1 Faculty of Medicine and Life Sciences, University of Tampere, Finland.
2 Pihlajalinna Työterveys, Finland.
Scand J Public Health. 2019 Feb;47(1):28-36. doi: 10.1177/1403494818777436. Epub 2018 May 27.
This study characterizes frequent attenders in primary care provided by occupational health services (OHS) in Finland.
This is a nationwide cross-sectional study using medical record data from an OHS provider in 2015. Frequent attenders were defined as persons who were within the top decile of annual visits to healthcare professionals (frequent attender 10%, FA10) at any of the OHS's 37 stations. FA10s within this study consulted the OHS primary care unit eight or more times during 2015. We used logistic regression to analyse factors associated with frequent attendance in OHS primary care. The independent variables were age, gender, employer size and industry, health professionals visited and diagnoses given during visits to the OHS. The dependent variable was belonging to the FA10 group.
Altogether 31,960 patients met the inclusion criteria and were included in the study. The FA10 group included 3617 patients, who conducted 36% of visits to healthcare professionals. The findings indicate that working within the manufacturing industry, health and social services, or public administration, and being employed in medium or large companies, are associated with frequent attendance. Frequent attendance was also associated with being female, diagnoses of the musculoskeletal system, or mental and behavioral disorders. In particular, depressive episodes and anxiety were associated with FA10s.
This research characterized FA10 clients at a Finnish OHS. Illnesses of the musculoskeletal system and mental and behavioral disorders were accentuated among FA10s. The stability of the FA10 group, along with their sickness absences and work disabilities, should be investigated further.
本研究描述了芬兰职业健康服务（OHS）提供的初级保健中的频繁就诊者。
这是一项全国性的横断面研究，使用了 2015 年 OHS 提供商的医疗记录数据。频繁就诊者被定义为在 OHS 的 37 个站点中，任何一个站点的年度就诊次数都处于前十分位数的人（频繁就诊者 10%，FA10）。本研究中的 FA10 在 2015 年期间在 OHS 初级保健部门就诊了 8 次或以上。我们使用逻辑回归分析与 OHS 初级保健中的频繁就诊相关的因素。自变量为年龄、性别、雇主规模和行业、就诊时访问的卫生保健专业人员和诊断。因变量是属于 FA10 组。
共有 31960 名患者符合纳入标准并纳入研究。FA10 组包括 3617 名患者，他们进行了 36%的医疗保健专业人员就诊。研究结果表明，在制造业、卫生和社会服务或公共管理部门工作，以及在中型或大型公司工作，与频繁就诊相关。频繁就诊还与女性、肌肉骨骼系统诊断或精神和行为障碍有关。特别是，抑郁发作和焦虑与 FA10 相关。
本研究描述了芬兰 OHS 的 FA10 患者。FA10 患者的肌肉骨骼系统疾病和精神行为障碍更为突出。FA10 组的稳定性，以及他们的病假和工作能力丧失，应进一步调查。
