ArticleAnnals of family medicine
Predicting persistently high primary care use.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 42 citations in OpenAlex.
- Perinatal outcomes of frequent attendance in midwifery care in the Netherlands: a retrospective cohort study.BMC pregnancy and childbirth · 2020Article
- Integrating clinical medicine and population health: where to from here?Canadian journal of public health = Revue canadienne de sante publique · 2019Article
- Article
- Characteristics of Elderly Frequent Attendees in Slovene Family Medicine Practices - a Cross-sectional Study.Materia socio-medica · 2019Article
- Clinical Population Medicine: Integrating Clinical Medicine and Population Health in Practice.Annals of family medicine · 2017Article
- Variation in the Types of Providers Participating in Breast Cancer Follow-Up Care: A SEER-Medicare Analysis.Annals of surgical oncology · 2017Article
- Impact of Patient Aligned Care Team Interprofessional Care Updates on Metabolic Parameters.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2016Article
- Diagnosis isn't enough: Understanding the connections between high health care utilization, chronic conditions and disabilities among U.S. working age adults.Disability and health journal · 2015Article
- Neighbourhood immigration, health care utilization and outcomes in patients with diabetes living in the Montreal metropolitan area (Canada): a population health perspective.BMC health services research · 2015Article
- Characteristics of Newly Enrolled Members of an Integrated Delivery System after the Affordable Care Act.The Permanente journal · 2015Article
- Using self-reported health measures to predict high-need cases among Medicaid-eligible adults.Health services research · 2014Article
- High-cost health care users in Ontario, Canada: demographic, socio-economic, and health status characteristics.BMC health services research · 2014Article
- Primary care utilization and mental health diagnoses among adult patients requiring interpreters: a retrospective cohort study.Journal of general internal medicine · 2013Article
- Association between Cognitive Decline in Older Adults and Use of Primary Care Physician Services in Pennsylvania.Journal of primary care & community health · 2012Article
- The MMPI-2: a contemporary normative study of midwestern family medicine outpatients.Journal of clinical psychology in medical settings · 2008Article
- Patient-reported care coordination: associations with primary care continuity and specialty care use.Annals of family medicineArticle
- Impact of spiritual symptoms and their interactions on health services and life satisfaction.Annals of family medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe wanted to identify risk factors for persistently high use of primary care.
methodsWe analyzed outpatient office visits to practitioners in family medicine, general internal medicine, general pediatrics, and obstetrics for 1997-1999 among patients in a small Midwestern city covered by a fee-for-service insurance plan with no co-payments for physician visits and no requirement for referral to specialty care. Logistic regression was used to predict which patients with 10 or more primary care visits in 1997 would repeat high use in 1998 based on demographic and diagnostic categories (adjusted clinical groups [ACGs]). A confirmatory data set (high primary care use in 1998 persistent into 1999) was used to evaluate the model.
resultsTwo percent of the 54,074 patients had 10 or more primary care visits in 1997, and of these, almost 19% had 10 or more visits in the next year. Among adults, 4 ambulatory diagnosis groups (ADGs) were simultaneously positive predictors of repeated high primary care visits: unstable chronic medical conditions, see and reassure conditions, minor time-limited psychosocial conditions, and minor signs and symptoms. Meanwhile, pregnancy was negatively associated. The area under the receiver operating characteristic (ROC) curve was 0.794 for adults in the developmental data set and 0.752 in the confirmatory data set, indicating a moderately accurate assessment. A satisfactory model was not developed for pediatric patients.
conclusionsMany persistently high primary care users appear to be overserviced but underserved, with underlying problems not addressed by a medical approach. Some may benefit from psychosocial support, whereas others may be good candidates for disease management interventions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.