70,489 primary care encounters: retrospective analysis of morbidity at a primary care centre in Ireland
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While considerable changes are happening in primary care in Ireland and considerable potential exists in intelligence derived from practice-based data to inform these changes, relatively few large-scale general morbidity surveys have been published.
To examine the most common reasons why people attend primary care, specifically ‘reasons for encounter’ (RFEs) among the general practice population and among specific demographic groups (i.e., young children and older adults).
We retrospectively examined clinical encounters (which had a diagnostic code) over a 4-year time period. Descriptive analyses were conducted on anonymised data.
70,489 RFEs consultations were recorded (mean 13.53 recorded RFEs per person per annum) and consultations involving multiple RFEs were common. RFE categories for which codes were most commonly recorded were: ‘general/unspecified’ (31.6 %), ‘respiratory’ (15.4 %) and ‘musculoskeletal’ (12.6 %). Most commonly recorded codes were: ‘medication renewal’ (6.8 %), ‘cough’ (6.6 %), and ‘health maintenance/prevention’ (5.8 %). There was considerable variation in the number of RFEs recorded per age group. 6239 RFEs (8.9 %) were recorded by children under 6 years and 15,295 RFEs (21.7 %) were recorded by adults aged over 70. RFEs recorded per calendar month increased consistently through the study period and there was a marked seasonal and temporal variation in the number of RFEs recorded.
Practice databases can generate intelligence on morbidity and health service utilisation in the community. Future research to optimise diagnostic coding at a practice level and to promote this activity in a more representative sample of practices is a priority.
KeywordsMorbidity Primary care Epidemiology ICPC
Compliance with ethical standards
This study received no external funding. Dr Molony is a senior partner in The Red House Family Practice, the site of the research in question. The practice has received no financial support of any type from any source to support this research project. Dr Molony is a Board Member of Health Information and Quality Authority, Ireland, a member of the National General Practitioner Committee of the Irish Medical Organisation, a partner in Mallow Primary Healthcare Centre, Mallow, Ireland, Honorary Medical Director of Complete GP, medical software company and is a Tutor to the Graduate Entry Medical School at University of Limerick. Dr John Crowley, Dr Michele Quinlan and Dr Tom Dennehy were registrars in training in The Red House Family Practice and Dr Molony was their GP Trainer attached to the HSE South West General Practitioner Training Scheme. They have no financial link to the practice or the research carried out. Mr Carl Beame is the Director of Complete GP, medical software company which is employed by The Red House Family Practice to supply medical software to the practice and assists in the collection of data without financial incentive for this work. Dr William Behan declares that he has no conflict of interest. Prof Walter Cullen has been Principal Investigator on research that has been funded by the Health Research Board of Ireland, the Irish College of General Practitioners and the Department of Health & Children, Ireland. He was also responsible for coordinating clinical placements for medical students at Mallow Primary Healthcare Centre.
The paper reports practice level data and all procedures were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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