The association between daytime attendance and out-of-hours frequent attendance among adult patients in general practice.

BACKGROUND

Frequent attenders (FAs) account for a large proportion of daytime consultations in general practice. However, no studies have so far been conducted to establish whether daytime FAs are also out-of-hours FAs.

AIM

To analyse the association between daytime attendance and out-of-hours frequent attendance.

DESIGN OF STUDY

A registry-based study of individual face-to-face contacts with general practice during daytime and out of hours, based on National Health Insurance files.

SETTING

General practices in Aarhus County, Denmark (630,000 inhabitants).

METHOD

A total of 416,172 adults, i.e. all adults registered with a general practice during a 12-month period from November 1997 to October 1998 were included. Odds ratios (OR) for frequent attendance out of hours were stratified for age, sex, and frequency of contacts during daytime were calculated.

RESULTS

A strong association was observed between daytime level of attendance and out-of-hours level of attendance (OR = 2.9-6.3 among patients with low daytime attendance, OR = 33.7-99.8 among daytime FAs). Daytime FAs accounted for one-third of the daytime contacts, one-third of the out-of-hours contacts, and 42% of out-of-hours FAs. More than half of the daytime FAs did not attend out of hours. Two per cent of the out-of-hours FAs had no contacts during the daytime.

CONCLUSION

Frequent attendance in daytime was very strongly associated with frequent attendance out of hours, and daytime FAs accounted for a large proportion of all contacts with general practice.