© 1992 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
research-article |
Non-consulters and high consulters in general practice: cardio-respiratory health and risk factors
Joan K. Morris, Research Statistician
Derek G. Cook, Senior Lecturer in Medical Statistics
Mary Walker, Research Administrator
A. Gerald Shaper, Professor of Clinical Epidemiology
Department of Public Health and Primary Care, Royal Free Hospital School of Medicine London NW3 2PF
Address correspondence to Dr D. G. Cook
The 1990 General Practitioner contract requires that health promotion and illness prevention services should be provided to all patients aged 16–74 years. Consultation rates over a period of three years were examined in 7010 middleaged men in Great Britain to compare the cardio-respiratory health and risk factor status of non-consulters (men who did not consult in three years) with those of average consulters (men who consulted 3–5 times in three years) and high consulters (men who consulted 24 or more times in three years) to assess their relative need for health promotion and illness prevention services. The non-consulters (n=1025) were remarkably similar to the average consulters (n=1585) in health and lifestyle characteristics. The high consulters (n=306) had a greater burden of ill-health and a less healthy lifestyle. Chest pain on exertion, chronic bronchitis, breathlessness or wheeze were present in 23 per cent of non-consulters, 27 per cent of average consulters and over 50 per cent of high consulters. Similarly, 48 per cent of the non-consulters smoked, drank heavily or were obese compared with 47 per cent of the average consulters and 61 per cent of the high consulters. The prevalence of recall of high blood pressure which had been diagnosed by a doctor rose from 6 per cent in non-consulters and 10 per cent in average consulters to 29 per cent in high consulters. The percentage of men who had high blood pressure as measured at our examination but did not recall a diagnosis of high blood pressure was similar in all the consulting groups. In this population of middle-aged men the cardio-respiratory health and risk factor status of the non-consulters was similar to that of the average consulters. The high consulters had the greatest need of effective health promotion and illness prevention. The similar prevalence of undetected high blood pressure amongst all the consultation rate groups is of concern.