Proportional rates; per 1.000 visits, will
r-llal
r.-~-*-n
Table I.
LU1uLLLbL
IJal
ab lLU1Jb
cu~aUKZfTOns( see table I ).
DISTRIBUTION O F PHYSICIAL AND NURSE CONSULTATIONS O F POLICLINIC
ATTENDANCES IN PASUHUAN - 1968.
A r e a
Physician
consultation
Municipality
4,365
C o a s t
10,719
P l a i n
14,552
Mountain
T O T A L
Nurse
consultatio
T o t a l
consultation
8,385
28,021
86,971
124,992
METHODOLOGY
type of consultation and diagnosis as recorded.
From each policlinic a sample of 500 was
selected by simple random sampling evenly
distributed over the available data on the record
or register.
The findings of this sample is transformed into
the available data, grouped according the area,
In Indonesia the C-list of the International
Classification, revision 1948, is commonly used
for the records and reports of policlinics. In
this study another grouping of diseases is
introduced using the C-list classification (see
table [I).
Table 11.
Abbreviation
DISEASE GROUPING OUT O F THE C-LIST
INTERNATIONAL CLASSIFICATION, REVISION 1948
Disease group
Intern classification
revision
1948
IMM
Infective and Parasitic disease (I & P)
that can be controlled hy immunizatio
WAT
I & P that can be controlled by water
supply
T BC
Tuberculosis. all types
VEN
Venereal diseases, all types
C-list 3 - 4
MAL
Malaria, all types
C-list 9a. 9 b , 9 c
C-list I l h , I l d
C-list 1
YAL
Yaws and leprosy, all types
0IP
Other I & P
RESP
Acute respiratory diseases
C-list 2 8
EYE
Diseases of the eye
C-list 2 1
-
2
Ile-2, l l g , l l h , l l i .
-
32
SKIN
Diseases o f the skin
C-list 44. 45a. 4Sh.
cv
Cardiovascular diseases
C-list 2 3
NUT
Nutritional diseases
C-list I 7a. 17h, 17c 1 8
NEO
Neoplasms
C-list 12, 1 3
ACC
Accidents, poisoning, violence.
C-list 50
MENT
Mental disorders
C-list 19
COPR
Complications of pregnancy, childbirth
and puerperiun~
C-list 43h
MAT
Normal pregnancy and childbirth
CHIL
Healthy children
MEX
Medical examination for certificate
lDEF
Illdefined diagnosis
OTH
All others
-
27
Proportional rates; per 1.000 visits, will
6e calculated for the various disease-groups in
each area.
The ranking of the disease-groups according
to proportion of visits will indicate the work
load of the policlinic activities of the health
centres
In the new grouping certain diseases of the
C-list has been combined into one group, those
where the same programme for prevention or
attack can be executed,
RESULTS
Excluding the proportional rates for the
municipality, the group IDEF and NDlA comTable 111.
pnses about 10 percent.
th the municipality too-much proportion of the
illnesses h a s not been diagnosed (40 - 6C
percent).
From the distribution of disease groups ir
table Ill and looking at the regional proportions
by physician, nurse as well as combined con.
sultations six high ranking of disease-groups
can be recognized, viz. SKIN, K a P , tYh
WAT, NUT and TBC. More than 50 percent 02
the attendances belong to these 6 groups
The physician consultations have a somewhat
different ranking of these 6 groups, viz. SKIN
RESP, WAT, TBC, EYE and NUT.
PROPORTIONAL RATES O F DISEASE-GROUPS
O F POLICLINIC ATTENDANCES
Dis.
gr.
