The association between daytime attendance and out-of-hours frequent attendance among adult patients in general practice

Background: Frequent attenders (FAs) account for a large proportion of dayt ime consultations in general practice. However, no studies have so far been conducted to establish whether daytime FAs are also out-of-hours FAs. Aim: To analyse the association between daytime attendance and out-of-hours frequent attendance. Design of study: A registry-based study of individual face-to-face contacts with general practice during daytime and out of hours, based on National H ealth Insurance files. Setting: General practices in Aarhus County, Denmark (630 000 inhabitants) Method: A total of 416 172 adults, i.e. all adults registered with a genera l practice during a 12-month period from November 1997 to October 1998 were included. Odds ratios (OR) for frequent attendance out of hours were strat ified for age, sex, and frequency of contacts during daytime were calculate d. Results: A strong association was observed between daytime level of attenda nce and out-of-hours level of attendance (OR = 2.9-6.3 among patients with low daytime attendance, OR = 33.7-99.8 among daytime FAs). Daytime FAs acco unted for one-third of the daytime contacts, one-third of the out-of-hours contacts, and 42% of out-of-hours FAs. More than half of the daytime FAs di d not attend out of hours. Two per cent of the out-of-hours FAs had no cont acts during the daytime. Conclusion. Frequent attendance in daytime was very strongly associated wit h frequent attendance out of hours, and daytime FAs accounted for a large p roportion of all contacts with general practice.