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

Moona Huhtakangas; Helvi Kyngäs; Risto Bloigu; Outi Kanste

doi:10.1111/scs.12896

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

Scand J Caring Sci. 2021 Sep;35(3):813-823. doi: 10.1111/scs.12896. Epub 2020 Aug 2.

Authors

Moona Huhtakangas¹, Helvi Kyngäs², Risto Bloigu³, Outi Kanste¹

Affiliations

¹ Department of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland.
² Department of Nursing Science and Health Management, Faculty of Medicine, Medical Research Centre, University Hospital of Oulu, University of Oulu, Oulu, Finland.
³ Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland.

PMID: 32740948
DOI: 10.1111/scs.12896

Abstract

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 study's (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.

Keywords: healthcare utilisation; long-term frequent attender; middle-aged; population-based cohort.

MeSH terms

Cohort Studies
Female
Finland
Follow-Up Studies*
Humans
Logistic Models
Middle Aged