Change in frequency of patient requests for diagnostic screening and interventions during primary care encounters from 1985 to 2014

Abstract

Background. The reason why patients contact a care provider, the reason for encounter (RFE), reflects patients’ personal needs and expectations regarding medical care. RFEs can be symptoms or complaints, but can also be requests for diagnostic or therapeutic interventions. Objectives. Over the past 30 years, we aim to analyse the frequency with which patients consult a GP to request an intervention, and to analyse the impact of these requests on the subsequent diagnostic process. Methods. We included all patients with a request for diagnostics, medication prescription or referral from 1985 to 2014.We analysed the number of requests, granted requests and interventions originating from a request. We compared the final diagnosis (symptom or disease diagnosis) between patients with and without a request. Design and Setting. This is a retrospective cohort study with data from Family Medicine Network, a Dutch primary healthcare registration network. Results. Over time, patients more often present to their GP with a request for intervention. GPs are increasingly compliant with these requests. Patients presenting with a request for intervention are more likely to be diagnosed with a symptom rather than a disease. Conclusion. This study provides insight into the changes in patients’ and GPs’ behaviour and patients’ influence on the medical process, and confirms the clinical relevance of the RFE. This study could support GPs in daily practice when deciding whether or not to grant a request.