Morbidity in Primary Care Dr. Abdul Sattar Khan MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK) Assistant Professor Family Medicine Department [email protected]

Morbidity in Primary Care

Dr. Abdul Sattar KhanMBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK)

Assistant Professor Family Medicine Department

[email protected]

Can we measure diseases?

Objectives At the end of the session, the students will be able to:• Understand the concept of morbidity• Know the definition of incidence & prevalence• Explain the current status of expertise in family

medicine in Turkey• Explain why is a different pattern of morbidity in the

practice of family medicine • Count common diseases• Advocate the importance of family medicine expertise

in health care

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Definition • Morbid: Morbidity: Morbidity Rate:• Morbidity (from Latin morbidus, meaning "sick,

unhealthy") is a diseased state, disability, or poor health due to any cause.

• In epidemiology and actuarial science, the term morbidity rate can refer to either the incidence rate, or the prevalence of a disease or medical condition..

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the discipline that applies mathematical and statistical methods

to assess risk

the discipline that applies mathematical and statistical methods

to assess risk

Measures of Disease Frequency

Prevalence RateIncidence rate

Types of Fractions Used in Describing Disease Frequency

• Ratio- A fraction in which….. the numerator is not part of the denominator. e.g. Males & Female Ratio in the class

• Proportion- A fraction in which….. the numerator is part of the denominator.e.g. Fetal Death in the community: Fetal deaths/all births

• Rate- A proportion in which….. change over time is considered

e.g. Infant Mortality Rate: Infant deaths/live births(17/1000 live births)

Prevalence rate

1. Point prevalence rate

Proportion of individuals in a specified population at risk who have the disease of Interest at a given point in time.

(when the type of prevalence rate is not specified it is usually point prevalence)

2. Period prevalence rate

• Proportion of individuals in a specified population at risk who have the disease of interest over a specified period of time.

• For example: annual prevalence rate, lifetime prevalence rate.

Incidence rate

1. Cumulative incidence rate

Number of new cases of disease occurring over a specified period of time in a population at risk at

the beginning of the interval.

2. Incidence density

Number of new cases of disease occurring over a specified period

of time in a population at risk throughout the interval.

Health Transformation Program in Turkeyby

Ministry of Health

New era in primary health care: Family medicine

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Primary health care is on the rise

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The Ministry of Health of TurkeyHealth Statistics Yearbook - 2008

Referral Rate drop

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2009


EUROPEP Scale Satisfaction Survey in 81 provinces for 2009

Overall satisfaction level of our citizens with primary health care in

the provinces where family medicine has been launched is

around 83%.

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Common problems encounter at primary health care

1. High Blood Glucose2. High Blood Pressure3. High cholesterol4. Arthritis 5. Depression6. Low back pain7. Fatigue8. Impaired memory

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9. Anxiety10. Eating disorders11. Obesity12. STI13. Headache14. Conjunctivitis

Distribution of Hospital Discharges by ICD-10 Main Diagnosis Codes and Gender, (%), Turkey, 2008

ICD10 DiagnosisCodes

Code Female

Male Total

Infectious and Parasitic A00 B99 2.7 4.0 3.2

Neoplasm C00 D49 5.0 7.1 5.9

Blood & Immune mechanism D50 D89 1.3 1.3 1.3

Endocrine, Nutritional and Metabolic E00 E99 3.3 2.4 2.9

Circulatory system 100 -199 7.8 13.5 10.2

Respiratory system J00 J99 8.4 15.0 11.2

Digestive system K00 K99 6.9 10.1 8.3

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Why primary care?

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System characteristics

• Better health outcomes

• Lower costs • Greater equity in health

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Practice Characteristics • First-contact• Longitudinality• Comprehensiveness• Coordination• Family-centeredness• Community orientation

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Summary • Define morbidity?• Can you count 10 most common

problems encounter at PHC?• Is is important to have primary care ?• What is patient-centered approach?

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ThanksTeşekkürler

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Documents

Morbidity in Primary Care Dr. Abdul Sattar Khan MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK) Assistant Professor Family Medicine Department [email protected]