1322: Contact urgency of frequent attenders in primary care out-of-hours services

Conference: 
Author(s): 
K. Hek, M. Zwaanswijk, R.A. Verheij
Primary Care, NIVEL, Utrecht, Netherlands
Text: 
Objective: Frequent attenders (FAs) of primary care out-of-hours services account for approximately one-fifth of all out-of-hour consultations. It is sometimes suggested that FAs excessively use services for health problems that do not require immediate help. To test this hypothesis, we compared contact urgency between FAs and non-frequent attenders (NFAs) and explored whether urgency of FA contacts varied between out-of-hours services.
Methods: Data (including patient age, gender, and contact urgency labels) were extracted from electronic medical records kept by 9 out-of-hours services (36 locations) in the Netherlands, servicing a population of 4 million inhabitants, 650,000 of whom contacted the out-of-hours service at least once in 2011. Patients with >2 consultations were regarded as Fas.
Results: Preliminary analyses showed that 9.7% of patients were FAs (range for the 9 services: 7.9-11.4%). They accounted for 28% of the contacts (23.3-31.8%). The frequency of highly urgent contacts for FAs (11.1%) was higher than for NFAs (8.3%). Eighteen percent of the FAs only had non-urgent contacts for their health problems (5.3-45.6%). The group of FAs who had only non-urgent contacts was younger and comprised more females than FAs who had also urgent contacts.
Conclusions: Although FAs had a higher frequency of highly urgent contacts than NFAs, a significant portion of FAs repeatedly consulted out-of-hours services for health problems that did not require immediate help. Numbers varied greatly between services. Reasons for this variation (e.g. collaboration with hospital emergency departments) will be explored and discussed.

Disclosure: No conflict of interest declared