Social Isolation Predicts Frequent Attendance in Primary Care
Open accessAbstract
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.
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Traditional medical management of people with long-term conditions does not tackle their social needs, leading to repeat primary care appointments and unnecessary admissions to secondary care.
“However, the traditional medical management of people with LTCs does not tackle their social needs leading to repeat primary care appointments and unnecessary admissions to secondary care.5”
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Self-citation
- Authors
- Cruwys, T., Wakefield, J. R. H., Sani, F., Dingle, G. A., & Jetten, J.
- Affiliations
- The University of Queensland (AU)
- Nottingham Trent University (GB)
- University of Dundee (GB)
- Corresponding author
- Cruwys, Tegan
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-02-03
- Volume
- 52
- Issue
- 10
- Pages
- 817-829
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- OpenAlex
- W2769006414
- Cited by
- 57
- References
- 58
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 10 · 2023: 6 · 2022: 8 · 2021: 10 · 2020: 13 · 2019: 4 · 2018: 1
- FWCI
- 7.47
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (acceptedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion, other-oa)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- Australian Research Council (DE160100592)
- Economic and Social Research Council (ES/I038349/1)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- social isolation, frequent attenders, primary care visits, unmet social needs, social support networks, youth, life transitions, disadvantaged adults, health care utilization
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Community Participation, Cross-Sectional Studies, Female, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Patient Acceptance of Health Care, Primary Health Care, Scotland, Social Isolation, Students, Universities, Young Adult, Social Networking
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