The workload of GPs: patients with psychological and somatic problems compared

Abstract

Background. GPs state that patients with mental problems make heavy demands on their available time. To what extent these perceived problems correspond with reality needs more investigation. Objectives. To investigate the effect of patients with psychological or social diagnoses on GP’s workload, expressed in time investments. Methods. Data were derived of a cross-sectional National Survey in General Practice, conducted in The Netherlands in 2000–2002. For a year, all patient contacts with a representative sample of 104 general practices were registered. Patients diagnosed with one or more diagnoses in ICPC (International Classification of Primary Care) chapter ‘Psychological’ or ‘Social’ (n = 37 189) were compared to patients with only somatic diagnoses (n = 189 731). A subdivision was made in diagnoses depression, anxiety, sleeping disorders, stress problems, problems related to work or partner and ‘other psychological or social problems’. Workload measures are the consultation frequency, number of diagnoses and episodes of illness of the patients involved. Results. Patients in all categories of psychological or social problems had almost twice as many contacts with their general practice as patients with only somatic problems. They received more diagnoses and more episodes of illness were shown. Patients with psychological or social diagnoses also contacted their general practice about their somatic problems more frequently, compared to patients with only somatic problems. Conclusion. Patients with psychological or social problems make heavy demands on the GP’s workload, for the greater part due to the increase in somatic problems presented.