Frequent attenders in late life in primary care: a systematic review of European studies
Abstract Background High utilization of health care services is a costly phenomenon commonly observed in primary care practices. However, while frequent attendance in primary care has been broadly studied across age groups, aspects of high utilization by elderly patients have not been investigated i...
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doaj-1340cdc985fc44abb526c913fd7d14502020-11-25T02:02:37ZengBMCBMC Family Practice1471-22962017-12-0118111410.1186/s12875-017-0700-7Frequent attenders in late life in primary care: a systematic review of European studiesFranziska D. Welzel0Janine Stein1André Hajek2Hans-Helmut König3Steffi G. Riedel-Heller4Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of LeipzigInstitute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of LeipzigDepartment of Health Economics and Health Services Research, University Medical Centre Hamburg-EppendorfDepartment of Health Economics and Health Services Research, University Medical Centre Hamburg-EppendorfInstitute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of LeipzigAbstract Background High utilization of health care services is a costly phenomenon commonly observed in primary care practices. However, while frequent attendance in primary care has been broadly studied across age groups, aspects of high utilization by elderly patients have not been investigated in detail. The aim of this paper is to provide a systematic review of frequent attendance in primary care among elderly people. Methods We searched five databases (PubMed, PsycINFO, Web of Science, PubPsych, and Cochrane Library) for published papers addressing frequent attendance in primary health care among elderly individuals. Quality of studies was assessed using established criteria for evaluating methodological quality. Results Ten studies met inclusion criteria and were included for detailed analysis. The average number of patients frequently utilizing primary care services varied across studies from 10% to 33% of the elderly samples and subsamples. The definition of frequent attendance across studies differed substantially. The most consistent associations between frequent attendance and old age were found for presence and severity of physical illness. Results on mental disorders and frequent attendance were heterogeneous. Only a few studies have assessed frequent attendance in association with factors such as drug use, social support or sociodemographic aspects; however results were inconsistent. Conclusions Severe ill health and the need for treatment serve as the main drivers of frequent attendance in older adults. As results were scarce and divergent, future studies are needed to provide more information on this topic. Since prior studies have offered only a snapshot of this service use behaviour, a longitudinal approach would be preferable in the future.http://link.springer.com/article/10.1186/s12875-017-0700-7Primary careGeneral practiceElderlyFrequent attendance |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Franziska D. Welzel Janine Stein André Hajek Hans-Helmut König Steffi G. Riedel-Heller |
spellingShingle |
Franziska D. Welzel Janine Stein André Hajek Hans-Helmut König Steffi G. Riedel-Heller Frequent attenders in late life in primary care: a systematic review of European studies BMC Family Practice Primary care General practice Elderly Frequent attendance |
author_facet |
Franziska D. Welzel Janine Stein André Hajek Hans-Helmut König Steffi G. Riedel-Heller |
author_sort |
Franziska D. Welzel |
title |
Frequent attenders in late life in primary care: a systematic review of European studies |
title_short |
Frequent attenders in late life in primary care: a systematic review of European studies |
title_full |
Frequent attenders in late life in primary care: a systematic review of European studies |
title_fullStr |
Frequent attenders in late life in primary care: a systematic review of European studies |
title_full_unstemmed |
Frequent attenders in late life in primary care: a systematic review of European studies |
title_sort |
frequent attenders in late life in primary care: a systematic review of european studies |
publisher |
BMC |
series |
BMC Family Practice |
issn |
1471-2296 |
publishDate |
2017-12-01 |
description |
Abstract Background High utilization of health care services is a costly phenomenon commonly observed in primary care practices. However, while frequent attendance in primary care has been broadly studied across age groups, aspects of high utilization by elderly patients have not been investigated in detail. The aim of this paper is to provide a systematic review of frequent attendance in primary care among elderly people. Methods We searched five databases (PubMed, PsycINFO, Web of Science, PubPsych, and Cochrane Library) for published papers addressing frequent attendance in primary health care among elderly individuals. Quality of studies was assessed using established criteria for evaluating methodological quality. Results Ten studies met inclusion criteria and were included for detailed analysis. The average number of patients frequently utilizing primary care services varied across studies from 10% to 33% of the elderly samples and subsamples. The definition of frequent attendance across studies differed substantially. The most consistent associations between frequent attendance and old age were found for presence and severity of physical illness. Results on mental disorders and frequent attendance were heterogeneous. Only a few studies have assessed frequent attendance in association with factors such as drug use, social support or sociodemographic aspects; however results were inconsistent. Conclusions Severe ill health and the need for treatment serve as the main drivers of frequent attendance in older adults. As results were scarce and divergent, future studies are needed to provide more information on this topic. Since prior studies have offered only a snapshot of this service use behaviour, a longitudinal approach would be preferable in the future. |
topic |
Primary care General practice Elderly Frequent attendance |
url |
http://link.springer.com/article/10.1186/s12875-017-0700-7 |
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