Psychological malaise and the sociodemographic and familial characteristics of the over-user of primary care

OBJECTIVES: To find the social, demographic and family characteristics, the psychological malaise and reasons for consultation of normal and hyper-attenders at a primary care practice. DESIGN: Crossover study with a control. SETTING: Primary care. PATIENTS: 127 hyper-attenders (they attended the practice as often as, or more often than, the mean number of visits, stratified by sex and age) and 120 normal attenders chosen by stratified random sampling. INTERVENTIONS: Questionnaire with characterisation data, family demography, psychological malaise (Goldberg general health questionnaire) and reasons for consultation. RESULTS: To be considered a hyper-attender, the number of attendances per year ranged from > or = 8 (in 15 to 44-year olds) to > or = 20 (in men over 65). Hyper-attenders were about 12% of almost all groups, except in men between 45 and 64 and women over 64, in whom it was around 18%. We found no relevant differences between normal and hyper-attenders as to demography or perception of family function. In almost 60% of hyper-attenders and 34% of normal attenders (p < 0.001), psychological malaise was detected. CONCLUSIONS: If the definition of hyper-attenders is stratified by age and sex, their social and demographic characteristics are very different from in other studies, even though there are a similar number of them. However, these demographic and/or family characteristics are similar in normal and hyper-attenders.