaaij@nivel.nl
Lea
L
Jabaaij
Dinny H
DH
de Bakker
Henk J
HJ
Schers
Patrick Je
PJ
Bindels
Janny H
JH
Dekker
François G
FG
Schellevis
D000328:Adult; D003266:Continuity of Patient Care; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors