Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107593

Beatriz Lares, MD, La Clinica de La Raza - Fruitvale Health Project, Inc., 1515 Fruitvale Avenue, Oakland, CA 94601, 510.535.2914, blares@laclinica.org

At La Clínica de La Raza - Fruitvale Health Project, Inc. (La Clínica), a preliminary analysis of patient utilization for the year 2003 revealed that 7% (704/10,233) of patients had ten or more visits per year. A detailed study followed to investigate the possible reasons for over-utilization.

Literature of emergency room utilization and hospitalization rates document that frequent users differ from infrequent users by age, insurance status, prevalence of mental health and chronic disease diagnoses. Studies involving primary care utilization are few.

La Clínica patients were assigned to either the frequent user group for 10 plus visits per year or to non-frequent users group with less than 10 visits per year. A random sample of charts from each group was audited.

Results indicated that: 1) Frequent users have a higher proportion of ten or more chronic disease diagnosis (13% versus 15%), 2) Frequent users have a slightly higher mean continuity of care index (0.56 versus 0.42) and, 3) On average, the percentage of all sick visits accesses through triage was lower in frequent users (40% versus 56%).

Our data demonstrated that frequent users tended to be sicker with respiratory, metabolic, or mental health diseases. Although counter-intuitive, they have more consistent continuity of care with one provider, and had more frequent appointments given for follow-up rather than sporadic urgent same day appointments. Considering the number of chronic medical conditions in this population, utilization was not inappropriate. Strategies such as group visits, may be useful to clinics serving individuals with multiple chronic diseases.

Learning Objectives: "At the conclusion of the session, the participant (learner) in this session will be able to

• Evaluate the process and data information gathering needed for analyzing patient profiles who are considered "frequent users" of health care services."

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.