An international comparative family medicine study of the Transition Project data from the Netherlands, Malta and Serbia. Is family medicine an international discipline? Comparing incidence and prevalence rates of reasons for encounter and diagnostic titles of episodes of care across populations.
BACKGROUND
This is a study of the epidemiology of family medicine (FM) in three practice populations from the Netherlands, Malta and Serbia. Incidence and prevalence rates, especially of reasons for encounter (RfEs) and episode labels, are compared.


METHODS
Participating family doctors (FDs) recorded details of all their patient contacts in an episode of care (EoC) structure using electronic patient records based on the International Classification of Primary Care (ICPC), collecting data on all elements of the doctor-patient encounter. RfEs presented by the patient, all FD interventions and the diagnostic labels (EoCs labels) recorded for each encounter were classified with ICPC (ICPC-2-E in Malta and Serbia and ICPC-1 in the Netherlands).


RESULTS
The content of family practice in the three population databases, incidence and prevalence rates of the common top 20 RfEs and EoCs in the three databases are given.


CONCLUSIONS
Data that are collected with an episode-based model define incidence and prevalence rates much more precisely. Incidence and prevalence rates reflect the content of the doctor-patient encounter in FM but only from a superficial perspective. However, we found evidence of an international FM core content and a local FM content reflected by important similarities in such distributions. FM is a complex discipline, and the reduction of the content of a consultation into one or more medical diagnoses, ignoring the patient's RfE, is a coarse reduction, which lacks power to fully characterize a population's health care needs. In fact, RfE distributions seem to be more consistent between populations than distributions of EoCs are, in many respects.
Mediterranean Institute of Primary Care, 19, Triq ir-Rand, Attard ATD1300, Malta. jksoler@synapse.net.mt
Jean K
JK
Soler
Inge
I
Okkes
Sibo
S
Oskam
Kees
K
van Boven
Predrag
P
Zivotic
Milan
M
Jevtic
Frank
F
Dobbs
Henk
H
Lamberts
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017050:Episode of Care; D005194:Family Practice / Q000145:classification / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D038622:Internationality; D008297:Male; D008319:Malta; D008490:Medical Informatics; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000145:classification / Q000706:statistics & numerical data*; D055771:Serbia; D055815:Young Adult