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KMID : 0377619870520010001
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Korean Jungang Medical Journal
1987 Volume.52 No. 1 p.1 ~ p.12
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A Study on the Practice Contents of 4 Community Health Practitioners in Jeon Bug Province
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Abstract
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In order to describe the practice contents of community health practitioners and to examine the applicability of international classification of health problems in primary care (ICHPPC) as a tool of morbidity classification in primary health care, 2,639 encounters and 3,161 health problems were collected from July 1, 1984 to November 30, 1984 by 4 community health practitioners (CHP) in Jeon Bug Province. The result were as follow.
The 2,639 encounters composed of 54.6% of males and 45.4% of females. Patients less than 1 year old were 4.5%, 1-4 years were 12.7%, 5-14 years were 17.4%, 15-24 years were 24.9%, 45-64 years were 22.3%, and those older than 65 years were 9.0%.
Of the encounters, 67.0% were consulted in scheduled hours, 28.1% were in unschedul-ed hours and 4.9% were night encounters. And 96.1% of the encounters were consulted at CHP´s offices and only 3.3% of them were at patient´s homes.
The average number of problem contacts in each encounter were 1.2.
During the study period of 5 months, the 4 CHPs listed up 185 health problems among the total of 361 from ICHPPC. The major 20 problems contained 77.0% of all problems, the 30 common problems contained 83.9% and the 50 common problems contained 90.3% of all. The category VIII (Respiratory System Diseases) and XVI (Symptoms, Signs, And Ill-Defined Condition), the most frequent causes of sickness encounters in the rural people, were 28.7% and 18.1% of all health problems, respectively.
The activities of CHPs were broken down into as follow: diagnostic services 42.9%, therapeutic services 50.1%, and preventive services 5.2%, 84.1% of patients were expected to return at the specified time or if needed.
The referral rate was 3.4%, of them, 53.3% were referred to local private physician, 30.0% were to general or university hospital, 16.7% were to public health centers. Among the referral specialties internal medicine and family practice were the leading ones. 74.4% of the cases were referred to doctors for more specific diagnosis and/or treatment and 11.1% were referred because of lack of equipment and/or drugs.
According to the findings of the study, the following conclusions were made;
1. The health problems dealt by the CHPs differed from those dealt by physicians in kinds and severity’s of sickness. So communication channel between physicians and CHPs should be developed for efficient patient referral and for effective medical supervision.
2. ICHPPC was found as a useful and applicable tool of morbidity classification in the practice of CHP as in the practice of primary physician.
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