Comparing occasional and persistent frequent attenders in occupational health primary care – a longitudinal study

ObjectivesFrequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in occupational health (OH) primary care.Setting and participantsThis is a longitudinal study using medical record data (2014–2016) from an OH care provider in Finland. In total, 59 676 patients were included and categorised into occasional and persistent FAs or non-FAs. Sick-leave episodes and their lengths were collected along with associated diagnostic codes. Logistic regression was used to analyse associations between FA status and sick leaves of different lengths (1–3, 4–14 and ≥15 days).ResultsBoth occasional and persistent FA had more and longer duration of sick leave than non-FA through the study years. Persistent FAs had consistently high absence rates. Occasional FAs had elevated absence rates even 2 years after their frequent attendance period. Persistent FAs (OR=11 95% CI 7.54 to 16.06 in 2016) and occasional FAs (OR=2.95 95% CI 2.50 to 3.49 in 2016) were associated with long (≥15 days) sickness absence when compared with non-FAs. Both groups of FAs had an increased risk of long-term sick leaves indicating a risk of disability pension.ConclusionBoth occasional and persistent FAs should be identified in primary care units caring for working-age patients. As frequent attendance is associated with long sickness absences and possibly disability pensions, rehabilitation should be directed at this group to prevent work disability.

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Sociodemographic characteristics and disability pensions of frequent attenders in occupational health primary care – a follow-up study in Finland

BMC Public Health ◽

10.1186/s12889-021-11873-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tiia Reho ◽

Salla Atkins ◽

Mikko Korhonen ◽

Anna Siukola ◽

Markku Sumanen ◽

...

Keyword(s):

Primary Care ◽

Occupational Health ◽

Medical Record ◽

Work Disability ◽

Service Use ◽

Sociodemographic Factors ◽

Medical Record Data ◽

Frequent Attenders ◽

Frequent Attendance ◽

Record Data

Abstract Background Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors. Methods This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors. Results In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time. Conclusions Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.

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Frequent attenders in occupational health primary care: A cross-sectional study

Scandinavian Journal of Public Health ◽

10.1177/1403494818777436 ◽

2018 ◽

Vol 47 (1) ◽

pp. 28-36 ◽

Cited By ~ 7

Author(s):

Tiia T.M. Reho ◽

Salla A. Atkins ◽

Nina Talola ◽

Mervi Viljamaa ◽

Markku P.T. Sumanen ◽

...

Keyword(s):

Primary Care ◽

Occupational Health ◽

Musculoskeletal System ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Frequent Attenders ◽

Frequent Attendance ◽

Mental And Behavioral Disorders

Aims: This study characterizes frequent attenders in primary care provided by occupational health services (OHS) in Finland. Methods: This is a nationwide cross-sectional study using medical record data from an OHS provider in 2015. Frequent attenders were defined as persons who were within the top decile of annual visits to healthcare professionals (frequent attender 10%, FA10) at any of the OHS’s 37 stations. FA10s within this study consulted the OHS primary care unit eight or more times during 2015. We used logistic regression to analyse factors associated with frequent attendance in OHS primary care. The independent variables were age, gender, employer size and industry, health professionals visited and diagnoses given during visits to the OHS. The dependent variable was belonging to the FA10 group. Results: Altogether 31,960 patients met the inclusion criteria and were included in the study. The FA10 group included 3617 patients, who conducted 36% of visits to healthcare professionals. The findings indicate that working within the manufacturing industry, health and social services, or public administration, and being employed in medium or large companies, are associated with frequent attendance. Frequent attendance was also associated with being female, diagnoses of the musculoskeletal system, or mental and behavioral disorders. In particular, depressive episodes and anxiety were associated with FA10s. Conclusions:This research characterized FA10 clients at a Finnish OHS. Illnesses of the musculoskeletal system and mental and behavioral disorders were accentuated among FA10s. The stability of the FA10 group, along with their sickness absences and work disabilities, should be investigated further.

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Assessing factors for choosing a primary care specialty in medical students; A longitudinal study

Medical Education Online ◽

10.1080/10872981.2021.1890901 ◽

2021 ◽

Vol 26 (1) ◽

pp. 1890901

Author(s):

Corry McDonald ◽

Austin Henderson ◽

Patrick Barlow ◽

Jerrod Keith

Keyword(s):

Primary Care ◽

Longitudinal Study ◽

Medical Students ◽

Primary Care Specialty

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Utilization of Pap testing among women living with HIV enrolled in primary care in Baltimore, Maryland: A 10-year longitudinal study, 2005–2014

Papillomavirus Research ◽

10.1016/j.pvr.2018.10.002 ◽

2018 ◽

Vol 6 ◽

pp. 52-57

Author(s):

Sally Peprah ◽

Jenell S. Coleman ◽

Anne F. Rositch ◽

Christopher J. Vanden Bussche ◽

Richard Moore ◽

...

Keyword(s):

Primary Care ◽

Longitudinal Study ◽

Pap Testing ◽

Women Living With Hiv ◽

Living With Hiv

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A short-term intervention in a multidisciplinary referral clinic for primary care frequent attenders: description of the model, patient characteristics and their use of medical resources

Family Practice ◽

10.1093/fampra/19.3.251 ◽

2002 ◽

Vol 19 (3) ◽

pp. 251-256 ◽

Cited By ~ 32

Author(s):

A. Matalon

Keyword(s):

Primary Care ◽

Patient Characteristics ◽

Short Term ◽

Medical Resources ◽

Frequent Attenders

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Is continuity of primary care declining in England? Practice-level longitudinal study, 2012-2017

British Journal of General Practice ◽

10.3399/bjgp.2020.0935 ◽

2020 ◽

pp. BJGP.2020.0935

Author(s):

Peter Tammes ◽

Richard Morris ◽

Mairead Murphy ◽

Chris Salisbury

Keyword(s):

Primary Care ◽

Longitudinal Study ◽

Continuity Of Care ◽

Multilevel Modelling ◽

Population Characteristics ◽

Urban Location ◽

Practice Level ◽

Level Data ◽

Appointment System ◽

Over Time

Background: Continuity of care is a core principle of primary care and related to improved patient outcomes and reduced healthcare costs. Evidence suggests continuity of care is declining. Aim: (i) to confirm reports of declining continuity of care, (ii) to explore differences in decline according to practice characteristics, (iii) to examine associations between practice populations or appointment provision and changes in continuity of care. Design and Setting: Longitudinal study of aggregated practice-level data from repeated questions in GP-Patient surveys between 2012-2017 on having a preferred GP, seeing this GP always/often (usually), appointment system and practice population characteristics, linked to rural/urban location and deprivation. Method: Multilevel modelling; time (level-1) and practices (level-2). Results: 56.7% of patients had a preferred GP in 2012, declining by 9.4%-points (95%CI -9.6 to -9.2) by 2017. 66.4% of patients with a preferred GP saw this GP usually in 2012, which declined by 9.7%-points (95%CI -10.0 to -9.4) by 2017. This decline was visible in all types of practices, irrespective of baseline continuity, rural/urban location, or deprivation. At practice-level, an increase over time in the percentage of patients reporting good overall experience of making appointments was associated with an increase in both the percentage of patients having a preferred GP, and the percentage of patients being able to see that GP usually. Conclusion: Patients reported a steady decline in continuity of care over time, which should concern clinicians and policymakers. The ability of practices to offer patients a satisfactorily working appointment system could partly counteract this decline.

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