Chapter 6
Reasons For Encounter
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CHAPTER 6: REASONS FOR ENCOUNTER
Reasons for encounter RFE or patients’ presenting complaint refers to the reasons why a patient seeks health care; whether due to a symptom or complaint, follow-up on a known problem, request for
screening or diagnostic investigations, request for medical management or administrative procedures. The documentation of RFE is important in the patient-centred approach as it takes into consideration
the patient’s perspective of why he or she seeks health services. The RFE also serves as the basis for HVWDEOLVKLQJDGLDJQRVLVDQGLQÁXHQFHVWKHSURFHVVHVRIFDUHDQGPDQDJHPHQWZKLFKIROORZV
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This chapter reports the RFE of the patients. Doctors were allowed to record RFEs based on three major types of complaints; symptoms, a follow-up on a known diagnosis or a procedure or administrative request.
6.1 NUMBER OF REASONS FOR ENCOUNTER PER VISIT
Figure 6.1 shows the number of RFEs at encounter. There were 233,326 RFEs recorded for NMCS 2012. Approximately 50.0 of encounters in both public and private clinics had only one RFE. Majority of
patients had between one to three RFEs at the point of visit. There were 3,201 encounters 2.3 with no known RFEs and recorded as not available nil.
Figure 6.1: Number of patient reasons for encounter in primary care clinics in 2012
6.2 REASONS FOR ENCOUNTER BY ICPC-2 COMPONENTS
Table 6.1 shows the distribution of RFEs by ICPC-2 components. 0RUHWKDQKDOIRIWRWDO5VZHUHEDVHGRQV\PSWRPVDQGFRPSODLQWV
5VGHVFULEHGDVGLVHDVHFRQVWLWXWHGRI5V0RVWZHUHIRU‘other diagnoses, diseases’ which LQFOXGHGLVHDVHVWKDWGRQRWIDOOLQWRWKHFODVVLÀFDWLRQRILQIHFWLRXVGLVHDVHVQHRSODVPVLQMXULHVRU
congenital anomalies. 5V ZHUH DOVR H[SUHVVHG DV SURFHVV RI FDUH WKRXJK LW DFFRXQWHG IRU OHVV WKDQ RI 5V
These include diagnostic and preventive procedures, request for medications, test results, medical FHUWLÀFDWHRUUHIHUUDOV
Nil One
Two Three
Four Public
1.1 49.2
29.1 16.7
3.8 Private
2.8 51.9
30.8 11.6
2.9 10
20 30
40 50
60
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Number of patient RFEs
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Table 6.1: Reasons for encounter by ICPC-2 components in primary care clinics in 2012
ICPC-2 component Number
Percentage of all RFEs
n = 233,326 Rate per 100
encounters n = 141,593
95 CI LCL
UCL
Symptoms complaints 138,664
59.43 97.93
97.86 98.00
Diagnosis, diseases 71,580
30.68 50.55
50.29 50.81
Infectious diseases 10,439
4.47 7.37
7.24 7.51
Neoplasms 100
0.04 0.07
0.06 0.09
Injuries 2,298
0.98 1.62
1.56 1.69
Congenital anomalies 68
0.03 0.05
0.04 0.06
Other diagnoses, diseases 58,675
25.15 41.44
41.18 41.70
Diagnostic and preventive procedures
19,899 8.53
14.05 13.87
14.24 Treatment procedures, medication
2,474 1.06
1.75 1.68
1.82 Test results
538 0.23
0.38 0.35
0.41 Administrative
114 0.05
0.08 0.07
0.10 Referral and other reasons for
encounter 57
0.02 0.04
0.03 0.05
Total 233,326
100.00 164.78
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LVWULEXWLRQRI5VE\,3FRPSRQHQWZDVIXUWKHUVWUDWLÀHGE\VHFWRUWRFRPSDUHWKHGLIIHUHQFHV between RFEs recorded in public and private clinics Table 6.2. Interestingly, majority of the RFEs
presented in public clinics were described as diseases 50.4 whereas 70.6 of RFEs at private clinics were of symptoms and complaints.
Table 6.2: Reasons for encounter by ICPC-2 components and sector
ICPC-2 Component Public
Private Number
Percentage of all RFEs
Number Percentage
of all RFEs
Symptoms complaints 25,951
35.25 112,713
70.57 Diagnosis, diseases
37,122 50.43
34,458 21.58
Infectious diseases 1,161
1.58 9,277
5.81 Neoplasms
18 0.02
82 0.05
Injuries 344
0.47 1,955
1.22 Congenital anomalies
31 0.04
37 0.02
2WKHUVSHFLÀFGLVHDVHV 35,568
48.32 23,107
14.47 Diagnostic and preventive procedures
9,887 13.43
10,011 6.27
Treatment procedures, medication 339
0.46 2,135
1.34 Test results
211 0.29
328 0.21
Administrative 77
0.10 37
0.02 Referral and other reasons for encounter
29 0.04
28 0.02
Total 73,616
100.00 159,710
100.00
