title: The role of patient activation in frequent attendance at primary care: a population-based study of people with chronic disease.
abstract: OBJECTIVE
  This study explores a range of relevant socio-demographic, physical and psychological factors in a unique examination of the risk factors for frequent attendance at primary care. The impact of patient activation for self-management on health service utilisation is of particular interest.
  
  
  METHODS
  A population-based sample of people with chronic disease from Queensland, Australia, was interviewed using computer assisted telephone surveying. Data were collected from a random sample of 1470 people with either diabetes or a cardiovascular condition.
  
  
  RESULTS
  As participants became more activated they were less likely to frequently attend their main health care provider for assistance with their chronic condition. For both conditions the association was graduated and for participants with a cardiovascular condition this association remained statistically significant even after controlling for other potentially influential factors such as disease severity, length of time since diagnosis, and psychological distress.
  
  
  CONCLUSIONS
  Characteristics of the individual, including patient activation and psychological functioning, as well as disease factors contribute to primary care consulting patterns among people with chronic illness.
  
  
  CONCLUSIONS
  Efforts to improve patient activation for self-management should remain a central element of chronic care.
authors.affiliation: School of Population Health, The University of Queensland, Herston, QLD 4006, Australia. m.donald@sph.uq.edu.au
authors.forename: Maria
authors.initials: M
authors.lastname: Donald
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.forename: Ieva Z
authors.initials: IZ
authors.lastname: Ozolins
authors.forename: Nelufa
authors.initials: N
authors.lastname: Begum
authors.forename: Ruth
authors.initials: R
authors.lastname: Crowther
authors.forename: Christopher
authors.initials: C
authors.lastname: Bain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000523:psychology; D002908:Chronic Disease; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000523:psychology; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007406:Interview, Psychological; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods*; D011594:Psychometrics; D011793:Queensland; D012307:Risk Factors; D012648:Self Care / Q000379:methods; D013689:Telephone; D055815:Young Adult