MOST FREQUENTLY PRESCRIBED MEDICATIONS IN PUBLIC AND PRIVATE

✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✤ ★ Investigation Number Percentage of all investigations n = 53,028 Rate per 100 encounters 95 CI n = 141,593 Rate per 100 diagnoses 95 CI n = 188,944 Test;prolactin 40 0.08 0.03 0.02 - 0.04 0.02 0.02 - 0.03 Test;albumin 6 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 Test;electrolytes 5 0.01 0.00 0.00 - 0.01 0.00 0.00 - 0.01 Test;calciummagnesium phosphate 2 0.00 0.00 0.00 - 0.0.1 0.00 0.00 - 0.00 Diagnostic radiology imaging; pregnancy 4,831 9.11

3.41 3.32 - 3.51 2.56 2.49 - 2.63

Ultrasound;obstetric 4,831 9.11 3.41 3.32 - 3.51 2.56 2.49 - 2.63 Other laboratory test NEC; urinary 4,020 7.58

2.84 2.75 - 2.93 2.13 2.06 - 2.19

Test;renal function 4,020 7.58 2.84 2.75 - 2.93 2.13 2.06 - 2.19 Diagnostic radiology imaging 3,543 6.68 2.50 2.42 - 2.58 1.88 1.81 - 1.94 X-ray;chest 2,920 5.51 2.06 1.99 - 2.14 1.55 1.49 - 1.60 Ultrasound 378 0.71 0.27 0.24 - 0.30 0.20 0.18 - 0.22 Ultrasound;abdomen 104 0.20 0.07 0.06 - 0.09 0.06 0.05 - 0.07 Ultrasound;pelvis 93 0.18 0.07 0.05 - 0.08 0.05 0.04 - 0.06 X-ray;abdomen 47 0.09 0.03 0.03 - 0.04 0.03 0.02 - 0.03 Blood test digestive 3,002

5.66 2.12 2.05 - 2.20

1.59 1.53 - 1.65

Test;liver function 2,485 4.69 1.76 1.69 - 1.82 1.32 1.26 - 1.37 Test;bilirubin 516 0.97 0.37 0.33 - 0.40 0.27 0.25 - 0.30 Test;gGT 2 0.00 0.00 0.00 - 0.01 0.00 0.00 - 0.00 Electrical tracing; cardiovascular 1,268 2.39

0.90 0.85 - 0.95 0.67 0.64 - 0.71

Electrocardiogram 1,260 2.38 0.89 0.84 - 0.94 0.67 0.63 - 0.70 Electrocardiogram; stress test 6 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 Holter monitor 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 Blood test; bloodlymph 943

1.78 0.67 0.62 - 0.71

0.50 0.47 - 0.53

Test;haemoglobin 689 1.30 0.49 0.45 - 0.52 0.37 0.34 - 0.39 Test;iron studies 69 0.13 0.05 0.04 - 0.06 0.04 0.03 - 0.05 Test;INR 52 0.10 0.04 0.03 - 0.05 0.03 0.02 - 0.04 Test;ferritin 49 0.09 0.04 0.03 - 0.05 0.03 0.02 - 0.03 Test;haemoglobin epg 44 0.08 0.03 0.02 - 0.04 0.02 0.02 - 0.03 Test;prothrombin time 21 0.04 0.02 0.01 - 0.02 0.01 0.01 - 0.02 Table 9.1 continued: Types of investigations by ICPC-2 chapters and common individual test within chapter in primary care clinics in 2012 continued 1RWH1QRWHOVHZKHUHFODVVLÀHGJ7JDPPDJOXWDP\OWUDQVSHSWLGDVH,15LQWHUQDWLRQDOQRUPDOL]HGUDWLR Haemoglobin EPG = haemoglobin electrophoresis ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✤ ✩ Investigation Number Percentage of all investigations n = 53,028 Rate per 100 encounters 95 CI n = 141,593 Rate per 100 diagnoses 95 CI n = 188,944 Test;APTT 15 0.03 0.01 0.01 - 0.02 0.01 0.00 - 0.01 Test;reticulocyte count 2 0.00 0.00 0.00 - 0.01 0.00 0.00 - 0.00 Test;blood;platelets 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 Urine test; endocrine metabolic 873 1.65

