title: [Frequent attendance: the primary care professional's perceptions on the influence of social factors and health care system organisation].
abstract: FREQUENT ATTENDANCE: The primary care professional's perceptions on the influence of social factors and health care system organisation.
  
  
  OBJECTIVE
  To find out the primary care (PC) professional's perceptions on the social factors and healthcare system organisation that influence frequent attendance.
  
  
  METHODS
  A qualitative study using semi-structured interviews in Primary Care Centres of six Health Areas in 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 analysed by two investigators and an agreement of interpretation was reached.
  
  
  RESULTS
  Among the social factors, health professionals perceived as determining factors: the influence of the media and the medicalization of society, lack of health education and self-care abilities of the population and contextual factors of the patient (social, work and family). Among the health care organisation factors that could influence frequent attendance were, system saturation, appointment on demand, fear of potential lawsuits by the patient, chronic patients protocols, administrative consultations, professional behaviour, and poor coordination with specialised care.
  
  
  CONCLUSIONS
  According to PC professionals, there are multiple environmental factors, both social and healthcare system organisational factors that encourage frequent attendance. Within the scope of health care system, organisational actions (such as teamwork and coordination with specialists) would help to manage demand.
authors.affiliation: Departamento de Ciencias Sanitarias y Médico Sociales, Universidad de Alcalá, Alcalá de Henares, Madrid, España. maria.sandin@uah.es
authors.forename: M
authors.initials: M
authors.lastname: Sandín-Vázquez
authors.forename: P
authors.initials: P
authors.lastname: Conde-Espejo
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006300:Health Services Misuse; D006801:Humans; D011320:Primary Health Care; D012959:Socioeconomic Factors; D013030:Spain