Frequent attenders in primary health care:a cross-sectional study of frequent attenders’ psychosocial and family factors, chronic diseases and reasons for encounter in a Finnish health centre
Bibliographic record
Abstract
The aim of this cross-sectional controlled study was to determine frequent attenders' chronic diseases and their reasons for encounter in primary health care.Furthermore, the study aimed to determine the associations of social, psychological and family factors with frequent attendance in a Finnish health centre.Patients who made eight or more annual visits to physicians in the health centre during one year were defined as frequent attenders (FA).All the FAs during 1994 (N = 304) and 304 randomly selected age-and sex-matched controls constituted the study population.The data were collected from annual statistics, medical records and postal questionnaires.Over one third of the study population was interviewed.International Classification of Primary Care (ICPC) was used to determine the reasons for encounter and Symptom Checklist -36 (SCL-36) to assess the psychological distress.Toronto Alexithymia Scale -20 (TAS-20) was used as a measure of alexithymia and Whiteley Index (WI) to determine hypochondriacal beliefs.The results showed that 4.7% of the whole population aged 15 years or older in Oulainen were FAs.They accounted for 23.5% of all visits made within the respective age group.The mean age of the FAs was 49.8 years.Over two thirds of them were female.The FAs had lower basic education and occupational status than the controls.The FAs visited physicians in the health centre mostly for reasons related to the musculoskeletal, respiratory and digestive systems.There appeared to be more chronic diseases among the FAs than among the controls.The FAs had over three times more mental disorders than the controls.The interviewed FAs had significantly more psychological distress, somatization and hypochondriacal beliefs than the controls.The risk of frequent attendance was higher in the older family life cycle phases than in the younger family life cycle phases.Multivariate analyses showed chronic somatic disease and hypochondriacal beliefs to be risk factors for frequent attendance.Concurrence of somatization and hypochondriacal beliefs increased the risk to be a FA.As a conclusion, the results emphasize the need to consider the FAs' own bodily concerns expressed as hypochondriacal beliefs when managing them.Furthermore, the study implicates a need to integrate the biomedical, psychological and social dimensions in the care of FAs in primary health care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".