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Frequent users of rural primary care: comparisons with randomly selected users
1Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, USA.
The Journal of the American Board of Family Practice
|June 6, 1998
Summary
Frequent primary care users often have psychosocial needs and nonmedical reasons for visits. Understanding these factors is key to improving care for high-utilization patient populations.
Area of Science:
- Primary Care Medicine
- Health Services Research
- Psychosocial Factors in Health
Background:
- Frequent primary care utilization is common but not well-characterized.
- Understanding the drivers of high healthcare use is essential for resource allocation and patient care.
- Psychosocial factors may significantly influence healthcare-seeking behaviors.
Purpose of the Study:
- To characterize frequent primary care users.
- To identify reasons for high healthcare utilization.
- To explore the role of psychosocial factors in frequent primary care visits.
Main Methods:
- Retrospective chart review of a rural primary care clinic's billing system.
- Comparison of frequent users (n=211) with a random sample of patients (n=250).
- Analysis included diagnoses, procedures, costs, psychotropic medication use, and patient interviews.
Main Results:
- Frequent users were younger/older, had more specialist/ED visits, and higher rates of mental health diagnoses.
- Frequent users were more likely to have Medicaid and less likely to have Medicare.
- They underwent more tests, received more psychotherapy, and had visits driven by nonmedical reasons.
Conclusions:
- Nonmedical factors significantly contribute to frequent primary care use.
- Future interventions for frequent users must address psychosocial needs.
- A holistic approach is necessary for managing high-utilization patient populations.