Clinically inexplicable frequent attenders in general practice

Area of Science:

• Primary Care Medicine
• Health Services Research
• Rural Health

Background:

• Frequent attenders represent a disproportionate burden on primary healthcare resources.
• Understanding the characteristics of frequent attenders is crucial for optimizing healthcare delivery.

Purpose of the Study:

• To identify and characterize frequent attenders in an isolated rural general practice.
• To investigate the reasons for frequent attendance and associated patient factors.

Main Methods:

• Retrospective analysis of patient records in a rural general practice.
• Identification of frequent attenders based on consultation rates.
• Classification of attendance reasons by general practitioners (GPs).

Main Results:

• 107 frequent attenders (1.95% of practice population) generated five times the consultation workload compared to controls.
• 60% of frequent attenders were classified as having clinically inexplicable reasons for attendance.
• This subgroup showed higher rates of long-term medication, hospital referral, and free healthcare access.
• High levels of kinship (47%) were observed within the frequent attender group.

Conclusions:

• Frequent attenders significantly increase primary care workload, particularly in rural settings.
• A substantial proportion of frequent attendance may be driven by factors beyond immediate clinical need.
• Understanding social dynamics, such as kinship, may be relevant in managing frequent attender groups.