N ' u r s e
T o t a l
Physician
MUN COA PLAI MOU REG MUN COA PLAl MOU REG MUN COA PLAl MOU REG
IMM
-
1
1
9
39
58
56
47
33
TBC 1 1
VEN 4
MAL YAL OIP 32
RESP 103
EYE 21
SKIN 67
CVD
I
NUT 26
NEO ACC MENT COKP -
65
33
59
46
7
WAT
3
1
2
-
2
5
2
-
2
1
5
2
64 ,411
54
52
27
57
50
55
50
28
34
27
8
39
30
43
33
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
1000
30
MAT CHIL MEX OTH 97
IDEF' 3
TOT 1000 1000
Note : Dis. gr. = Disease group
MUN = Municipality
= Coastal
COA
PLAI
MOU
REG
= Plain
= Mountain
= Regency
DISCUSSION AND CONCLUSION
SIX nlgn ranklng
disease-groups in similar sequence, SKIN, RESP
EYE, WAT- NUT and TBC, have been found at
coastal and plain area for more than 50 percent
of the visits, at mountain area these 6 groups
comprise more than 60 percent but in somewhat
different ranking SKIN, RESP, WAT, NUT,
EYE, and TBC.
In the municipal area another ranking
can be recognized, SKIN, RESP, EYE, WAT,
ACC, MAL, NUT, TBC, still less than 45
percent of the visits.
RANKING O F IMPORTANT DISEASE -,CROUPS
Table IV.
Disease
groups
r-ns..lta tion
Area
TOTAL MUN COA PLAI
MOU
PHYS
NURSE
PHYS
NURSE
TOTAL
MUN
COA
PLAl
MOU REG
208
152
41
47
40
46
240
138
69
32
43
27
230
142
61
50
42
33
143
107
85
27
14
8
188
161
61
57
44
39
249
132
59
50
46
30
322
154
44
55
47
43
230
142
61
50
42
33
534
569
558
384
550
566
655
558
10
8
I8
18
16
15
5
25
15
8
15
12
22
22
16
15
18
36
31
30
23
27
44
31
6
0
6
4
2
2
6
0
-
2
I
5
2
2
3
6
I5
1
5
2
6
4
2
2
Disease
Consultation
POUPS
SIX HIGH
SKIN
RESP
EYE
WAT
NUT
TBC
Subtotal
ADDITIONAL
VEN
ACC
Subtotal
LOW
CVD
MAL
Area
IMM
1
YAL
3
10
14
14
18
12
8
14
14
0
0
0
0
0
0
-
-
-
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
OTH 306
NDIA 132
251
130
267
1 30
85
482
322
93
329
70
226
51
267
130
438
381
397
567
415
399
277
397
1000
1000
1000
1000
1000
1000
NEO
MENT
Subtotal
OTHERS
REG
5
5
2
2
Subtoal
SPORADIC
Although a great difference can be noticed
in the NDIA-group between the proportional
rates in the regency
- - ( .l u -pelcent) and that m
the municiualitv- (40
. - 60 percent). the combination of the groups O I ~ OTH;.IDEF,
,
and
NDIA, for the regency and- the municipality
shows a less marked difference 40 percent for
regency and 57 percent for municipality (see
table IV).
With this in mind, the ranking of the diseasegroups in the regency and municipality will
be considered as the disease-pattern of the
attendances.
Subtotal
TOTAL
--
1
I
1000 1000
Note : In OTH are included OIP and OTH of table 3, and in NDlA both IDEF
and NDIA of the same table.
For the whole region, municipality as
weu as the various areas of the regency, the
first two high ranking show similar sequence,
SKIN followed by RESP.
The followine three
of the 6-hioh in the
various areas of the regency may be considered
as having similar sequence, viz. EYE, WAT,
NUT because the defferences of the rates are
quite small, ranging between 44-6 1 per 1,000
.yipitc
All
of
there
07.-
fr\llnx.rarl
h.r
TDP
~ n composition
e
ol ulc ~ U I I G I I I U L arrGlldances shows a quite different proportion in
the municipality. This is mainly due to the
fact that a larger number of patients have
attended private policlinics, under which one
clinic as TB-clinic. As a work load problem
for the government policlinic TBC had a lower
ranking in the six-high, even lower than ACC
and MAL.
