Original scientific paper
Chronic Patients – Persons with Diabetes Frequent Attenders in Croatian Family Practice
Marija Vrca Botica
Luka Kovačić
Milica Katić
Hrvoje Tiljak
Ivana Pavlić Renar
Iva Botica
Abstract
Chronic diseases cause high frequency visits and generate the long-term frequent attenders (FAs). The connection between
frequent attendance and specific morbidities in the health care systems in transitional Europe has been underestimated.
We investigated whether frequent visits of chronic patients in primary care are related to characteristic of chronic
disease (diabetes mellitus) and whether this is influenced by the family practice in the transitional health care. We analyzed
the number of visits a day time work for 490 persons with diabetes in the period 1997 to 2000. As the cut-off points
between frequent attenders and non frequent attenders (NFAs) we used the value of the third quartile (Q3) of visits determined
for the sex and age groups in the parallel study in the whole population. The analysis was performed for 23 variables:
demographic characteristics of patients, disease characteristic and variables of physician. Logistic regressions
were employed to identify the predictors of FAs/NFAs. 56.9% (in 1997) to 62.4% (in 2000) persons with diabetes were FAs,
compared to 22.4% to 24.3% FAs patients in the whole population. Logistic regression analysis significantly differentiated
the two grup of visits with 68% accuracy. 4 variables are significant predictors for FAs/NFAs: diabetes as the main
disease (p=0.0005), diet-only-treatment (p=0.0062), treatment by secondary care (p=0.0116), and if glycated hemoglobin
test (HbA1c) is determined (p=0.0272). Understanding the similarities and differences of FAs/NFAs persons with diabetes
may be important in improving the care and management of chronic diseases in family medicine in transitional
health care systems.
Keywords
persons with diabetes; frequent attender; transition family medicine; Croatia
Hrčak ID:
27375
URI
Publication date:
10.4.2007.
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