‘Veelkomers’ bij de huisarts: factoren bij zowel arts als patient

Neal RD, Heywood PL, Morley S. Frequent attenders' consulting patterns with general practitioners. Br J Gen Pract 2000 Dec;50(461):972-6.

Ondanks de groeiende hoeveelheid literatuur over de veelkomers, is er weinig bekend over de consultpatronen van veelkomers bij verschillende artsen. Voor het ontwikkelen van passende maatregelen en strategieën ter verbetering van de klinische zorg van veelkomers is een volledig begrip van deze consultpatronen essentieel. DOEL: Deze paper heeft drie doelstellingen: te bepalen of veelkomers meer met sommige artsen raadplegen dan andere artsen, om te bepalen hoe veel verschillende artsen veelkomers raadplegen, en om te bepalen of de zorg bij veelkomers een grotere continuïteit vertoont dan de zorg van niet-veelkomers.

BACKGROUND: Despite the growing literature on frequent attendance, little is known about the consulting patterns of frequent attenders with different doctors. To develop appropriate intervention strategies and to improve the clinical care of frequent attenders, a full understanding of these consulting patterns is essential. AIMS: This paper has three aims: to determine whether frequent attenders consult more with some doctors than others; to determine how many different doctors frequent attenders consult with; and to determine whether frequent attenders exhibit greater continuity of care than non-frequent attenders. METHOD: Analysis of a validated dataset of 592,028 consultations made by 61,055 patients from four practices over 41 months. Comparisons between the consulting patterns of the frequent attenders, defined as the most frequently consulting 3% of the population by practice, with non-frequent attenders and the overall practice populations. RESULTS: There was considerable variation in the numbers and proportions of consultations with frequent attenders between individual doctors. Most of the frequent attenders consulted with most or all of the doctors within practices over the timeframe. Frequent attenders exhibited more continuity of care than non-frequent attenders. CONCLUSION: The reasons why some doctors have more consultations with frequent attenders is unclear. Some doctors may actively encourage frequent attendance. While many frequent attenders have clear allegiances to one doctor, many also consult widely with a large number of doctors. The consequences of such behaviour are unknown. These findings have important implications in the development of appropriate interventions for reducing problematic frequent attendance

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