Hiperfreqüentadors

Paraules Mesh

Cerques fetes

• "Primary Health Care"[Mesh] AND "Health Services Misuse/statistics and numerical data"[Mesh]

• "Primary Health Care/utilization"[Mesh] AND "Models, Theoretical"[Mesh] AND "Cross-Sectional Studies"[Mesh]
• "Primary Health Care/utilization"[Mesh] AND Attitude to Health [mesh]
• "Primary Health Care/utilization"[Mesh] AND "Models, Theoretical"[Mesh] AND"Cohort Studies"[Mesh]
• "Primary Health Care/utilization"[Mesh] AND "Religion and Psychology"[Mesh]
• "Primary Health Care/utilization"[Mesh] AND "Age Factors"[Mesh] AND "Models, Theoretical"[Mesh]
• "Primary Health Care/utilization"[Mesh] AND "Age Factors"[Mesh] AND "Health Services Research"[Mesh]
• "Primary Health Care/utilization"[Mesh] AND Capitation Fee[Mesh]
• "Primary Health Care/utilization"[Mesh] AND Chronic Disease/epidemiology [Mesh]
• "Primary Health Care/utilization"[Mesh] AND Chronic Disease/psychology
• "Primary Health Care/utilization"[Mesh] AND Educational Status
• "Primary Health Care/utilization"[Mesh] AND Health Status[mesh] AND "Health Services Research"[Mesh]
• "Primary Health Care/utilization"[Mesh] AND Morbidity[Mesh] AND Health Services Research[mesh]

• "Appointments and Schedules"[Mesh] AND "Models, Theoretical"[Mesh] AND "Primary Health Care/utilization"[Mesh]

Freqüentació

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

Factors associats

Affective Symptoms/epidemiology Age Factors Attitude to Health Attitude of Health Personnel* Capitation Fee Catholicism Chronic Disease Chronic Disease/epidemiology Chronic Disease/psychology Depression/epidemiology* Educational Status Family Characteristics* 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 Poverty Areas* Physician-Patient Relations* Physicians, Family/utilization* 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) Severity of Illness Index 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].
• Descripció de la freqüentació [8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18].
• Variabilitat [19].
• Demanda induïda [20].
• Perfil de l'HF [21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34].
• Factors explicatius de l'HF [35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57], el model explicatiu d'Andersen [58], socio-economics [59, 60, 61], factors psicològics [62, 63, 64, 65, 66, 67, 68, 69], sistemes d'organització dels serveis sanitaris [70], religió [71].
• Metodologia:
  • Estudis qualitatius [72, 73].
  • Multivariant [74].

Pendents de buscar

• Referència 15, 22 de [1].

Referències

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49. äsjärvi pmid=9800226

59. 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.