Bergh Håkan, Baigi Amir, Marklund Bertil
Research and Development Unit, Primary Health Care, County Council Halland, Falkenberg, Sweden.
Scand J Public Health. 2005;33(3):228-32. doi: 10.1080/14034940510005761.
A study was carried out to determine whether frequent attenders' (FAs') consultations for injuries are medically appropriate or not.
A retrospective review was undertaken of medical records in a primary healthcare centre. All injury consultations by frequent attenders and controls during a period of one year were evaluated by two general practitioners (GPs). Outcome variables were: number of injuries, chronic diseases, type of injuries, and their treatments. The GPs made a comprehensive picture of each case and evaluated whether it was medically appropriate to consult a doctor or not.
Injuries were 7.2 times more common among frequent attenders compared with the controls. Frequent attenders had significantly more chronic diseases. Mean number of injury consultations was the same for frequent attenders with or without chronic disease. There was no difference concerning medically appropriate consultations between frequent attenders and controls.
Consultations for injuries with frequent attenders were considered medically appropriate. Chronic diseases did not explain the higher injury incidence among frequent attenders. These findings are interesting and contradict the opinion that increased healthcare consumption by FAs is a waste of resources. Our findings may suggest that FAs are more vulnerable individuals.
开展一项研究以确定频繁就诊者因伤就诊是否具有医学合理性。
对一家基层医疗中心的病历进行回顾性分析。两位全科医生(GP)对频繁就诊者和对照组在一年期间的所有因伤就诊情况进行评估。结果变量包括:受伤次数、慢性病、损伤类型及其治疗方法。全科医生对每个病例进行全面了解,并评估就医是否具有医学合理性。
与对照组相比,频繁就诊者受伤的情况要常见7.2倍。频繁就诊者患慢性病的情况明显更多。有慢性病和无慢性病的频繁就诊者平均因伤就诊次数相同。频繁就诊者和对照组在医学上合理的就诊情况方面没有差异。
频繁就诊者因伤就诊被认为具有医学合理性。慢性病并不能解释频繁就诊者中较高的受伤发生率。这些发现很有趣,与认为频繁就诊者增加的医疗保健消费是资源浪费的观点相矛盾。我们的发现可能表明频繁就诊者是更易受伤的个体。