Hiperfreqüentadors

Paraules Mesh

Cerques fetes

• "Primary Health Care/utilization"[Mesh] AND "Models, Theoretical"[Mesh] AND "Cross-Sectional Studies"[Mesh]
• "Primary Health Care/utilization"[Mesh] AND "Models, Theoretical"[Mesh] AND"Cohort Studies"[Mesh]
• "Appointments and Schedules"[Mesh] AND "Models, Theoretical"[Mesh] AND "Primary Health Care/utilization"[Mesh]
• "Primary Health Care"[Mesh] AND "Health Services Misuse/statistics and numerical data"[Mesh]

Freqüentació

Appointments and Schedules Continuity of Patient Care/statistics & numerical data* Health Services/utilization* Health Services Misuse/statistics & numerical data Office Visits/statistics & numerical data* Office Visits/utilization* Primary Health Care*/statistics & numerical data Primary Health Care/utilization* utilization Utilization Review/statistics & numerical data Workload*

Factors associats

Affective Symptoms/epidemiology Age Factors Attitude to Health Attitude of Health Personnel* Catholicism Chronic Disease/epidemiology Chronic Disease/psychology* Depression/epidemiology* Educational Status Family Characteristics* Family Practice* Family Practice/organization & administration Family Practice/statistics & numerical data* Family Relations Health Behavior Health Care Rationing* Health Services Accessibility* Health Services for the Aged/utilization* Health Services Needs and Demand Health Status Jews/psychology Jews/statistics & numerical data Marital Status Mental Disorders/diagnosis Mental Disorders/epidemiology Mental Disorders/psychology Models, Organizational* Morbidity* Motivation Neurotic Disorders/epidemiology* Outpatients/classification* Outpatients/psychology Patient Acceptance of Health Care Patient Acceptance of Health Care/ethnology Patient Acceptance of Health Care/psychology* Patient Acceptance of Health Care/statistics & numerical data* Patients/psychology* Patient Satisfaction Personality Assessment Personality Inventory Physician-Patient Relations* Physician's Practice Patterns/statistics & numerical data* Practice Management, Medical Practice Management, Medical/organization & administration* Protestantism Psychology, Social Religion and Psychology* Risk Factors Self Assessment (Psychology) Sex Factors Sick Role* Social Class Social Support Socioeconomic Factors Urban Health

Mètodes

Case-Control Studies Chi-Square Distribution Cross-Sectional Studies Cohort Studies Follow-Up Studies Confidence Intervals Health Care Surveys Health Services Research Health Surveys Interviews Likelihood Functions Logistic Models Models, Theoretical Odds Ratio Prospective Studies Qualitative Research Questionnaires Regression Analysis Retrospective Studies

Estat actual del tema

Definició d'hiperfreqüentador

• Majors de 14 anys i amb més de 8 visites/metge/any.
• Número de visites superior a 2 desviacions estàndard de la mitja de freqüentació.

Perfil de l'hiperfreqüentador

• Són una part important de la demanda, son un 12-21% de la població que usa el 46-50% de les consultes.
• Edat mitja.
• Predomini femení.
• Múltiples problemes de salut tant físics com mentals.
• Valorar si cal recollir si el pacient és pensionista o no. En l'article [1], ho tenen en compte, però no sé en què es basen.

Factors que condicionen la hiperfreqüentació

• Característiques de la població.
  • L'edat cada cop més gran de la població.
  • Estat de salut de la població.
  • Segons la importància que se li dóna a la malaltia [1]. Sobretot les cardiovasculars, osteoarticulars, però també les cròniques i mentals.
  • El nivell socioeconòmic podria influir en la HF dels serveis públics, ja que se sposa que els rics van a la privada [1].
  • Falta de suport social o familiar augmenten la HF [1].
• Factors del professional.
  • No influeix la satisfacció amb el seu metge o infermera.
• Factors de la organització.
  • Un augment d'accessibilitat augmenta la freqüentació segons els propis pacients [1].
  • La satisfacció amb el centre podria augmentar la HF [1].

Metodologia utilitzada

• Per als factors que determinen l'hiperfreqüentació:
  • Metodologia qualitativa amb grups focals [1].

Bibliografia

Llegits

• Factors explicatius de la HF amb metodologia qualitativa [1].

Pendents de llegir

• Definició HF [2, 3, 4, 5, 6, 7, 8]
• Perfil de l'HF [9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19].
• Factors explicatius de l'HF [20, 21, 22, 23, 24, 25], el model explicatiu d'Andersen [26], socials [27], personalitat neuròtica [28], sistemes d'organització dels serveis sanitaris [29], religió [30]. Estudis qualitatius [31, 32].

Pendents de buscar

• Referència 15, 22 de [1].

