第讲IllnessintheCommunityandAProfileofFamilyPractice.pptVIP

The ten most common presenting in females Canadian British Abdominal/pelvic pain Cough Cough Rash Sore throat Sore throat Menstrual disorders Spots, sores, ulcers Colds Abdominal pain Rash Bowel symptoms Depression Back pain Vaginal discharge Chest pain Anxiety Gastric symptoms Headache Headache Diagnoses Diagnostic categories from the ICD and ICHPPC are grouped into clusters that bring together discrete conditions that are clinically related. 367 rubrics of ICHPPC-2 are condensed into a smaller number of clusters suitable for compara-tive analysis. Other Features of General Practice Women consult family physicians more often than males, even after allowing for attendances during pregnancy. The reasons for this difference are not known. Between 70 percent and 80 percent of members of a practice consult at least once a year. The average number of visits per member is between three and five. Ranking order of diagnostic chapters for principal diagnoses in patients visiting GP ICD-9 Chapters Percentage Distribution Respiratory 20.9 Preventive and administrative (supplementary classification) 12.1 Circulation 9.3 Injuries and poison 8.9 Nervous system and sense organs 7.0 Musculoskeletal and connective tissue 6.9 Symptoms, signs, and ill-defined disorders 5.1 Genitourinary system 5.0 Skin and subcutaneous tissue 4.8 Endocrine, nutritional, and metabolic 4.4 Digestive system 4.0 Infectious and parasitic 3.8 Mental disorders 3.7 Neoplasms 0.9 Unknown 1.8 All other diagnoses 0.6 Sources of Variation in Family Practice The age of the physician The gender of the physician. Female physicians see a higher proportion of female patients than male physicians. Distribution of diagnoses Vocational training. did more tests, pre-scribed fewer drugs, gave fewer injections, spent more time with patients, and did more counseling Local conditions the local con-text, including the population structure, economic conditions, the physician-population ratio, availabili