Patients lists: a tricky balance

Inês Pinheiro, Sofia Esquível, Hélder Henriques

Background:

A list of users of a family doctor in Portugal entails a certain workload that varies according to multiple factors that force it’s dimension to be weighed by it’s characteristics and the context in which it operates. When this weighted dimension is excessive, there are negative repercussions on the access and quality of the care provided. Moreover, it affects the satisfaction of health professionals and health of the patients.
Currently, patients up to 6 years old or over 65 years old are multiplied by factors to balance the list of users in terms of the weight of their needs/pathologies.
The covid 19 pandemic encouraged users to make contacts via email/telephone more
frequently, a trend that seems to continue after the normalization of face-to-face assistance.
Empirically, a family doctor has the notion that a small number of patients consumes a great percentage of resources/appointments/contacts.

Research questions:

Are really the patients who represent the higher weight in the list the most troublesome?

Method:

Descriptive retrospective study on the top 100 users who made more contacts belonging to a list of users of a GP pratice in Porto, Portugal in 2021.

Results:

The top 100 of frequent users corresponds to 1349 contacts out of 6255 throughout the year, which corresponds to an average of 13.5 contacts for each of these 100 patients. Of these, 65% of patients were aged between 7 and 65 years old.

Conclusions:

According to the results found in the year 2021, more than 50% of the contacts made by the 100 people most frequent are not considered as the age recommended as having more support needs or chronic pathologies.
These contacts include telephone or email contacts, letters, or face-to-face consultations.
Is this the best way to balance patient lists? Aren’t patients with less digital skills disadvantaged in relation to the others?

Points for discussion:

Is this the best way to balance patient lists?

Aren’t patients with less digital skills disadvantaged in relation to the others?