Diagnoses by ICPC-2 components in primary care clinics in 2014

75 .5 298 2.2 070 2.2 155 0.1

018 0.9

951 0.9 ly 213 5.6 458 2.9 103 4.3 097 2.8 106 1.6 878 0.9 036 0.9 1 343 1.0 969 1 729 1.1 114 1.6 929 0.9 674 1.4 389 1.0 226 0.7

0.2 135

0.0 743

134.0 5 Chapter 8 : Diagnoses : .4 MOST COMMON DIAGNOSES MANAGED IN P ; LIC AND PRIVATE CLINICS Significant differences were observed in the types of problems most commonly managed in the public and private spheres of Malaysia’s two-tier health system. Table 8.4.1 and Table 8.4.2 list the top 30 diagnoses in descending order of frequency for public and private clinics, respectively, reflecting the general morbidity pattern among primary care patients in 2014. Public clinics The top three diseases managed in the public sector were all chronic diseases. Together, they accounted for 50.8 of all diagnoses managed in government health clinics Table 8.4.1. • Hypertension, which was reported at a rate of 33.1 diagnoses per 100 encounters, accounted for 21.4 of all diagnoses. • The second most frequent condition was diabetes, which accounted for 15.1 of all diagnoses, followed by lipid disorder at 14.3. • Approximately one-sixth 15.6 of patients who sought treatment in public clinics were diagnosed with an upper respiratory tract infections 10.1 of all diagnoses. • Antenatal check-ups accounted for 3.9 of all diagnoses and ranked fifth among the top diagnoses managed in public primary care clinics. Private clinics Table 8.4.2 lists the 30 most frequently managed diagnoses in private clinics in 2014. Together, these diagnoses accounted for approximately two-thirds 76.0 of all diagnoses in private clinics; the top 10 diagnoses amounted to 52.9 of all diagnoses. • More than one-quarter 27.2 of patients seeking treatment in private clinics were diagnosed with an upper respiratory tract infection, which accounted for 22.7 of all diagnoses. • Hypertension is the second most common condition managed in private clinics, occurring at rate of 6.5 diagnoses per 100 encounters 5.4 of all diagnoses. • Ranking third to fifth among the top diagnoses in private clinics were acute conditions — gastroenteritis 4.5 of all diagnoses, musculoskeletal symptomscomplaints 3.7 and fever 3.2 — which accounted for 28.7 of the top five diagnoses. • Diabetes and lipid disorders, which were the second and third most common diagnoses in public clinics, accounted for only 2.5 and 2.4 of all diagnoses managed in private clinics, respectively. 76 National Medical Care Statistics 2014 Tabl = ?

4.1: Thirty most common diagnoses managed in public clinics in 2014

Rank Diagnosis nweighted count n A B C D 760 Weighted count n A B EC D F GF H Percent I J total diagnoses n A BE C D FG F H Rate per 100 encounters K LM CI n A N C N D 624 1 Hypertension - a OO P 4,966 43,597 21.4 33.1 29.8–36.4 Hypertension - Cardiovascular P 4,927 43,292 21.2 32.9 29.6–36.2 Hypertension in pregnancy 39 305 0.2 0.2 0.1–0.4 2 Diabetes - a OO P 3,334 30,776 15.1 23.4 20.1–26.7 Diabetes type 2 2,691 24,798 12.2 18.8 15.4–22.3 Diabetes - unspecified 435 4,337 2.1 3.3 1.7–4.9 Gestational diabetes 141 1,152 0.6 0.9 0.6–1.2 3 Lipid disorder 3,366 29,115 14.3 22.1 19.3–25.0 4 Upper respiratory tract infection 2,687 20,527 10.1 15.6 14.2–17.0 5 Medical examination - pregnancy P 881 7,864 3.9 6.0 4.3–7.6 6 Musculoskeletal symptomcomplaints P 552 5,028 2.5 3.8 3.1–4.6 7 Asthma 420 4,272 2.1 3.3 2.4–4.1 8 Fever 420 3,870 1.9 2.9 2.1–3.8 9 Medical examination P 404 3,488 1.7 2.7 1.9–3.4 10 Gastroenteritis P 361 2,741 1.3 2.1 1.7–2.5 11 Stomach function disorder 319 2,500 1.2 1.9 1.6–2.2 12 High risk pregnancy P 235 1,873 0.9 1.4 0.8–2.0 13 Headache - a OO P 223 1,849 0.9 1.4 1.0–1.8 Headache 134 1,153 0.6 0.9 0.6–1.2 14 Ischaemic heart disease P 215 1,821 0.9 1.4 1.0–1.7 15 Diseasecondition of unspecified naturesite 167 1,712 0.8 1.3 0.9–1.7 16 Urinary tract infection P 166 1,460 0.7 1.1 0.8–1.4 17 Tonsillitis 194 1,396 0.7 1.1 0.8–1.4 18 Dermatitis P 198 1,340 0.7 1.0 0.7–1.3 Dermatitis, contactallergic 190 1,287 0.6 1.0 0.7–1.3 19 Conjunctivitis P 164 1,167 0.6 0.9 0.7–1.1 20 Cough 98 972 0.5 0.7 0.3–1.1 21 Anaemi a P 98 964 0.5 0.7 0.4–1.0 22 Q iral disease 84 910 0.5 0.7 0.4–1.0 23 Contraception, femal R P 96 906 0.4 0.7 0.4–1.0 24 Arthritis - a O O P 93 878 0.4 0.7 0.4–0.9 25 Perinatal morbidity, other 151 872 0.4 0.7 0.3–1.0 26 Fear of infection; general 60 731 0.4 0.6 0.1–1.0 27 Gout 93 707 0.4 0.5 0.4–0.7 28 Back problems P 83 672 0.3 0.5 0.3–0.7 29 Fear of respiratory disease 61 635 0.3 0.5 0.2–0.8 30 Allergyallergic reaction 72 610 0.3 0.6 0.3–0.6 S Comprise multiple ICPC-2 codes see Appendix 4