Structure of visits persons with diabetes in Croatian family practice--analysis of reasons for encounter and treatment procedures using the ICPC-2

Vrca Botica, Marija and Zelić, Ines and Pavlić Renar, Ivana and Bergman Marković, Biserka and Stojadinović Grgurević, Slavica and Botica, Iva (2006) Structure of visits persons with diabetes in Croatian family practice--analysis of reasons for encounter and treatment procedures using the ICPC-2. Collegium Antropologicum, 30 (3). pp. 495-499. ISSN 0350-6134

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Abstract

The reasons for encounter and the procedures conducted during the visit persons with diabetes to family practice have been investigated. Five family practitioners located in two Croatian counties took part in this study. In this study patients with diagnoses E10-E14 according to International Classification Disease-10 (ICD-10), were involved. There were 543 persons with diabetes (women 324) in the total population of 10,150 patients Data were registered according to the International Classification Primary Care-2 (ICPC-2) (components 1-7 for reasons of encounter, and components 2-6 for procedures during the visit), in period october till december 2005. 871 visits of persons with diabetes (average age 65.7 +/- 12.5 were registered. Patients presented in total 1921 reasons for encounter or 2.1 +/-1.1 per visit. Family practitioner made in total 2,341 procedures or 2.6 +/- 1.5 procedures per visit. 85.0% of patients had 1 to 3 reasons for encounter, 78.4% of patients had 1 to 3 procedures per visit. 64.4% of patients with diabetes presented at least one reason for encounter connected to diabetes. The most common reasons for encounter were prescriptions of medication 46.4 per 100 reasons for encounter, the second was dignostic procedure 19.9, request for analysis of findings 11.1, symptoms complaints 11, request for referrals to diagnostic procedures or specialist consultation 8.9 and administrative reuqests 1.6 per 100 reasons for encounter. Family practitioner performed procedure prescriptions of medication 47 per 100 procedures. The second was dignostic procedure 32.8 per 100 procedures, referrals to diagnostic procedures or specialist consultation 14.7 and administrative procedures 1.7 per 100 procedures. From the total number of 100 referrals to specialist, 23 were to diabetologist, 15 to ophtalmologist, 13 to cardiologist. The largest proportion of procedure belong to diabetics 33.8%, followed by the circulatory system 25.4%, musculosceletal 6.9%, symptoms 5.1%, respiratory 4.5%. The reasons for encounter and the procedures conducted during the visit have direct influence to the quality of care for persons with diabetes. It is necessery collecting the data and research in the field of reasons for encounter and procedures during the visit of person with diabetes. The results then can be compared to the results already found in literature.

Abstract in Croatian

Istražili smo razloge dolaska osoba oboljelih od šećerne bolesti i postupke tijekom posjeta obiteljskom liječniku. U studiji je sudjelovalo 5 obiteljskih liječnika iz 2 županije u Hrvatskoj. Prema Međunarodnoj klasifikaciji bolesti -10 (MKB-10), izdvojeni su pacijenti s E10–E14: 543 pacijenta (324 žene) od 10 150 ukupno opredijeljenih pacijenata u skrbi obiteljskog liječnika. Podatci su bilježeni prema International Classification Primary Care-2 (ICPC-2), komponente 1–7 za razloge dolaska, a komponente 2–6 za postupke tijekom posjeta. U razdoblju listopad-prosinac 2005. Zabilježen je 871 posjet bolesnika oboljelih od šećerne bolesti prosječne dobi 65.7±12.5. Pacijenti su iznijeli 1,921 razlog dolaska ili 2.1±1.1 razloga po posjetu. Obiteljski liječnik je učinio 2,341 postupak ili 2.6±1.5 postupaka po posjetu. 85.0% pacijenata iznijeli su od 1 do 3 razloga dolaska. 78.4% pacijenata imali su od 1 do 3 postupka u posjetu. 64.4% bolesnika oboljelih od dijabetesa prezentirali su najmanje 1 razlog dolaska vezan uz dijabetes. Najčešći razlog za dolazak bilo je propisivanje lijekova ili druge terapije u ordinaciji, i to 46.4 na 100 razloga dolaska. Na drugom mjestu s 19.9 su dijagnostički postupci. Ostali razlozi su: nalazi na uvid 11.1; neobjašnjeni simptomi i tegobe 11; traženje uputnica za dijagnostiku i specijalističke konzultacije 8.9; administrativni postupci 1.6 na 100 razloga dolaska. Obiteljski liječnik je propisao lijekova ili druge terapije u ordinaciji 47 na ukupno 100 postupaka. Na drugom mjestu s 32.8 su dijagnostički postupci u ordinaciji. Potom slijede: slanje na dijagnostiku i konzultacije specijalistima 14.7; administrativni postupci 1.7 na 100 postupaka u ordinaciji. Od 100 slanja specijalistima 23 su dijabetologu, 15 očnom, 13 kardiologu. Najveći udio postupaka odnosi se na za dijabetes, i to 33.8%, zatim kardiovaskularne bolesti 25.4%, lokomotorne 6.9%, neobjašnjene simptome i tegobe 5.1%, za respiratorne bolesti 4.5% postupaka. Razlozi dolaska i postupci tijekom posjeta obiteljskom liječniku imaju izravan utjecaj na kvalitetu zaštite osoba oboljelih od šećerne bolesti. Potrebno je stoga podatke bilježiti, istraživati i uspoređivati s podatcima iz literature.

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