(The number of attendances to the private
policlinic in the municipality has been 22,250
against 17,028 attendances to the government
policlinics.
In fact the proportion of the same six-high
shows a similar order, viz. SKIN 149, RESP
190, EYE 50, WAT 34, NUT 35 and TBC 32).
The location of special clinics for eyedisease and tbc did not alter the composition of
the attendances as a whole. It seems that no
difference can be observed between the municipality and the areas of the regency regarding
the six-high ranking. This pattern might indicate a low hygienic living conditions and habits.
The same six-high ranking can be observed
for the physician and nurse consultations.
Apparently for TBC and RESP-a higher proportion of each 1000 visits can be noticed for the
physician consultations.
Considering the additional and low ranking
disease-groups (see table 4) VEN and ACC
still rank higher than CVD and MAL, while
IMM and YAL comprised just a small portion
Ul
L11G W V l f i - I V r n ~ .
1 3 - v
vv-r
-.aI-.
------
attendance only in less than 1 per 1,000 visit
in one year.
SUMMARY
A disease pattern has been observed tl
indicate a work load as required, according tt
demand for policlinic s e ~ c e sof governmen
health establishments in a region which consist
of a municipality and a regency in East Javi
Indonesia. It is a retrospective survey of pc
licl~nic records of the attendances in 196b
From the C-list of the International Clasificatior:
revision 1948, which is commonly used ir
Indonesia for policlinic records and report:
another grouping of diseases is introduced
By considering the proportional rates a six-hig,
ranking of disease groups can be observed
1.
2.
3.
4.
Skin diseases
Acute respiratory diseases
Eye diseases
Infective and parasitic diseases contro'
able by water supply
5. Nutritional diseases
6. Tuberculosis, all types.
This ranking is then followed by Venerea
diseases and Accidents. In continuing descendink
order Cardiovascular diseases is followed bj
infective and parasitic diseases as malaria, thos
controllable by immunization and Yaws-Lepro
sy. Neoplasm and Mental diseases has bee1
only sporadically observed.
r.-~-*-n
Table I.
LU1uLLLbL
IJal
ab lLU1Jb
cu~aUKZfTOns( see table I ).
DISTRIBUTION O F PHYSICIAL AND NURSE CONSULTATIONS O F POLICLINIC
ATTENDANCES IN PASUHUAN - 1968.
A r e a
Physician
consultation
Municipality
4,365
C o a s t
10,719
P l a i n
14,552
Mountain
T O T A L
Nurse
consultatio
T o t a l
consultation
8,385
28,021
86,971
124,992
METHODOLOGY
type of consultation and diagnosis as recorded.
From each policlinic a sample of 500 was
selected by simple random sampling evenly
distributed over the available data on the record
or register.
The findings of this sample is transformed into
the available data, grouped according the area,
In Indonesia the C-list of the International
Classification, revision 1948, is commonly used
for the records and reports of policlinics. In
this study another grouping of diseases is
introduced using the C-list classification (see
table [I).
Table 11.
Abbreviation
DISEASE GROUPING OUT O F THE C-LIST
INTERNATIONAL CLASSIFICATION, REVISION 1948
Disease group
Intern classification
revision
1948
IMM
Infective and Parasitic disease (I & P)
that can be controlled hy immunizatio
WAT
I & P that can be controlled by water
supply
T BC
Tuberculosis. all types
VEN
Venereal diseases, all types
C-list 3 - 4
MAL
Malaria, all types
C-list 9a. 9 b , 9 c
C-list I l h , I l d
C-list 1
YAL
Yaws and leprosy, all types
0IP
Other I & P
RESP
Acute respiratory diseases
C-list 2 8
EYE
Diseases of the eye
C-list 2 1
-
2
Ile-2, l l g , l l h , l l i .
-
32
SKIN
Diseases o f the skin
C-list 44. 45a. 4Sh.
cv
Cardiovascular diseases
C-list 2 3
NUT
Nutritional diseases
C-list I 7a. 17h, 17c 1 8
NEO
Neoplasms
C-list 12, 1 3
ACC
Accidents, poisoning, violence.
