ArticleBMJ open2021
Consultation patterns and frequent attenders in UK primary care from 2000 to 2019: a retrospective cohort analysis of consultation events across 845 general practices.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Frequent attenders in primary health care in Finland: use of primary care services and patient characteristics.Scandinavian journal of primary health care · 2026Article
- Health and Social Care Professionals' Perspectives of the Desired Interprofessional Collaboration in Frequent Attenders' Person-Centred Care: A Qualitative Study.Scandinavian journal of caring sciences · 2026Article
- Exploring spillover effects following surgical de-implementation: an observational evaluation of primary care, referrals, and time to surgical intervention following reductions in the use of tonsillectomy and Dupuytren's contracture.Implementation science communications · 2026Article
- Predicting multiple long-term conditions with role limitation at age 46 using early-life data from the 1970 British Cohort Study.BMJ public health · 2026Article
- Rate and Characteristics of Frequent Attenders at Primary Healthcare Centres in Muscat Governorate, Oman:Sultan Qaboos University medical journal · 2026Article
- Correcting for the Inflated Adult Population Denominator in an English Nationwide Health Care Cohort: Database Analysis Study.JMIR public health and surveillance · 2025Article
- Tailoring Antibiotic Duration for Respiratory Tract Infections in Primary Care: Protocol for a Pragmatic Randomized Controlled Trial Study (STORM).JMIR research protocols · 2025Article
- Characteristics of patients with frequent contact with general practice: a retrospective study.BJGP open · 2025Article
- Patterns in GP appointment systems: a cluster analysis of 3480 English practices.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Observational
- Continuity and locum use for acute consultations: observational study of subsequent workload.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Observational
- Article
- The global, regional, and national patterns of change in the burden of edentulism, 1990-2021: an analysis of the global burden of disease study 2021 and forecast to 2041.Frontiers in oral health · 2025Article
- Challenges to quality in contemporary, hybrid general practice a multi-site longitudinal case study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Changing patterns of general practice services during a period of public sector investment in Britain.PloS one · 2025Article
- Understanding access to general practice through the lens of candidacy: a critical review of the literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Review
- Trends in clinical workload in UK primary care 2005-2019: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Article
- Reducing patients' rate of frequent attendance through a training intervention for physicians.BMC medical education · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe the distribution of consultations at the practice level and examine whether increases are uniform or driven by people who consult more frequently.
designRetrospective cohort study.
settingUK general practice data from the Clinical Practice Research Datalink (CPRD) GOLD database.
participants1 699 709 314 consultation events from 12 330 545 patients, in 845 general practices (1 April 2000 to 31 March 2019).
methodsConsultation information was aggregated by financial year into: all consultations/all staff; all consultations/general practitioners (GPs); face-to-face consultations/all staff; face-to-face consultations/GPs. Patients with a number of consultations above the 90th centile, within each year, were classified as frequent attenders. Negative binomial regressions examined the association between available practice characteristics and consultation distribution.
resultsAmong frequent attenders, all consultations by GPs increased from a median (25th and 75th centile) of 13 (10 and 16) to 21 (18 and 25) and all consultations by all staff increased from 27 (23-30) to 60 (51-69) over the study period. Approximately four out of ten consultations of any type concerned frequent attenders and the proportion of consultations attributed to them increased over time, particularly for face-to-face consultations with GPs, from a median of 38.0% (35.9%-40.3%) in 2000-2001 to 43.0% (40.6%-46.4%) in 2018-2019. Regression analyses indicated decreasing trends over time for face-to-face consultations and increasing trends for all consultation types, for both GPs and all staff. Frequent attenders consulted approximately five times more than the rest of the practice population, on average, with adjusted incidence rate ratios ranging between 4.992 (95% CI 4.917 to 5.068) for face-to-face consultations with all staff and 5.603 (95% CI 5.560 to 5.647) for all consultations with GPs.
conclusionsFrequent attenders progressively contributed to increased workload in general practices across the UK from 2000 to 2019. Important knowledge gaps remain in terms of the demographic, social and health characteristics of frequent attenders and how UK general practices can be prepared to meet the needs of these patients.
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