Differentiating middle‐aged long‐term and short‐term frequent attenders by means of the Northern Finland Birth Cohort 1966 Study

• Published in: Scandinavian Journal of Caring Sciences
• Main Authors: Huhtakangas, Moona, Kyngäs, Helvi, Bloigu, Risto, Kanste, Outi
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2020
• Subjects: Public Health, Environmental and Occupational Health; Northern Finland
• Online Access: http://dx.doi.org/10.1111/scs.12896; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fscs.12896; https://onlinelibrary.wiley.com/doi/pdf/10.1111/scs.12896; https://onlinelibrary.wiley.com/doi/full-xml/10.1111/scs.12896

Background Frequent attendance is largely a temporary phenomenon, but only few previous studies have made a distinction between long‐term frequent attenders (FAs) and short‐term FAs. Aims The aim of this study is to compare the characteristics of middle‐aged long‐term FAs and short‐term FAs. Methods Data from a large Northern Finland Birth Cohort 1966 studyʼs (NFBC1966) 46‐year follow‐up study (performed in 2012, N = 10 321) were used. The participants (n = 4390) had used public primary healthcare (PPHC) services at least once during 2013–2016 according to Finnish national register data on outpatient visits. A FA was considered a patient who had used PPHC services ≥8 times during 1 year. A long‐term FA: a patient who was a FA in at least 3 years during 2013–2016. A short‐term FA: a patient who was a FA in 1 or 2 years in 2013–2016. Cross‐tabulation, Pearson’s chi‐squared test, Mann–Whitney U test, and univariate and multivariate binary logistic regression analyses were used. Results Of the 4390 participants, 132 (3.0%) were long‐term FAs, 645 (14.7%) were short‐term FAs, and 3613 (82.3%) were non‐FAs. During 2013–2016, long‐term FAs accounted for 34.8% of PPHC visits, while short‐term FAs accounted 15.4%. Compared to short‐term FAs, depression and high income (preventive attribute) were associated with long‐term FAs. Female gender and managing usual activities were associated with short‐term FAs. Poor self‐reported health was associated with both long‐term FAs and short‐term FAs but increased the risk of being a long‐term FA over three times compared to short‐term FAs. Conclusions Middle‐aged long‐term FAs and short‐term FAs have distinct characteristics; namely, depression and high income differentiate long‐term FAs from short‐term FAs. Poor self‐reported health was associated with long‐term FAs in particular. In order to identify FAs with prolonged service needs and to develop far‐reaching interventions, the focus of research should be on long‐term FAs.