Stability of attendance in general practice

Area of Science:

• General Practice
• Health Services Research
• Patient Behavior Analysis

Background:

• Understanding patient attendance stability is crucial for healthcare resource allocation and service planning.
• Previous studies collected patient attendance data from three Western Australian general practices over two 6-month periods, 11 months apart.

Purpose of the Study:

• To examine the stability of patient attendance patterns over time.
• To analyze patient flow, visit frequency, and diagnostic trends between two distinct periods.
• To identify characteristics of consistent versus fluctuating patient attenders.

Main Methods:

• Patients were categorized into four attendance groups: low-to-low, low-to-high, high-to-low, and high-to-high, based on their attendance in the two study periods.
• Demographic data (age, sex) and diagnoses were compared across these attendance groups.
• Statistical analysis was employed to assess the stability of patient populations and attendance behaviors.

Main Results:

• The overall patient population remained stable across the two 6-month periods, but the composition of patients changed significantly.
• Only 45% of patients attending in the first period also attended in the second period.
• While 8% of patients were classified as high attenders in each period, only 22% of first-period high attenders remained high attenders in the second period.
• Long-term high attenders were older and predominantly had chronic diagnoses.
• Short-term high attenders were more likely to have self-limiting conditions like depression and pregnancy.

Conclusions:

• General practice patient populations exhibit significant individual-level attendance variability despite overall population stability.
• High attendance is not a consistently stable characteristic for most patients.
• Patient attendance patterns are influenced by age, diagnostic categories (chronic vs. self-limiting conditions), and potentially other unmeasured factors.