[Frequent attendance: primary care professional's perceptions of definitions, motives, situations and relationships with frequent attenders patients].
OBJECTIVE
To find out how health professionals in Primary Care (PC) perceive the definition criteria for frequent attendance, as well as their perceptions of the reasons for the visits of patients referred to as frequent attenders, their situations and their relationships with them.


METHODS
We performed a qualitative study using semi-structured interviews in Primary Care centers of six health areas of the Community of Madrid. Eighteen interviews were conducted, three per area (two physicians and one nurse). Structural sampling was carried out with regards to the variables that could influence the discourse: health area, occupation, sex and number of years worked. The transcriptions were analyzed by two investigators who gave a consensus interpretation.


RESULTS
The proportion of frequent attenders varies according to each professional and it is defined more by quality reasons than by number of visits. They make appointments associated with chronic diseases, but also for psychosocial or work problems. There are frequent attenders of all ages and both sexes, and the doctor-patient relationship depends on each individual case.


CONCLUSIONS
Frequent attendance is defined by the professionals by a number of qualitative criteria in which the number of visits is of little importance. The reasons for consultation and patient characteristics are numerous, so a unique profile cannot be determined. A common factor in the discourses is that many of the frequent attenders' reasons for consultation were psychosocial problems, so streamlining coordination with psychosocial resources would help to make PC consultations more efficient and effective.
Departamento de Ciencias Sanitarias y Médico Sociales, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España. maria.sandin@uah.es
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Sandín-Vázquez
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Conde-Espejo
D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006300:Health Services Misuse; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care