[Motives that condition use of the health services by over-users: study with focus groups]

Much is known about the profile of over-users and the cost of their demands, but their personal views about the reasons for their behaviour have been little examined.

To identify the reasons over-users give for their behaviour.

Qualitative analysis of transcriptions of video-recorded focus group meetings.

Two urban primary care clinics of the Andalusian Health Service in Seville, Spain.

Twelve women and 15 men; 9 between 45 and 65 years old and 18 over 65. Average of 55 attendances at the health centre (HC) during the previous year. Group meetings were held in Seville between November 26, 2003 and December 12, 2003.

Inductive analysis of focus group interview transcriptions.

Most over-users attend their HC because of perception of problems (psychological, physical) and their belief that they will find effective help from the health services. Factors such as their relationships with health staff or organisation of care are perceived as barriers or facilitators of health service use. Low family and social support are perceived as important factors in seeking help in primary care.

Health services should bear in mind these motives of over-users, on designing and introducing support systems to manage demand more rationally and effectively. These systems could be based on new technology (internet and telephone information and consulting) and the cooperation of other professionals, such as pharmacists or nurses.