Data from: Is frequent attendance of longer duration related to less transient episodes of care? A retrospective analysis of transient and chronic episodes of care

Objectives
Frequent attenders (FAs) suffer from more and consult general practitioners (GP) more often for chronic physical and psychiatric illnesses, social difficulties and distress than non-FAs. However, it is unclear to what extent FAs present transient episodes of care (TECs) compared to non-FAs.
Design
Retrospective analysis of all episodes of care (ECs) in 15,116 consultations in one year. Reasons for encounter (RFEs) linked to patients’ problem lists were defined as chronic episodes of care (CEC), other episodes as TECs.
Setting
One Dutch urban primary healthcare centre served by five GPs.
Participants
All 5,712 adult patients enlisted 2007-2009. FAs were patients whose attendance rate ranked within the top decile of their sex and age group in at least one of the years 2007 to 2009.
Outcome measures
Number of RFEs linked to TECs/CECs for non-FAs and 1-, 2- and 3-year FAs, and the adjusted effect of frequent attendance of different duration on the number of TECs.
Results
The average number of RFEs linked to TECs (non-FAs 1.4; 3yFAs 7.3) and to CECs (non-FAs 0.9; 3yFAs 6.2) increased substantially with the duration of frequent attendance. The ratio of TECs to all ECs differed little for FAs (52-54%) and non-FAs (64%). Compared with non-FAs, the adjusted additional number of TECs was 3.4 (95%CI 3.2-3.7, 1yFAs), 6.6 (95%CI 6.1-7.0, 2yFAs) and 9.4 (95%CI 8.8-10.1, 3yFAs).
Conclusion
FAs present more TECs and CECs with longer duration of frequent attendance. The constant ratio of TECs might be a sign of a low threshold for FAs to consult their GP. The large numbers of TECs in FAs might be associated with their high level of anxiety and low mastery. The consultation pattern of FAs may best be characterized by describing both TECs and CECs.