Menéndez Granados Nicolás, Vaquero Abellán Manuel, Toledano Estepa Manuel, Pérez Díaz Manuel Modesto, Redondo Pedraza Rosa
Grupo «Investigación epidemiológica en atención primaria» del Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España.
Grupo «Investigación epidemiológica en atención primaria» del Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España.
Gac Sanit. 2019 Jan-Feb;33(1):38-44. doi: 10.1016/j.gaceta.2017.07.011. Epub 2017 Oct 10.
To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain).
An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural).
The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics.
A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused.
描述西班牙科尔多瓦-瓜达尔基维尔河卫生区（科尔多瓦）不同基层医疗实践中频繁就诊者（FA）的分布情况。
进行了一项生态研究，纳入2011年至2015年的数据。将FA定义为每年预约就诊12次及以上的患者；分别对护理、全科医疗和儿科进行分析。将频繁就诊的患病率和FA/专业人员比例作为因变量。还检查了该地区人口的人口统计学特征、卫生专业人员数量和一般设施的使用情况。为了解FA的分布情况，根据设施规模和环境位置（城市、郊区和农村）对基层医疗机构进行分类。
护理方面FA的平均患病率为10.86%（标准误0.5）；全科医疗为21.70%（标准误0.7），儿科为16.96%（标准误0.7）。不同专业类别的FA/专业人员比例分别为：护理101.07（标准误5.0），全科医疗239.74（标准误9.0），儿科159.54（标准误9.8）。
大部分基层医疗服务使用者进行了大量的咨询。在这一群体中，女性比男性更多地过度使用护理和全科医生服务。在较小规模的农村医疗机构中观察到较高的FA患病率。尽管以FA/专业人员比例为标准，但中等规模的医疗机构被过度使用的程度更高。
