[Patients over-using a primary care centre: their social, demographic and clinical characteristics, and their use of health service facilities].

OBJECTIVES

To find the social and clinical characteristics of patients over-using (OUP) our centre. To find how much these patients use the health services.

DESIGN

Observational, descriptive study.

SETTING

Urban primary care centre (36 408 inhabitants).

PARTICIPANTS

Patients over 15 seen at the centre during the year 2000, who exceeded in their number of attendances the mean plus two standard deviations for their age group.

MAIN MEASUREMENTS

The records of OUPS were reviewed to analyse their social and demographic characteristics, kinds of attendance, reasons for consultation, further tests, medication, referrals, and time off work this year.

RESULTS

The sample was of 954 OUPs, 50.9% of whom were male with an average age of 50.54 (SD, 19.68). 86.3% had some risk factor recorded (34% hypertension, 32.4% mental health, 27.7% obesity, 25.7% tobacco dependency, 17.7% diabetes mellitus). They generated a mean of 9.6 visits to the doctor per year, with 95% CI (8.09-11.19), with the most common reason for attendance the monitoring of acute pathology (19.29%), followed by monitoring of chronic pathology (14.32%). There was an average of 1 analysis per OUP per year, and 0.68 image tests per OUP per year (48.38% were simple x-rays). 46.8% of the medication prescribed were analgesics. Average time off work was 0.5 periods off per OUP per year, with a mean period of 49.4 days off (SD, 113.69). They engendered an average of 4.15 nursing visits per OUP per year, 95% CI (2.60-5.70), with monitoring of chronic pathology the most common reason for consultation. 30.3% of OUP had a visit to hospital casualty recorded, with osteo-muscular pathology the most common reason for consultation (34.29%). Mean referrals were 0.88 OUP per year, with traumatology being the department to which most referrals were made (13.92%).

CONCLUSIONS

OUP are middle-aged, have associated chronic pathology and use programmed appointments a lot. The additional tests conducted matched the centre's procedures for monitoring chronic pathologies. The most common reason for attendance at casualty was traumatology, as was the specialist clinic to which most referrals were made.