# Rate and Characteristics of Frequent Attenders at Primary Healthcare Centres in Muscat Governorate, Oman: A cross-sectional study

## TL;DR

The study finds that a small percentage of patients in Oman's primary healthcare centers visit very frequently, often due to mental illness and chronic conditions, suggesting a need for targeted interventions.

## Contribution

This study identifies sociodemographic and clinical factors associated with frequent attendance in primary healthcare in Muscat, Oman.

## Key findings

- Frequent attenders constituted 1.1% of patients but accounted for 6.9% of all visits.
- Mental illness was the strongest predictor of frequent attendance.
- 26.2% of frequent attenders persisted in high utilization across two consecutive years.

## Abstract

Frequent attenders (FAs) are patients who use primary healthcare centre (PHC) services at disproportionately high rates which puts a strain on health systems and affects the quality of care. This study aimed to determine the prevalence of FAs in PHCs in Muscat Governorate, Oman, and to identify their demographic, socioeconomic and clinical characteristics.

This cross-sectional study was conducted across 10 randomly selected PHCs in Muscat from January to December 2024. Data were collected retrospectively from electronic medical records for 2023. FAs were defined as individuals with 10 or more visits per year. Descriptive statistics and multivariate Poisson regression were used to identify factors associated with frequent attendance.

A total of 83,749 visits by 41,017 adult patients were analysed. FAs constituted 1.1% of patients (95% confidence interval: 0.95–1.15%) and accounted for 6.9% of all visits. The mean number of visits among FAs was 13.4 ± 5.5 per year, with 8.6% meeting the criteria for extremely frequent attendance (20 or more visits per year). Persistence in frequent attendance was observed in 26.2% of FAs across two consecutive years. FA was significantly associated with being female, unmarried, unemployed, having a low education level, chronic disease (P = 0.002) and mental illness (P <0.001), with mental illness having the strongest effect.

FA in Muscat's PHCs is influenced by medical, behavioural and sociodemographic factors. Early identification of FAs and targeted interventions, such as integrated chronic disease and mental health services, administrative reforms and patient education, are essential to improve care quality and reduce unnecessary utilization.