Primary Care utilisation in different patients’ profiles: findings from a Spanish population-based cohort with cardiovascular risk factors.

Abstract

Abstract Background Chronic patients with higher complexity are those with the greatest need for care and to whom, foreseeably, more health care should be provided, especially at the Primary Care level. This study aimed to identify profiles of patients with cardiovascular disease (CVD) risk factors, based on their sociodemographic and clinical characteristics, and to analyse how their complexity is related to their frequency of visits in Primary Care. Methods Observational longitudinal study conducted in the CArdiovascular Risk factors for HEalth Services research (CARhES) cohort. Individuals older than 15, resident in Aragón (Spain), with hypertension, type 2 diabetes mellitus (DM) and/or dyslipidaemia in 2017 were selected and followed-up until 2021. Secondary use of data from health system provided sociodemographic, clinical and healthcare services utilisation information. Cluster analyses were performed to identify patients’ profiles according to age, sex and morbidity burden. Characteristics and annual visits in Primary Care in the different profiles were described. Panel data models were applied to study the variability of the frequency of visits to both physicians and nurses in Primary Care in the profiles across different time points. Results In this population-based cohort of 436,601 individuals, different profiles were identified among those with hypertension, type 2 DM and/or dyslipidaemia. Profiles comprising the elderly and the women, up to the age of 80 years, showed the greatest morbidity burden. This higher complexity was associated with higher frequency of Primary Care visits, regardless of the patient’s socioeconomic level and depopulation level of his/her Basic Health Area. Conclusions Women and the elderly comprised the profiles with the greatest morbidity burden and the higher Primary Care attendance. Tailoring care and resources according to the complexity profile is essential to ensure that the patient receives the best possible care based on their needs.