Hong Kong primary care morbidity survey 2007-2008

Abstract

Objective: To examine the morbidity pattern as presented to primary care doctors in Hong Kong such that service needs can be identified.

Design: Prospective recording of all consecutive patient encounters in one week of each month from July 2007 to June 2008 using standardized forms.

Subjects: All subjects consulting doctors who volunteered to participate in the study.

Main outcome measures: Patients’ demographic data and health problems or diagnoses presented which were coded using the International Classification of Primary care (ICPC-2)

Results: One hundred and nine primary care doctors took part in the study and identified 69,973 health problems / diagnoses. The mean number of health problems per encounter was 1.3±0.3. The respiratory system ranked top (36.2%) in the overall morbidity pattern by system, followed by cardiovascular system (12.8%), digestive system (9.8%) and endocrine system (9.3%). Psychological problems accounted for 2.6% of all problems encountered and were probably under-represented in this study. More than one-third of all health problems encountered were of chronic in nature. The five most common diagnoses were upper respiratory tract infections (26.4%), hypertension (10.0%), diabetes mellitus (4.0%), gastroenteritis (3.9%) and lipid disorder (2.7%). Immunization and health check-up accounted for 1.9% and 1.7% of all reasons for encounter respectively.

Conclusion: Primary care doctors in Hong Kong are consulted for a diversity of health problems and a significant proportion of their workload is in the care of chronic diseases. Thus the challenge lies in enabling and empowering them in chronic disease care as well as mental health care as it appeared to be under-diagnosed in this study. The results are also useful in guiding the content of family medicine curriculum at both undergraduate and postgraduate levels.

目的：研究香港基層醫生所治療的患者的發病規律，從而確定服務需求。

設計：採用標准表格對2007年7月至2008年6月每月某一周內所有患者連續就診的情況進行前瞻性記錄。

對象：所有自願參與本研究的就診病人。

主要測量內容：患者的人口統計學數據，以及採用《基層醫療國際分類（ICPC-2）》編碼患者的健康問題或診斷。

結果：109位基層醫生參與了此次研究，合共確定了69,973個健康問題/診斷。每次就診的健康問題均數為1.3?.3。呼吸系統問題佔各系統發病總數的首位（36.2%），其次為心血管系統（12.8%）、消化系統（9.8%）和內分泌系統（9.3%）。心理問題佔所有就醫門診的2.6%，本次研究就此類病人可能診斷不足。在就醫的所有健康問題中，三分之一以上為慢性疾病。最常見的五種診斷為上呼吸道感染（26.4%）、高血壓病（10.0%）、糖尿病（4.0%）、腸胃炎（3.9%）和血脂異常（2.7%）。免疫接種和體檢分別佔全部就診原因的1.9%和1.7%。

結論：香港基層醫生要治療各種健康問題，慢性病在工作中佔較大比例，如何提供處理慢性疾病和診斷不足的精神衛生問題的能力成為一項挑戰。本調查的結果還有助於指導本科和研究生的家庭醫學課程內容的設置。