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