Your browser doesn't support javascript.
Consultation patterns and frequent attenders in UK primary care from 2000 to 2019: a retrospective cohort analysis of consultation events across 845 general practices.
Kontopantelis, Evangelos; Panagioti, Maria; Farragher, Tracey; Munford, Luke A; Parisi, Rosa; Planner, Claire; Spooner, Sharon; Tse, Alice; Ashcroft, Darren M; Esmail, Aneez.
  • Kontopantelis E; Division of Informatics, Imaging and Data Science, The University of Manchester, Manchester, UK e.kontopantelis@manchester.ac.uk.
  • Panagioti M; National Institute for Health Research (NIHR) School for Primary Care Research, Oxford, UK.
  • Farragher T; Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK.
  • Munford LA; NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.
  • Parisi R; Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK.
  • Planner C; Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK.
  • Spooner S; Division of Informatics, Imaging and Data Science, The University of Manchester, Manchester, UK.
  • Tse A; National Institute for Health Research (NIHR) School for Primary Care Research, Oxford, UK.
  • Ashcroft DM; National Institute for Health Research (NIHR) School for Primary Care Research, Oxford, UK.
  • Esmail A; Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK.
BMJ Open ; 11(12): e054666, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1594963
ABSTRACT

OBJECTIVE:

To describe the distribution of consultations at the practice level and examine whether increases are uniform or driven by people who consult more frequently.

DESIGN:

Retrospective cohort study.

SETTING:

UK general practice data from the Clinical Practice Research Datalink (CPRD) GOLD database.

PARTICIPANTS:

1 699 709 314 consultation events from 12 330 545 patients, in 845 general practices (1 April 2000 to 31 March 2019).

METHODS:

Consultation information was aggregated by financial year into all consultations/all staff; all consultations/general practitioners (GPs); face-to-face consultations/all staff; face-to-face consultations/GPs. Patients with a number of consultations above the 90th centile, within each year, were classified as frequent attenders. Negative binomial regressions examined the association between available practice characteristics and consultation distribution.

RESULTS:

Among frequent attenders, all consultations by GPs increased from a median (25th and 75th centile) of 13 (10 and 16) to 21 (18 and 25) and all consultations by all staff increased from 27 (23-30) to 60 (51-69) over the study period. Approximately four out of ten consultations of any type concerned frequent attenders and the proportion of consultations attributed to them increased over time, particularly for face-to-face consultations with GPs, from a median of 38.0% (35.9%-40.3%) in 2000-2001 to 43.0% (40.6%-46.4%) in 2018-2019. Regression analyses indicated decreasing trends over time for face-to-face consultations and increasing trends for all consultation types, for both GPs and all staff. Frequent attenders consulted approximately five times more than the rest of the practice population, on average, with adjusted incidence rate ratios ranging between 4.992 (95% CI 4.917 to 5.068) for face-to-face consultations with all staff and 5.603 (95% CI 5.560 to 5.647) for all consultations with GPs.

CONCLUSIONS:

Frequent attenders progressively contributed to increased workload in general practices across the UK from 2000 to 2019. Important knowledge gaps remain in terms of the demographic, social and health characteristics of frequent attenders and how UK general practices can be prepared to meet the needs of these patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: General Practice Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-054666

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: General Practice Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-054666