[Profiles of high-frequency users of primary care services and associations with depressive anxiety disorders in Cali, Colombia].
To determine the profiles of highly frequent users of primary care services and the associations of these profiles with depressive anxiety disorders in Cali, Colombia.
A case-control study, high-frequency cases were defined as those involving patients with a percentile >75 with regard to the frequency of spontaneous use of outpatient facilities in the last 12 months; controls were defined as those with a percentile <25. A multiple correspondence analysis was used to describe patient profiles, and the influences of depression and anxiety on frequent attendance was determined via logistic regression.
Among the 780 participating patients, differences in the profiles among frequent users and controls were related to predisposing factors such as sex, age, and education, capacity factors such as the time required to visit the institution and the means of transport used, and need factors such as health perceptions, social support, family function, and the presence of anxiety or depressive disorders. A depression or anxiety disorder was found to associate positively with frequent attendance (adjusted odds ratio [aOR]: 1.99, 95% confidence interval [CI]: 1.19-3.31) and a referral system (aOR: 1.61, 95% CI: 1.01-2.76), but negatively with mild or no family dysfunction (aOR: 0.79; 95% CI: 0.48-0.88) after adjusting for age, sex, ethnicity, and health service-providing institutions.
The profiles of high-frequency patients differ from control patients with respect to factors related to capacity, need, and willingness; in particular, the latter were independently associated with frequent attendance. Notably, the presence of an anxious or depressive disorder doubled the risk of highfrequency attendance at a primary care facility.
Grupo de investigación de Salud y Calidad de Vida de la Pontificia Universidad Javeriana. Cali, Colombia.|Grupo de evaluación de servicios de salud de la Caja de Compensación Familiar del Valle del Cauca. Cali, Colombia.
Mérida
M
Rodriguez-Lopez
Departamento de Salud Pública y Epidemiología de la Pontificia Universidad Javeriana. Cali, Colombia.
Marcela
M
Arrivillaga
Departamento de Salud Pública y Epidemiología de la Pontificia Universidad Javeriana. Cali, Colombia.
Jorge
J
Holguín
Universidad del Valle. Cali, Colombia.
Hoover
H
León
Universidad Icesi. Cali, Colombia.
Alfonso
A
Ávila
Grupo de evaluación de servicios de salud de la Caja de Compensación Familiar del Valle del Cauca. Cali, Colombia.|Grupo de investigación servicios de salud de la Universidad del Valle. Cali, Colombia.
Carlos
C
Hernández
Fundación Valle del Lili. Cali, Colombia.|Medicina Inteligente SAS. Cali, Colombia.
Hernán G
HG
Rincón-Hoyos
D000328:Adult; D001007:Anxiety; D001008:Anxiety Disorders / Q000628:therapy*; D016022:Case-Control Studies; D003105:Colombia; D003866:Depressive Disorder / Q000628:therapy; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care