Abstract
BackgroundHigh utilization of health care services is a costly phenomenon commonly observed in primary care practices. However, while frequent attendance in primary care has been broadly studied across age groups, aspects of high utilization by elderly patients have not been investigated in detail. The aim of this paper is to provide a systematic review of frequent attendance in primary care among elderly people.MethodsWe searched five databases (PubMed, PsycINFO, Web of Science, PubPsych, and Cochrane Library) for published papers addressing frequent attendance in primary health care among elderly individuals. Quality of studies was assessed using established criteria for evaluating methodological quality.ResultsTen studies met inclusion criteria and were included for detailed analysis. The average number of patients frequently utilizing primary care services varied across studies from 10% to 33% of the elderly samples and subsamples. The definition of frequent attendance across studies differed substantially. The most consistent associations between frequent attendance and old age were found for presence and severity of physical illness. Results on mental disorders and frequent attendance were heterogeneous. Only a few studies have assessed frequent attendance in association with factors such as drug use, social support or sociodemographic aspects; however results were inconsistent.ConclusionsSevere ill health and the need for treatment serve as the main drivers of frequent attendance in older adults. As results were scarce and divergent, future studies are needed to provide more information on this topic. Since prior studies have offered only a snapshot of this service use behaviour, a longitudinal approach would be preferable in the future.
Highlights
High utilization of health care services is a costly phenomenon commonly observed in primary care practices
Selection criteria Abstracts were screened using the following selection criteria: (i) published studies in the primary care/general practice settings, (ii) patient recruitment in primary care/general practice, (iii) study samples consisting of patients aged 65 years and older, (iv) studies focused on frequent attendance, (v) measurement of frequency by number of contacts with general practice, (vi) studies providing an explicit definition of frequent attendance, (vii) studies conducted in Europe
Previous literature on FAs in primary care has consistently shown that the presence of poor health and somatic diseases, chronic diseases, are significantly more prevalent among FAs than non-FAs [19,20,21,22, 53]. In line with those findings, the results of this review show that frequent attendance by the elderly is strongly associated with ill health and reflects the actual and justifiable needs of older primary care patients for frequent doctor consultations
Summary
High utilization of health care services is a costly phenomenon commonly observed in primary care practices. While frequent attendance in primary care has been broadly studied across age groups, aspects of high utilization by elderly patients have not been investigated in detail. FAs are patients who Across countries and differing definitions of frequent attendance, elderly people are overrepresented among this group of primary care utilizers [13,14,15,16]. High utilization of primary health care services among the elderly will have considerable consequences in terms of expenditure and costs for health care resources [7, 18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
