Transcript Morbidity in Primary Care

Morbidity in Primary Care
Dr. Abdul Sattar Khan
MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK)
Assistant Professor
Family Medicine Department
[email protected]
Can we measure diseases?
Objectives
At the end of the session, the students will be able to:
• Understand the concept of morbidity
• Know the definition of incidence & prevalence
• Explain the current status of expertise in family
medicine in Turkey
• Explain why is a different pattern of morbidity in the
practice of family medicine
• Count common diseases
• Advocate the importance of family medicine expertise
in health care
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Definition
the discipline that applies
• Morbid: Morbidity: Morbidity
Rate:
mathematical and statistical methods
to assess risk
• Morbidity (from Latin morbidus, meaning
"sick, unhealthy") is a diseased state,
disability, or poor health due to any cause.
• In epidemiology and actuarial science, the
term morbidity rate can refer to either the
incidence rate, or the prevalence of a disease
or medical condition..
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Measures of Disease Frequency
Prevalence Rate
Incidence rate
Types of Fractions
Used in Describing
Disease Frequency
• Ratio- A fraction in which…..
the numerator is not part of the denominator.
e.g. Males & Female Ratio in the class
• Proportion- A fraction in which…..
the numerator is part of the denominator.
e.g. Fetal Death in the community: Fetal deaths/all
births
• Rate- A proportion in which…..
change over time is considered
e.g. Infant Mortality Rate: Infant deaths/live births
(17/1000 live births)
Prevalence rate
1. Point prevalence rate
Proportion of individuals in a specified
population at risk who have the disease
of Interest at a given point in time.
(when the type of prevalence rate is not
specified it is usually point prevalence)
2. Period prevalence rate
• Proportion of individuals in a specified
population at risk who have the disease
of interest over a specified period of
time.
• For example: annual prevalence rate,
lifetime prevalence rate.
Incidence rate
1. Cumulative incidence rate
Number of new cases of disease
occurring over a specified period
of time in a population at risk at
the beginning of the interval.
2. Incidence density
Number of new cases of disease
occurring over a specified period
of time in a population at risk
throughout the interval.
Health Transformation Program in Turkey
by
Ministry of Health
New era in primary health care:
Family medicine
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Primary health care is on the rise
8000
7000
6000
5000
4000
PHC centres
3000
2000
1000
0
PHC centres
1
1996
4791
2 002
5055
3
2009
7216
Number of Active Primary Health Care
The Ministry of Health of Turkey
Health Statistics Yearbook - 2008
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Referral Rate drop
25
1996
20
2002
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Rate of referral
10
5
2009
0
Referral Rate from Primary Health Care to Secondary care
The Ministry of Health of Turkey
Health Statistics Yearbook - 2008
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EUROPEP Scale Satisfaction Survey in 81
provinces for 2009
Overall satisfaction level of our
citizens with primary health care in
the provinces where family
medicine has been launched is
around 83%.
The Ministry of Health of Turkey
Health Statistics Yearbook - 2008
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Common problems encounter at
primary health care
1.
2.
3.
4.
5.
6.
7.
8.
High Blood Glucose
High Blood Pressure
High cholesterol
Arthritis
Depression
Low back pain
Fatigue
Impaired memory
9.
10.
11.
12.
13.
14.
Anxiety
Eating disorders
Obesity
STI
Headache
Conjunctivitis
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Distribution of Hospital Discharges by ICD-10 Main
Diagnosis Codes and Gender, (%), Turkey, 2008
Code
Female
Male
Total
Infectious and Parasitic
A00 B99
2.7
4.0
3.2
Neoplasm
C00 D49
5.0
7.1
5.9
Blood & Immune mechanism
D50 D89
1.3
1.3
1.3
Endocrine, Nutritional and Metabolic
E00 E99
3.3
2.4
2.9
Circulatory system
100 -199
7.8
13.5
10.2
Respiratory system
J00 J99
8.4
15.0
11.2
Digestive system
K00 K99
6.9
10.1
8.3
ICD10 Diagnosis
Codes
The Ministry of Health of Turkey
Health Statistics Yearbook - 2008
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Why primary care?
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System characteristics
• Better health outcomes
• Lower costs
• Greater equity in health
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Practice Characteristics
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•
•
•
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First-contact
Longitudinality
Comprehensiveness
Coordination
Family-centeredness
Community orientation
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Summary
• Define morbidity?
• Can you count 10 most common
problems encounter at PHC?
• Is is important to have primary care ?
• What is patient-centered approach?
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Thanks
Teşekkürler
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