Social Isolation Predicts Frequent Attendance in Primary Care

Ann Behav Med. 2018 Sep 13;52(10):817-829. doi: 10.1093/abm/kax054.


Background: Frequent attenders in primary care have complex physical and mental healthcare needs as well as low satisfaction with their health care. Interventions targeting mental health or psychoeducation have not been effective in reducing attendance. Here, we test the proposition that both frequent attendance and poor health are partly explained by unmet social needs (i.e., limited social group support networks).

Methods: Study 1 (N = 1,752) was a large, cross-sectional community sample of primary care attenders in Scotland. Study 2 (N = 79) was a longitudinal study of a group of young people undergoing a life transition (moving countries and commencing university) that increased their risk of frequent attendance. Study 3 (N = 46) was a pre-post intervention study examining whether disadvantaged adults who joined a social group subsequently had reduced frequency of primary care attendance.

Results: All three studies found that low social group connectedness was associated with a higher frequency of primary care attendance. This was not attributable to poorer health among those who were socially isolated. In Study 3, joining a social group led to reduced primary care attendance to the extent that participants experienced a (subjective) increase in their social group connectedness.

Conclusions: Unmet social needs among frequent attenders warrant closer consideration. Interventions that target social group connectedness show promise for reducing overutilization of primary care services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Community Participation / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • Scotland
  • Social Isolation*
  • Social Networking*
  • Students / statistics & numerical data
  • Universities
  • Young Adult