Profiles of high-frequency users of primary care services and associations with depressive anxiety disorders in Cali, Colombia

Abstract

Objectives. To determine the profiles of highly frequent users of primary care services and the associations of these profiles

with depressive anxiety disorders in Cali, Colombia. Materials and Methods. A case-control study, high-frequency cases

were defined as those involving patients with a percentile >75 with regard to the frequency of spontaneous use of outpatient

facilities in the last 12 months; controls were defined as those with a percentile <25. A multiple correspondence analysis

was used to describe patient profiles, and the influences of depression and anxiety on frequent attendance was determined

via logistic regression. Results. Among the 780 participating patients, differences in the profiles among frequent users and

controls were related to predisposing factors such as sex, age, and education, capacity factors such as the time required to visit

the institution and the means of transport used, and need factors such as health perceptions, social support, family function,

and the presence of anxiety or depressive disorders. A depression or anxiety disorder was found to associate positively with

frequent attendance (adjusted odds ratio [aOR]: 1.99, 95% confidence interval [CI]: 1.19–3.31) and a referral system (aOR:

1.61, 95% CI: 1.01–2.76), but negatively with mild or no family dysfunction (aOR: 0.79; 95% CI: 0.48–0.88) after adjusting for

age, sex, ethnicity, and health service-providing institutions. Conclusions. The profiles of high-frequency patients differ from

control patients with respect to factors related to capacity, need, and willingness; in particular, the latter were independently

associated with frequent attendance. Notably, the presence of an anxious or depressive disorder doubled the risk of highfrequency attendance at a primary care facility.