71
• •
•
≥
Chapter 8 : Diagnoses
Figure 8.1.2 shows the age- and gender-specific rate of diagnoses in public and private clinics in 2014. In keeping with our previous findings in 2012,
1
the number of diagnoses increased with increasing age for both sectors, with the increase being more pronounced in the public sector, especially for age groups
over 40 years.
Figur
î ï
ð
1.2: Age- and gender- speci
ñ
ic rates
òñ
diagnoses managed per 100 encounters by sector in 2014
Note: Missing data excluded from analysis.
ï
.2 DIAGNOSES BY ICPC-2 COMPONENTS
Diagnoses managed in primary care were categorised by ICPC-2 components based on the aspects of the consultation. Table 8.2.1 shows the distribution of diagnoses by these components in terms of
proportion of all diagnoses and rate per 100 encounters. • Diagnosis of diseases accounted for 77.9 of all diagnoses. Nearly half 47.4 of all diagnoses
were categorised as
ó
other diagnosisdiseases”, a classification for diagnoses which did not fit into the categories of infectious diseases, injuries, neoplasms and congenital anomalies. This was
followed by infectious diseases 27.5, which were recorded at a rate of 36.9 diagnoses per 100 encounters.
• The second most frequent diagnosis by ICPC-2 component was the
ó
symptoms and complaints” category, which was reported at a rate of 22.2 diagnoses per 100 encounters.
ô õ ö ÷ø
209.6
139.9
ô ù ú
÷ø
50 100
150 200
250
1 1–4
5–19 20–39
40–59 ≥ 60
R a
te pe
r 1
e n
c o
un te
rs
Age group years
Public; male Public; female
Private; male Private; female
72
National Medical Care Statistics 2014
Tabl
û ü
ý
2.1: Diagnoses by ICPC-2 components in primary care clinics in 2014
Diagnosis ICPC-2 component
þ
nweighted count
Weighted count
Percent
ÿ
total diagnoses
n 743
Rate per 100 encounters
95 CI
n
8 8
Diagnosis, diseases 30,297
340,229 77.9
104.4 100.2–108.7 Infectious diseases
9,625 120,114
27.5 36.9 34.8–38.9
Injuries 1,006
12,720 2.9
3.9 3.4–4.4 Neoplasms
35 374
0.1 0.1 0.1–0.2
Congenital anomalies 21
190 0.0
0.1 0.0–0.1 Other
19,610 206,830
47.4 63.5 58.0–69.0
Symptom complaint 5,597
72,384 16.6
22.2 20.5–23.9 Diagnostic screening preventive
2,070 21,669
5.0 6.7 5.7–7.6
Medication, treatment procedures 110
1,573 0.4
0.5 0.3–0.7 Test results
11 141
0.0 0.0 0.0–0.1
Referrals other reason for encounter
54 648
0.2 0.2 0.1–0.3
Administrative 12
99 0.0
0.0 0.0–0.1
Total
8
151 436,743
100.0 134.0 130.6
137.5
ü
.3 DIAGNOSES BY ICPC-2 CHAPTERS
Table 8.3.1 presents the distribution of diagnoses according to ICPC-2 chapters classified based on the body systems involved and the most frequent diagnoses within each chapter. The conditions are
reported in descending order of percentage of all diagnoses. • The most frequent problem that presented to primary care was respiratory-related. This amounted
to 23.4 of all diagnoses and 31.4 of all patient encounters in primary care. Majority of the patients 71.7 were managed for an upper respiratory tract infection. Asthma only accounted for
2.9 diagnoses per 100 patient encounters recorded in primary care. • The second most frequently managed problem was under the endocrine, metabolic and nutritional
chapter 17.4 of all diagnoses, which includes diabetes and lipid disorder. Non-gestational diabetes type 1, type 2 and unspecified type inclusive accounted for 8.1 of all diagnoses, while lipid
disorder was reported at a rate of 10.6 diagnoses per 100 patient encounters 7.9 of all diagnoses. • Cardiovascular diseases ranked third among the leading diagnoses in primary care, representing
14.3 of all diagnoses. Hypertension, the cardiovascular disease which was also the second most frequent condition seen in primary care, accounted for 12.8 of all diagnoses and 17.2 of all patient
encounters.
73
104.4 36.9
3.9 0.1
0.1 63.5
22.2 ve
6.7 es
0.5 0.0
0.2 0.0
134.0
•
•
•
Chapter 8 : Diagnoses
Tabl
e
3.1: Diagnosis by ICPC-2 chapters and the most common individual diagnoses within each chapter in NMCS 2014
Diagnosis ICPC-2 chapter
U
nweighted count
Weighted count
Percent total
diagnoses n
743 Rate per 100
encounters 95
CI n
Respiratory 164
102,329 23.4
31.4 29.9 32.9
Upper respiratory tract infection 5,928
73,345 16.8
22.5 21.1–23.9 Asthma
718 9,343
2.1 2.9 2.3–3.4
Tonsillitis 416
4,662 1.1
1.4 1.2–1.7 Cough
283 3,468
0.8 1.1 0.8–1.3
Acute bronchitis 146
2,069 0.5
0.6 0.4–0.8
Endocrine, metabolic and nutritional
7, 75,929
17.4 23.3 19.6
27.0
Non-gestational diabetes 3,609
35,443 8.1
10.9 9.0–12.8 Diabetes type 2
2,993 29,024
6.7 8.9 7.0–10.8
Diabetes - unspecified 518
5,680 1.3
1.7 1.1–2.4 Lipid disorder
3,693 34,668
7.9 10.6 8.7–12.6
Cardiovascular 6,337
62,233 14.3
19.1 16.9 21.3
Hypertension - cardiovascular 5,747
55,940 12.8
17.2 15.1–19.3 Ischaemic heart disease
236 2,160
0.5 0.7 0.5–0.8
General unspeci
ied 3,449
42,
2
9.7 13.0 11.
14.1
Fever 900
11,267 2.6
3.5 2.9–4.1 Medical examination
711 7,509
1.7 2.3 1.8–2.8
Diseasecondition of unspecified naturesite
400 5,330
1.2 1.6 1.2–2.1
Digestive 2,
37,011 .5
11.4 10.6 12.2
Gastroenteritis 981
13,139 3.0
4.0 3.5–4.6 Stomach function disorder
687 8,748
2.0 2.7 2.3–3.1
Abdominal pai
n
171 2,573
0.6 0.8 0.6–1.0
Diarrheoa 186
2,387 0.6
0.7 0.6–0.9
Musculoskeletal 2,015
6.6 .9
.0 9.7
Musculoskeletal symptomcomplaints
1,101 13,551
3.1 4.2 3.7–4.6
Back problems 414
6,812 1.6
2.1 1.7–2.5 Arthritis - a
ll
257 4,278
1.0 1.3 0.7–1.9
Osteoarthritis 176
3,215 0.7
1.0 0.4–1.6 Sprainstrain
134 2,242
0.5 0.7 0.5–0.9