C-list 50
MENT
Mental disorders
C-list 19
COPR
Complications of pregnancy, childbirth
and puerperiun~
C-list 43h
MAT
Normal pregnancy and childbirth
CHIL
Healthy children
MEX
Medical examination for certificate
lDEF
Illdefined diagnosis
OTH
All others
-
27
Proportional rates; per 1.000 visits, will
6e calculated for the various disease-groups in
each area.
The ranking of the disease-groups according
to proportion of visits will indicate the work
load of the policlinic activities of the health
centres
In the new grouping certain diseases of the
C-list has been combined into one group, those
where the same programme for prevention or
attack can be executed,
RESULTS
Excluding the proportional rates for the
municipality, the group IDEF and NDlA comTable 111.
pnses about 10 percent.
th the municipality too-much proportion of the
illnesses h a s not been diagnosed (40 - 6C
percent).
From the distribution of disease groups ir
table Ill and looking at the regional proportions
by physician, nurse as well as combined con.
sultations six high ranking of disease-groups
can be recognized, viz. SKIN, K a P , tYh
WAT, NUT and TBC. More than 50 percent 02
the attendances belong to these 6 groups
The physician consultations have a somewhat
different ranking of these 6 groups, viz. SKIN
RESP, WAT, TBC, EYE and NUT.
PROPORTIONAL RATES O F DISEASE-GROUPS
O F POLICLINIC ATTENDANCES
Dis.
gr.
N ' u r s e
T o t a l
Physician
MUN COA PLAI MOU REG MUN COA PLAl MOU REG MUN COA PLAl MOU REG
IMM
-
1
1
9
39
58
56
47
33
TBC 1 1
VEN 4
MAL YAL OIP 32
RESP 103
EYE 21
SKIN 67
CVD
I
NUT 26
NEO ACC MENT COKP -
65
33
59
46
7
WAT
3
1
2
-
2
5
2
-
2
1
5
2
64 ,411
54
52
27
57
50
55
50
28
34
27
8
39
30
43
33
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
1000
30
MAT CHIL MEX OTH 97
IDEF' 3
TOT 1000 1000
Note : Dis. gr. = Disease group
MUN = Municipality
= Coastal
COA
PLAI
MOU
REG
= Plain
= Mountain
= Regency
DISCUSSION AND CONCLUSION
SIX nlgn ranklng
disease-groups in similar sequence, SKIN, RESP
EYE, WAT- NUT and TBC, have been found at
coastal and plain area for more than 50 percent
of the visits, at mountain area these 6 groups
comprise more than 60 percent but in somewhat
different ranking SKIN, RESP, WAT, NUT,
EYE, and TBC.
In the municipal area another ranking
can be recognized, SKIN, RESP, EYE, WAT,
ACC, MAL, NUT, TBC, still less than 45
percent of the visits.
RANKING O F IMPORTANT DISEASE -,CROUPS
Table IV.
Disease
groups
r-ns..lta tion
Area
TOTAL MUN COA PLAI
MOU
PHYS
NURSE
PHYS
NURSE
TOTAL
MUN
COA
PLAl
MOU REG
208
152
41
47
40
46
240
138
69
32
43
27
230
142
61
50
42
33
143
107
85
27
14
8
188
161
61
57
44
39
249
132
59
50
46
30
322
154
44
55
47
43
230
142
61
50
42
33
534
569
558
384
550
566
655
558
10
8
I8
18
16
15
5
25
15
8
15
12
22
22
16
15
18
36
31
30
23
27
44
31
6
0
6
4
2
2
6
0
-
2
I
5
2
2
3
6
I5
1
5
2
6
4
2
2
Disease
Consultation
POUPS
SIX HIGH
SKIN
RESP
EYE
WAT
NUT
TBC
Subtotal
ADDITIONAL
VEN
ACC
Subtotal
LOW
CVD
MAL
Area
IMM
1
YAL
3
10
14
14
18
12
8
14
14
0
0
0
0
0
0
-
-
-
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
OTH 306
NDIA 132
251
130
267
1 30
85
482
322
93
329
70
226
51
267
130
438
381
397
567
415
399
277
397
1000
1000
1000
1000
1000
1000
NEO
MENT
Subtotal
OTHERS
REG
5
5
2
2
Subtoal
SPORADIC
Although a great difference can be noticed
in the NDIA-group between the proportional
rates in the regency
- - ( .l u -pelcent) and that m
the municiualitv- (40
. - 60 percent). the combination of the groups O I ~ OTH;.IDEF,
,
and
NDIA, for the regency and- the municipality
shows a less marked difference 40 percent for
regency and 57 percent for municipality (see
table IV).
