Abstract
Primary health care is one of the most important pillars of the Tunisian health care system. However, very little information is available regarding the specificities of general practice and the patterns of morbidity encountered. We conducted a descriptive study from June 2002 to May 2003 in 85 primary health centres in Sousse during 12 randomly selected weeks in order to describe the variability of the morbidity in all seasons; (3 weeks were randomly selected in each season). Each working day of selected weeks, a systematic sample of patients was identified in each health centre by taking every fifth registered patient. There were 16,271 consultations. The International Classification of Primary Care (ICPC-2) was used to code recorded data of the consultation. There were 24,882 reasons for encounter, a total of 18,097 problems managed by general practitioners (GPs), and 40,190 interventions. There was a predominance of females (62%) and a relatively young population attending the primary health care settings as 50% was aged less than 25 years. According to ICPC-2 chapters, we found that respiratory diseases were the main problems managed in primary health care (43%), followed by digestive (10.1%), locomotive (8.9%), cardiovascular affections (8.7%) and skin diseases (8.4%). These five conditions alone constituted about 80% of the total cases. However, genital conditions for both males and females (1%) as well as psychological and social problems (0.85%) were rarely managed in primary care. The findings will be useful in helping to revise the educational curriculum of medical studies as required in general practice and to plan relevant vocational training for GPs. They will also be important for health policy makers in Tunisia.
Highlights
Primary health care is one of the most important pillars of the Tunisian health care system
The primary health care system in Tunisia consists of a public sector and a private sector, and both are almost equivalent as regards the number of physicians and consultants
The objectives of the study were to illustrate the patterns of morbidity in general practice and to identify the main problems managed by the general practitioners (GPs) at the consultation
Summary
Primary health care is one of the most important pillars of the Tunisian health care system. According to ICPC-2 chapters, we found that respiratory diseases were the main problems managed in primary health care (43%), followed by digestive (10.1%), locomotive (8.9%), cardiovascular affections (8.7%) and skin diseases (8.4%). These five conditions alone constituted about 80% of the total cases. The Department of Community Medicine at the Medical Faculty of Sousse carried out, for the first time in Tunisia, this one-year survey in all localities of the province of Sousse, which counted 505,370 inhabitants in 2002 This survey aimed to collect valid, complete, and representative data on reasons for encounter, problems managed by the general practitioner (GP) at the consultation, and interventions in managing these problems in primary health care. In this article, we are only considering one aspect of this survey, namely the problems managed by the GP at the consultation in general practice
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