Reattendances in primary care and their association with patient safety events: A cohort study in Spain

Objective

To analyze the frequency of reattendances in PC and their association with adverse events, considering sex-based differences.

Design

A retrospective observational study.

Site

Five primary care centres in the Valencia Region (Spain).

Participants

Patients over 50 years old attended in between 2019 and 2024.

Main measurements

A review of 541 electronic health records of patients was conducted to identify reattendances occurring within 20 days after an index visit Associated AEs were assessed as well.

Results

A total of 2077 reattendances were recorded (0.77 per patient-year), with significantly higher frequency among men (1601 in men vs. 476 in women; P < 0.001). Eighty-five AEs were identified (annual incidence: 3.1; 95% CI: 2.5–3.8), with women experiencing an 18% higher incidence compared to men (OR = 1.18; 95% CI: 1.13–1.24; P < 0.001). No significant sex-based differences were observed in the severity of harm (P = 0.713). Reattendances were associated with AEs (OR = 7.04; P < 0.001), as was cognitive impairment, measured using the Pfeiffer Index (OR = 1.21; P = 0.033). In contrast, low and medium PC utilization were associated with a lower probability of AEs (OR = 0.22 and 0.45; P = 0.003 and 0.043, respectively).

Conclusions

Reattendances in PC are frequent and significantly associated with the occurrence of preventable AEs. Sex-based differences and individual patient factors, such as cognitive status and care utilization patterns, should be considered in patient safety strategies.