0.62 0.58 - 0.66 0.46 0.43 - 0.49

Test;urine;endocrine metabolic 873 1.65

0.62 0.58 - 0.66 0.46 0.43 - 0.49

Urine test; pregnancy 664

1.25 0.47 0.43 - 0.51

0.35 0.33 - 0.38

Test;urine;pregnancy 664

1.25 0.47 0.43 - 0.51

0.35 0.33 - 0.38

Microbiological immunological test; digestive 636

1.20 0.45 0.42 - 0.49

0.34 0.31 - 0.36

Test;hepatitis B antigen 379 0.72 0.27 0.24 - 0.30 0.20 0.18 - 0.22 Test;hepatitis B antibody 148 0.28 0.11 0.09 - 0.12 0.08 0.07 - 0.09 Test;hepatitis C antigen 50 0.10 0.04 0.03 - 0.05 0.03 0.02 - 0.04 Test;blood;H Pylori 28 0.05 0.02 0.01 - 0.03 0.02 0.01 - 0.02 Test;hepatitis C antibody 17 0.03 0.01 0.01 - 0.02 0.01 0.01 - 0.01 Test;faeces;MCS 11 0.02 0.01 0.00 - 0.01 0.01 0.00 - 0.01 Test;hepatitis E antibody 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 Test;hepatitis E antigen 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 Microbiological immunological test; blood lymph 552

1.04 0.39 0.36 - 0.42

0.29 0.27 - 0.32

Test;HIV 469 0.88 0.33 0.30 - 0.36 0.25 0.23 - 0.27 Test;blood group 83 0.16 0.06 0.05 - 0.07 0.04 0.04 - 0.05 Blood test; urinary 545 1.03 0.39 0.35 - 0.42 0.29 0.27 - 0.31 Test;urateuric acid 393 0.74 0.28 0.25 - 0.31 0.21 0.19 - 0.23 Test;creatinine 152 0.29 0.11 0.09 - 0.13 0.08 0.07 - 0.09 Diagnostic radiology imaging; musculoskeletal 518 0.98

0.37 0.34 - 0.39 0.28 0.26 - 0.30

X-ray;footfeet 87 0.16 0.06 0.05 - 0.07 0.05 0.04 - 0.06 X-ray;elbow 76 0.14 0.06 0.04 - 0.07 0.04 0.03 - 0.05 X-ray;hand 54 0.10 0.04 0.03 - 0.05 0.03 0.02 - 0.04 ;UD\ÀQJHUVWKXPE 38 0.07 0.03 0.02 - 0.04 0.02 0.02 - 0.03 X-ray;toes 37 0.07 0.03 0.02 - 0.03 0.02 0.02 - 0.03 Table 9.1 continued: Types of investigations by ICPC-2 chapters and common individual test within chapter in primary care clinics in 2012 continued Note: APTT - activated partial thromboplastin time; MCS - microscopy, culture and sensitivity; +,9KXPDQLPPXQRGHÀFLHQF\YLUXV ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✤ ✤ Investigation Number Percentage of all investigations n = 53,028 Rate per 100 encounters 95 CI n = 141,593 Rate per 100 diagnoses 95 CI n = 188,944 X-ray;spine;lumbosacral 36 0.07 0.03 0.02 - 0.03 0.02 0.01 - 0.03 X-ray;knee 30 0.06 0.02 0.01 - 0.03 0.02 0.01 - 0.02 X-ray;heel 28 0.05 0.02 0.01 - 0.03 0.02 0.01 - 0.02 X-ray;spine;cervical 22 0.04 0.02 0.01 - 0.02 0.01 0.01 - 0.02 Plain X-ray;bones 21 0.04 0.02 0.01 - 0.02 0.01 0.01 - 0.02 X-ray;ankle 19 0.04 0.02 0.01 - 0.02 0.01 0.01 - 0.02 Ultrasound;neck 12 0.02 0.01 0.00 - 0.01 0.01 0.00 - 0.01 X-ray;back 12 0.02 0.01 0.00 - 0.01 0.01 0.00 - 0.01 X-ray;shoulder 10 0.02 0.01 0.00 - 0.01 0.01 0.00 - 0.01 X-ray;leg 7 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 X-ray;forearm 7 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 X-ray;spine 5 0.01 0.00 0.00 - 0.01 0.00 0.00 - 0.01 X-ray;spine; thoracolumbar 5 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 X-ray;arm 3 0.01 0.00 0.00 - 0.01 0.00 0.00 - 0.00 X-ray;clavicle 2 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 X-ray;wrist 2 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 X-ray;spine;lumbar 2 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 X-ray;femur 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 X-ray;metacarpal 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 Microbiological immunological test; respiratory 447