Referències

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2. ço_econh pmid=16127679

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13. Bellón JA, Delgado A, Luna JD, and Lardelli P. Psychosocial and health belief variables associated with frequent attendance in primary care. Psychol Med. 1999 Nov;29(6):1347-57. DOI:10.1017/s0033291799008995 |
14. Dowrick CF, Bellón JA, and Gómez MJ. GP frequent attendance in Liverpool and Granada: the impact of depressive symptoms. Br J Gen Pract. 2000 May;50(454):361-5.
15. Ortega Tallón MA, Roca Figueres G, Iglesias Rodríguez M, and Jurado Serrano JM. [Patients over-using a primary care centre: their social, demographic and clinical characteristics, and their use of health service facilities]. Aten Primaria. 2004 Feb 15;33(2):78-85. DOI:10.1016/s0212-6567(04)79355-5 |
16. Frostholm L, Fink P, Christensen KS, Toft T, Oernboel E, Olesen F, and Weinman J. The patients' illness perceptions and the use of primary health care. Psychosom Med. 2005 Nov-Dec;67(6):997-1005. DOI:10.1097/01.psy.0000189164.85653.bc |
17. Aguirre Rodríguez CJ, Hernández Martínez N, Aguirre Rodríguez FJ, and González Expósito JM. [Study of some parameters of ongoing care in a health district and the problem of over-use of the service]. Aten Primaria. 2004 Jun 30;34(2):105-6. DOI:10.1016/s0212-6567(04)79471-8 |
18. Segovia Martínez A, Pérez Fuentes C, Torío Durántez J, and García Tirado MC. [Psychological malaise and the sociodemographic and familial characteristics of the over-user of primary care]. Aten Primaria. 1998 Nov 30;22(9):562-9.
19. Orueta Sánchez R, Vigueras F, Orgaz P, and Torres C. [The family characteristics of overusers of primary care health services]. Aten Primaria. 1993 Jun 30;12(2):92-4.
20. Brugos Larumbe A, Guillén Grima F, Mallor Giménez F, and Fernández Martínez de Alegría C. [Models to explain and predict medical case-loads: their use in calculating the maximum family medicine list that allows at least ten minutes per consultation]. Aten Primaria. 2003 Jun 15;32(1):23-9. DOI:10.1016/s0212-6567(03)78853-2 |
21. Smucker DR, Zink T, Susman JL, and Crabtree BF. A framework for understanding visits by frequent attenders in family practice. J Fam Pract. 2001 Oct;50(10):847-52.
22. Kapur N, Hunt I, Lunt M, McBeth J, Creed F, and Macfarlane G. Psychosocial and illness related predictors of consultation rates in primary care--a cohort study. Psychol Med. 2004 May;34(4):719-28. DOI:10.1017/S0033291703001223 |
23. Mancera Romero J, Muñoz Cobos F, Paniagua Gómez F, Fernández Lozano C, Fernández Tapia M, and Blanca Barba F. [Health problems and factors determining the number of on-demand visits of over-users of a health centre]. Aten Primaria. 2001 May 31;27(9):658-62. DOI:10.1016/s0212-6567(01)78876-2 |
24. van der Meer JB and Mackenbach JP. Low education, high GP consultation rates: the effect of psychosocial factors. J Psychosom Res. 1998 May;44(5):587-97. DOI:10.1016/s0022-3999(97)00217-1 |
25. Báez K, Aiarzaguena JM, and Grandes G. [Overutilization and psychosocial factors: myth or reality?]. Aten Primaria. 1999 May 31;23(9):555-7.
26. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995 Mar;36(1):1-10.

27. Pescosolido B. Beyond Rational Choice: The Social Dynamics of How People Seek Help. The American Journal of Sociology, Vol. 97, No. 4, New Directions in the Sociology of Medicine. (Jan., 1992), pp. 1096-1138.

28. ten Have M, Oldehinkel A, Vollebergh W, and Ormel J. Does neuroticism explain variations in care service use for mental health problems in the general population? Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol. 2005 Jun;40(6):425-31. DOI:10.1007/s00127-005-0916-z |
29. Suominen-Taipale AL, Koskinen S, Martelin T, Holmen J, and Johnsen R. Differences in older adults' use of primary and specialist care services in two Nordic countries. Eur J Public Health. 2004 Dec;14(4):375-80. DOI:10.1093/eurpub/14.4.375 |
30. Reindl Benjamins M and Brown C. Religion and preventative health care utilization among the elderly. Soc Sci Med. 2004 Jan;58(1):109-18. DOI:10.1016/s0277-9536(03)00152-7 |
31. Neal RD, Heywood PL, and Morley S. 'I always seem to be there'--a qualitative study of frequent attenders. Br J Gen Pract. 2000 Sep;50(458):716-23.
32. Hodgson P, Smith P, Brown T, and Dowrick C. Stories from frequent attenders: a qualitative study in primary care. Ann Fam Med. 2005 Jul-Aug;3(4):318-23. DOI:10.1370/afm.311 |
33. Sihvonen M and Kekki P. Unnecessary visits to health centres as perceived by the staff. Scand J Prim Health Care. 1990 Dec;8(4):233-9. DOI:10.3109/02813439008994964 |