From demand to decision: Not progrmmed contact for adult family medicine

##plugins.themes.academic_pro.article.main##

Sriha Belguith Asma
Bouanene Iness
Elmhamdi Sana
Ben Saad Meriem
Ben Salah Aroua
Harizi Chahida
Soltani Essoussi Mohamed

Abstract

Background: the study of contact patterns, diagnostics assumptions, physical acts performed and procedures in primary care services orient the training of future GPs.
Aim: describe the elements of the contact in the Basic Health Centers. Methods: It is a transverse study, describing the elements of contact without appointment, the population served by 4 primary health centers, in Monastir governorate. Days of the survey were identified from the list of working days by taking two weeks per month and per season by excluding the days of chronic diseases. Contacts analyzed have been identified by a systematic random sampling with a step of sounding on two. Results: in the term of this study, we brought together 910 contacts. The mean age of consultants was 36 years, the sex-ratio H/F 0,38. The respiratory, ostéo-articular, digestive, neurological and general chapter’s complaints represented 74% of motives for contacts. The cough and the complaints of throat represented 25% of the reasons for consultation. The lung examination, Oto-rhino laryngeal and cardiovascular represented 80% of physical examinations. The pharyngitis, the infections of the superior respiratory tracts, acute bronchitises, flu and allergic rhinitis represented the half of the assumptions. Antibiotics, anti-inflammatory and the antipyretic/analgesic accounted for 69% of prescriptions.
Conclusion: this study allowed us to show the lack of preventive measures in the health center base and highlight the training of future family physicians must be based systems the most prevalent in primary care.

Keywords:

General practice, diagnosed morbidity, International Classification of Primary Care (ICPC)

##plugins.themes.academic_pro.article.details##

References

  1. Gataa R, Ajmi TN, Bougmiza I, Mtiraoui A. Diagnosed morbidity in primary health care in the sanitary region of Sousse (Tunisia).Rev Med Brux. 2008;29: 471-80
  2. Ben Abdelaziz A, Hadhri S, Touati S, Bouabid Z, Daouas F, Msakni N, et al. Morbidity diagnosed in the general medicine public structures in Tunisia. Santé Publique. 2003;15:191-202
  3. . Ben Abdelaziz A, Krifa I, Hadhri S, Bouabid Z, Daouas F, Msakni N, et al. La demande de soins dans les centres de médecine générale du Sahel tunisien. Cahier santé. 2004;14:223-9
  4. Ben Romdhane H., Skhiri H., Khaldi R., Oueslati A. Transition épidémiologique et transition alimentaire et nutritionnelle en Tunisie. Option méditerranéennes. 2002;41:7-27
  5. . Ben Hamida A, Fakhfakh R, Miladi W, Zouari B et Nacef T. La transition sanitaire en Tunisie au cours des 50 dernières années. Eastern Mediterranean Health Journal, 2005 ; 11 :181-91
  6. Alberti H, Boudriga N, Nabli M. Disease-specific medical records improve the recording of processes of care in the management of type 2 diabetes mellitus. Public Health. 2006;120: 650-3
  7. Smits FT, Brouwer HJ, ter Riet G, van Weert HC. Epidemiology of frequent attenders: a 3-year historic cohort study comparing attendance,morbidity and prescriptions of one-year and persistent frequent attenders. BMC Public Health. 2009;9: 1-7
  8. Formato V, Ronneau S. Le Dossier Médical Informatique et la standardisation de l'information. La Revue de la Médecine Générale. 2004;209: 89-91.
  9. Ben Abdelaziz A, Haddad S, Harrabi I, Gaha R, H. G. Attitudes et attentes des médecins généralistes à l'égard de la formation médicale continue. Pédagogie médicale. 2002;3:101-10.
  10. Bataillon R, Samzun JL, G L. Comment améliorer la prévention en médecine générale ? La revue du praticien médecine générale. 2006; 1314-16
  11. . Crosson JC, Ohman-Strickland PA, Hahn KA, Dicicco-Bloom B, Shaw E, Orzano AJ, et al. Electronic medical records and diabetes quality of care: results from a sample of family medicine practices. Ann Fam Med. 2007;5:209-15
  12. Brault I, Roy Denis A, Denis JL. Introduction à la gouvernance clinique : historique, composantes et conceptualisation renouvelée pour l'amélioration de la qualité et de la performance des organisations de santé. Prat Organ Soins 2008;39:167- 73