0.84 0.32 0.29 - 0.35

0.24 0.22 - 0.26

Culture;tuberculosis 403 0.76 0.29 0.26 - 0.31 0.21 0.19 - 0.24 Test;sputum MCS 34 0.06 0.03 0.02 - 0.03 0.02 0.01 - 0.03 Test;throat swab MCS 10 0.02 0.01 0.00 - 0.01 0.01 0.00 - 0.01 Microbiological immunological test 444 0.84

0.31 0.29 - 0.34 0.24 0.21 - 0.26

Test;sexually transmitted infection 355 0.67 0.25 0.23 - 0.28 0.19 0.17 - 0.21 Test;dengue fever 66 0.12 0.05 0.04 - 0.06 0.04 0.03 - 0.04 Test;measles virus antibodies 10 0.02 0.01 0.00 - 0.01 0.01 0.00 - 0.01 Test;alpha fetoprotein 6 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 Table 9.1 continued: Types of investigations by ICPC-2 chapters and common individual test within chapter in primary care clinics in 2012 continued Note: MCS - microscopy, culture and sensitivity ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✤ ✥ Investigation Number Percentage of all investigations n = 53,028 Rate per 100 encounters 95 CI n = 141,593 Rate per 100 diagnoses 95 CI n = 188,944 Test;lymphocyte type count 6 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 Test;culture and sensitivity 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00 Electrical tracing; pregnancy 433 0.82

0.31 0.28 - 0.34 0.23 0.21 - 0.25

Monitoring;foetal 428 0.81 0.30 0.27 - 0.33 0.23 0.21 - 0.25 Cardiotocography 6 0.01 0.01 0.00 - 0.01 0.00 0.00 - 0.01 Other diagnostic procedure; eye 427 0.81

0.30 0.27 - 0.33 0.23 0.21 - 0.25

Procedures;diagnostic; eye 427 0.81

0.30 0.27 - 0.33 0.23 0.21 - 0.25

Physical function test; respiratory 289 0.54

0.21 0.18 - 0.23 0.15 0.14 - 0.17

Test;lung function 177 0.33 0.13 0.11 - 0.15 0.09 0.08 - 0.11 7HVWSHDNÁRZ 110 0.21 0.08 0.06 - 0.09 0.06 0.05 - 0.07 Test;spirometry 1 0.00 0.00 0.00 - 0.00 0.00 0.00 - 0.00

9.3 INVESTIGATIONS MOST FREQUENTLY ORDERED IN PUBLIC AND PRIVATE

CLINICS Individual investigations or tests were ranked in decreasing order irrespective of ICPC-2 chapter and ten most frequently ordered investigations are presented in Figure 9.2 public clinics and Figure 9.3 private clinics. ‡ 7KHUHZHUHLQYHVWLJDWLRQVUHFRUGHGLQSXEOLFFOLQLFVDWDUDWHRISHUHQFRXQWHUVDQG 49.6 per 100 diagnoses. ‡ \FRPSDULVRQSULYDWHFOLQLFVUHFRUGHGLQYHVWLJDWLRQVDWDUDWHRISHUHQFRXQWHUV and 15.7 per 100 diagnoses. ‡ 7KH OHDGLQJ LQYHVWLJDWLRQV LQ SXEOLF DQG SULYDWH FOLQLFV ZHUH DOPRVW VLPLODU VHYHQ RI WKHVH investigations were listed among the top ten investigations for both sectors. Table 9.1 continued: Types of investigations by ICPC-2 chapters and common individual test within chapter in primary care clinics in 2012 ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✤ ✦ Figure 9.3 Top 10 investigations ordered in private clinics in 2012 Figure 9.2 Top 10 investigations ordered in public clinics in 2012

1.9 3.3

4.0 4.8

5.0 5.8

7.8 8.2

9.2 12.2

2 4 6 8 10 12 14 Electrocardiogram Test;urine;albumin Test;urine Test;HbA1c Test;liver functions Test;full blood count Test;lipids profile Test;renal function Ultrasound;obstetrics Test;glucose glucose tolerance Rate per 100 encounters 0.4 0.4

0.5 0.6

0.6 0.9

2.0 2.2

2.6 3.6

2 4 6 8 10 12 14 Electrocardiogram Test;HbA1c Test;urine;pregnancy Test;renal function Test;lipids profile Ultrasound;obstetric Test;blood X-ray;chest Test;glucose tolerance Test;urine Rate per 100 encounters