Infrequent attendance in general practice after a major disaster: a problem? A longitudinal study using medical records and self-reported distress and functioning.

G. Donker, P.G. van der Velden, J. Kerssens, C.J. Yzermans

Research output: Contribution to journalArticleScientificpeer-review


Objective. To assess the characteristics and implications for care of infrequent attendance in
general practice in the aftermath of disaster.
Methods. A study of the content of electronic medical records (EMRs) in pre- and post-disaster
periods linked to an enquiry using self-reported questionnaires administered 3 weeks and
18monthspost-disaster.Thedisaster (explosionof a fireworkdepot in Enschede,The Netherlands)
caused 23 deaths, about 1000 people injured and 1200 people who had to relocate. Sample included
survivors (N = 922) who participated in two surveys and whose data could be linked to
EMRs of GPs. A comparison of reported morbidity in ‘infrequent’ (a maximum of three times
in men and four times in women in the first two post-disaster years) and ‘more frequent attenders’
(frequency determined post-disaster) in general practice examined in relation to health status
(measured by diagnoses in EMRs, symptom checklist and quality of life instrument) was the
main outcome measure.
Results. Infrequent attenders reported approximately three times as few contacts as more frequent
attenders in the pre-disaster year (P < 0.001). Multivariate logistic regression analyses revealed
that infrequent attenders were likely to be younger, less depressed, have better subjective
health and physical functioning and exhibited more hostile behaviour (measured by questionnaire).
Infrequent attenders were less often personally bereaved by the disaster, but more often
relocated, and had a lower prevalence of psychological problems pre- and post-disaster although
this increased stronger (by 10-fold).
Conclusions. Both groups showed the same type of psychological problems post-disaster, but
differed in the frequency of contacting the GP.
Original languageEnglish
Pages (from-to)92-97
Number of pages5
JournalBMC Family Practice
Publication statusPublished - 2008


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