With this in mind, the ranking of the diseasegroups in the regency and municipality will
be considered as the disease-pattern of the
attendances.
Subtotal
TOTAL
--
1
I
1000 1000
Note : In OTH are included OIP and OTH of table 3, and in NDlA both IDEF
and NDIA of the same table.
For the whole region, municipality as
weu as the various areas of the regency, the
first two high ranking show similar sequence,
SKIN followed by RESP.
The followine three
of the 6-hioh in the
various areas of the regency may be considered
as having similar sequence, viz. EYE, WAT,
NUT because the defferences of the rates are
quite small, ranging between 44-6 1 per 1,000
.yipitc
All
of
there
07.-
fr\llnx.rarl
h.r
TDP
~ n composition
e
ol ulc ~ U I I G I I I U L arrGlldances shows a quite different proportion in
the municipality. This is mainly due to the
fact that a larger number of patients have
attended private policlinics, under which one
clinic as TB-clinic. As a work load problem
for the government policlinic TBC had a lower
ranking in the six-high, even lower than ACC
and MAL.
(The number of attendances to the private
policlinic in the municipality has been 22,250
against 17,028 attendances to the government
policlinics.
In fact the proportion of the same six-high
shows a similar order, viz. SKIN 149, RESP
190, EYE 50, WAT 34, NUT 35 and TBC 32).
The location of special clinics for eyedisease and tbc did not alter the composition of
the attendances as a whole. It seems that no
difference can be observed between the municipality and the areas of the regency regarding
the six-high ranking. This pattern might indicate a low hygienic living conditions and habits.
The same six-high ranking can be observed
for the physician and nurse consultations.
Apparently for TBC and RESP-a higher proportion of each 1000 visits can be noticed for the
physician consultations.
Considering the additional and low ranking
disease-groups (see table 4) VEN and ACC
still rank higher than CVD and MAL, while
IMM and YAL comprised just a small portion
Ul
L11G W V l f i - I V r n ~ .
1 3 - v
vv-r
-.aI-.
------
attendance only in less than 1 per 1,000 visit
in one year.
SUMMARY
A disease pattern has been observed tl
indicate a work load as required, according tt
demand for policlinic s e ~ c e sof governmen
health establishments in a region which consist
of a municipality and a regency in East Javi
Indonesia. It is a retrospective survey of pc
licl~nic records of the attendances in 196b
From the C-list of the International Clasificatior:
revision 1948, which is commonly used ir
Indonesia for policlinic records and report:
another grouping of diseases is introduced
By considering the proportional rates a six-hig,
ranking of disease groups can be observed
1.
2.
3.
4.
Skin diseases
Acute respiratory diseases
Eye diseases
Infective and parasitic diseases contro'
able by water supply
5. Nutritional diseases
6. Tuberculosis, all types.
This ranking is then followed by Venerea
diseases and Accidents. In continuing descendink
order Cardiovascular diseases is followed bj
infective and parasitic diseases as malaria, thos
controllable by immunization and Yaws-Lepro
sy. Neoplasm and Mental diseases has bee1
only sporadically observed.