Is frequent attendance in primary care disease-specific?
Is frequent attendance in primary care disease-specific?
复制标题
DOI：
10.1093/fampra/cml019
复制
发表时间：
2006-08-01
期刊：
影响因子：
2.2
通讯作者：
Croft, Peter
中科院分区：
文献类型：
--
作者：
Foster, Alison;Jordan, Kelvin;Croft, Peter
背景：一般实践中频繁参加者的社会人口特征是已知的。目前尚不清楚频繁就诊是否与特定疾病有关。目的：调查初级保健中的频繁咨询是否与特定发病率相关，以及这种关系是否受到患者就诊的全科诊所的影响。设计：咨询数据的一年调查。地点：英国北斯塔福德郡的 9 个全科诊所。参与者：从每个诊所中随机选择 1000 名 18 岁及以上、在研究年度内至少咨询过初级保健一次的成年人，并将其分为频繁（高和低）组。主要结果指标：每次咨询时编码的发病类型以及每种发病的重复咨询次数（基于阅读代码章节）。结果：所有发病章节均与频繁咨询相关。频繁咨询也与大多数疾病的重复咨询有关。与精神疾病、血液疾病、循环系统疾病、消化系统疾病、内分泌疾病以及受伤和中毒原因之间的关联性更强。与频繁咨询相关的发病率在实践中存在一些明显的差异；特别是对于皮肤病和未明确的病症。结论：初级保健中的频繁咨询并不限于特定的疾病群体。频繁咨询的某些方面是个人的特征，无论他们咨询的症状如何。在这组咨询者中，某些疾病比其他疾病更为突出，这可能有助于指导经常咨询的实践政策和未来研究。
Background: Sociodemographic characteristics of frequent attenders in general practice are known. It is not known whether frequent attendance is linked to specific diseases.Objective: To investigate whether frequent consultation in primary care is related to specific morbidities and whether this relationship is influenced by the general practice which the patient attends.Design: One-year survey of consultation data.Setting: Nine general practices in North Staffordshire, UK.Participants: 1000 adults aged 18 years and over who had consulted primary care at least once during the study year were randomly selected from each practice and grouped into frequent (high and very high), medium and low frequency consulters.Main outcome measures: Type of morbidity coded at each consultation and number of repeat consultations for each morbidity (based on Read Code Chapters).Results: All morbidity Chapters were associated with frequent consultation. Frequent consultation was also associated with repeated consultation within most morbidities. Stronger associations were seen with mental disorders, blood disorders, circulatory disorders, digestive disorders, endocrine diseases and with causes of injury and poisoning. Some variation between practices in the morbidities associated with frequent consultation were apparent; particularly for skin diseases and unspecified conditions.Conclusions: Frequent consulters in primary care are not restricted to particular groups of morbidities. There is some aspect of frequent consultation that is a characteristic of individuals regardless of the symptoms with which they consult. Some morbidities are more prominent than others in this group of consulters, and this may help guide practice policies and future research into frequent consulters.