title: [Factors associated with frequent attendance in a Bedouin primary care setting].
abstract: BACKGROUND
  Frequent attendance affects delivery and cost of effective health services, quality of care, and burden on primary care physicians. The aim of this study was to investigate factors associated with frequent attendance, as well as types of health care utilization, in a Bedouin primary care setting.
  
  
  METHODS
  A case-control study was conducted on adult frequent attenders (FAs) and controls in a primary care clinic serving a Bedouin population in southern Israel. Social, demographic and clinical data were manually extracted by reviewing the clinic's computerized medical records. The associations between these factors and frequent attendance were analyzed.
  
  
  RESULTS
  The study included 118 cases and 121 controls (59% female, mean age: 39.6 +/- 14.9 years). FAs were more likely to use consultation referrals, prescriptions, investigative studies, laboratory tests, and emergency department referrals than controls and were prescribed more sick-leave days than controls. Controlling for age and gender, FAs were significantly more likely to have a chronic disease (OR = 4.46, 95% CI: 1.86-10.71), use chronic medications (OR = 3.31, 95% CI: 1.57-6.99), have a musculoskeletal disease (OR = 2.08, 95% CI: 1.02-7.49) and be of African Bedouin ethnicity (OR = 2.77, 95% CI: 1.02-7.49).
  
  
  CONCLUSIONS
  FAs in a Bedouin community pose a special challenge for the primary care clinic, as they are more likely to be chronically ill, and utilize referrals to various services and consultations more frequently than controls.
authors.affiliation: Medical School for International Health, Ben-Gurion University, Beer Sheba, Israel.
authors.forename: Justin
authors.initials: J
authors.lastname: Groode
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Vardy
authors.forename: Jacob
authors.initials: J
authors.lastname: Dreiher
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D018912:Arabs / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002908:Chronic Disease / Q000453:epidemiology; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*