gms | German Medical Science

16. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

4. - 6. Oktober 2017, Berlin

Frequent attenders in late life in primary care – a systematic review

Meeting Abstract

  • Franziska D. Welzel - Universität Leipzig, Medizinische Fakultät, Leipzig, Germany
  • Janine Stein - Universität Leipzig, Medizinische Fakultät, Leipzig, Germany
  • Hans-Helmut König - Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg, Germany
  • André Hajek - Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg, Germany
  • Steffi G. Riedel-Heller - Universität Leipzig, Leipzig, Germany

16. Deutscher Kongress für Versorgungsforschung (DKVF). Berlin, 04.-06.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP073

doi: 10.3205/17dkvf229, urn:nbn:de:0183-17dkvf2297

Veröffentlicht: 26. September 2017

© 2017 Welzel et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Background: General practitioners are among the first contact for a broad range of health problems for most elderly people. However, a small proportion of patients produces a disproportionate amount of their workload by frequently attending primary health care practices. Frequent attenders are patients who consume large amounts of health care resources and present the primary health care setting with a costly phenomenon. While frequent attendance has been broadly studied across age groups, aspects of this utilizing behavior by elderly individuals have not been investigated in detail.

Objectives: The aim of this work is to provide a systematic review of frequent attendance in primary care among elderly people.

Methods: A systematic literature search in 5 databases (PubMed, PsycINFO, Web of Science, PubPsych, Cochrane Library) was conducted in November 2016. Electronic databases were searched for published papers addressing frequent attendance in primary health care among elderly individuals. Quality of studies was assessed using established criteria for evaluating methodical quality.

Results: Ten 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 or subsamples. The criteria for the definition of frequent attendance across studies differed substantially. Most consistent associations of frequent attendance among elderly patients were found for presence and severity of physical illness. Results on mental disorders and frequent attendance were more heterogeneous. Few studies assessed frequent attendance in association with factors such as drug use, social support or sociodemographic aspects and results seem to be more inconsistent.

Discussion: Severe ill health and the need for treatment serve as main drivers for frequent attendance in older adults. However, studies on frequent attendance among elderly primary health care patients were scarce and diversified. Furthermore, inconsistencies in the understanding of what constitutes frequent attendance hampered comparison across studies.

Practical implications: Future studies are needed to provide more information on further mediating aspects of older adults needs for frequent doctor consultations. Longitudinal approaches may be preferable to assessing only a snapshot of this service use behaviour.