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Episodes of care in family medicine in three countries : looking for similarities amongst the differences

Introduction. This is an international study of the epidemiology of family medicine in three practice populations from the Netherlands, Malta and Serbia. Distributions of incidence and prevalence rates and diagnostic associations between common reasons for encounter and episodes titles are compared, and similarities and differences are described and analysed. The research project also involved two systematic reviews of the literature, and research into the duration of episodes of care. Methodology. Participating family doctors (FDs) recorded details of all their patient contacts in an episode of care(EoC) structure using the International Classification of Primary Care (ICPC). Reasons for encounter (RfEs) presented by the patient and episode titles (diagnostic labels of EoCs) were classified with ICPC. The relationships between RfEs and episode titles were studied with Bayesian methods. Results. Distributions of incidence and prevalence rates and of diagnostic odds ratios from the three population databases are presented and compared. Conclusions. ICPC, the RfE and the EoC data model are appropriate tools to study the process of diagnosis in Family Medicine (FM) . Distributions of diagnostic associations between RfEs and episode titles in the Transition Project international populations show remarkable similarities and congruencies in the process of diagnosis from both the RfE and episode title perspectives. The congruence of diagnostic associations between populations supports the use of such data from one population to inform diagnostic decisions in another. Differences in the magnitude of such diagnostic associations are significant, and population-specific data are therefore desirable. It is proposed that both an international (common) and a local (health care system specific) content of FM exist, and that the empirical distributions of diagnostic associations presented in this paper are a reflection of both these effects. A new indicator of the chronicity of a health problem is proposed.
Date January 2013
CreatorsSoler, Jean Karl
PublisherUlster University
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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