The role of patient activation in frequent attendance at primary care: a population-based study of people with chronic disease

Patient Educ Couns. 2011 May;83(2):217-21. doi: 10.1016/j.pec.2010.05.031. Epub 2010 Jul 3.


Objective: This study explores a range of relevant socio-demographic, physical and psychological factors in a unique examination of the risk factors for frequent attendance at primary care. The impact of patient activation for self-management on health service utilisation is of particular interest.

Methods: A population-based sample of people with chronic disease from Queensland, Australia, was interviewed using computer assisted telephone surveying. Data were collected from a random sample of 1470 people with either diabetes or a cardiovascular condition.

Results: As participants became more activated they were less likely to frequently attend their main health care provider for assistance with their chronic condition. For both conditions the association was graduated and for participants with a cardiovascular condition this association remained statistically significant even after controlling for other potentially influential factors such as disease severity, length of time since diagnosis, and psychological distress.

Conclusion: Characteristics of the individual, including patient activation and psychological functioning, as well as disease factors contribute to primary care consulting patterns among people with chronic illness.

Practical implications: Efforts to improve patient activation for self-management should remain a central element of chronic care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Diseases / psychology
  • Chronic Disease
  • Confidence Intervals
  • Cross-Sectional Studies
  • Diabetes Mellitus / psychology
  • Female
  • Health Care Surveys
  • Health Services / statistics & numerical data*
  • Humans
  • Interview, Psychological
  • Life Style
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Satisfaction*
  • Primary Health Care / methods*
  • Psychometrics
  • Queensland
  • Risk Factors
  • Self Care / methods
  • Telephone
  • Young Adult