Management of unexplained: poly-consultation and hyperfrequency on Primary Health Chilean Attention. A qualitative and exploratory study

Abstract

Background: In Europe, Latin-America, and Asia, poly-consultation has become a complex problem for managing different healthcare systems. However, in the current literature, little attention has been paid to exploring territorial and critical analysis perspectives to manage unexplained symptoms. The purpose of this study is to analyze the socio-structural elements that underlie the users’ phenomenon of poly-consultation or hyperfrequency in the Chilean primary healthcare system (PHCS). Methods: This paper represents qualitative data collected as part of an exploratory study that used mixed methods across three metropolitan areas of Santiago, Valparaíso, and Concepción, Chile. The study involved a sample of 24 subjects from administrative and management positions in PHC who were recruited from Family Health Care Centers, considering urban municipalities from the low, medium, and high stratum. The study collected data using one set of semi-standardized interviews during a year—data analysis using qualitative content analysis. Results: This article shows that poly-consultant patients provide a critical clinic category to management that cannot be cover by current biomedical models. Data showed the strain of a somatoform category, especially in the clinic and epistemological exercise. Precisely, the relevance of Chile’s case, a mixed health system, and their effects: the naturalization of collective problems managed as individual problems. Conclusions: The study results can inform healthcare professionals and managers of developing practical and territorially based. We conclude that hyperfrequency and poly-consultation in Chile reveal relevant stratification in the territory. Those particularities open an opportunity to study quantitative methods, including current analysis categories, to develop new research.