A morbidity survey of South African primary care.
A morbidity survey of South African primary care.
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DOI：
10.1371/journal.pone.0032358
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Yogolelo W
中科院分区：
文献类型：
--
作者：
Mash B;Fairall L;Adejayan O;Ikpefan O;Kumari J;Mathee S;Okun R;Yogolelo W
最近的研究描述了南非的疾病负担。然而，这些研究并没有告诉我们这些疾病通常会出现在初级保健提供者身上，这些疾病是如何出现的，以及提供者如何根据他们的诊断来理解它们。临床护士从业人员是主要的初级保健提供者，需要为这一角色做好更好的准备。本研究旨在确定南非公立初级保健机构门诊患者遭遇和诊断原因的范围和流行程度。该研究是对南非四个省（西开普省、林波波省、北开普省和西北部）初级保健咨询进行的一项多中心前瞻性横断面调查。在分析之前，根据就诊原因（REF）和诊断，使用国际初级保健分类第2版对会诊进行编码。调查共纳入了18856个咨询，产生了31451个就诊原因（RFE）和24561个诊断。女性占12526人（66.6%），男性占6288人（33.4%）。护士16238人（86.1%），医生2612人（13.9%）。报告了前80例RFE和前25例诊断，高血压持续治疗是最常见的RFE和诊断。报告了20种最常见的RFE和按年龄组诊断。门诊初级保健主要是非传染性慢性病。艾滋病毒/艾滋病和结核病很常见，但没有达到疾病负担所预测的程度。肺炎和肠胃炎是常见病，尤其是儿童。妇女的健康问题，如计划生育和与怀孕有关的就诊也很常见。疾病负担造成的伤害并不像预期的那样普遍。初级保健提供者没有认识到精神健康问题。研究结果应指导今后对初级保健提供者的培训和评估。
Recent studies have described the burden of disease in South Africa. However these studies do not tell us which of these conditions commonly present to primary care providers, how these conditions may present and how providers make sense of them in terms of their diagnoses. Clinical nurse practitioners are the main primary care providers and need to be better prepared for this role. This study aimed to determine the range and prevalence of reasons for encounter and diagnoses found among ambulatory patients attending public sector primary care facilities in South Africa. The study was a multi-centre prospective cross-sectional survey of consultations in primary care in four provinces of South Africa: Western Cape, Limpopo, Northern Cape and North West. Consultations were coded prior to analysis by using the International Classification of Primary Care-Version 2 in terms of reasons for encounter (REF) and diagnoses. Altogether 18856 consultations were included in the survey and generated 31451 reasons for encounter (RFE) and 24561 diagnoses. Women accounted for 12526 (66.6%) and men 6288 (33.4%). Nurses saw 16238 (86.1%) and doctors 2612 (13.9%) of patients. The top 80 RFE and top 25 diagnoses are reported and ongoing care for hypertension was the commonest RFE and diagnosis. The 20 commonest RFE and diagnoses by age group are also reported. Ambulatory primary care is dominated by non-communicable chronic diseases. HIV/AIDS and TB are common, but not to the extent predicted by the burden of disease. Pneumonia and gastroenteritis are commonly seen especially in children. Women's health issues such as family planning and pregnancy related visits are also common. Injuries are not as common as expected from the burden of disease. Primary care providers did not recognise mental health problems. The results should guide the future training and assessment of primary care providers.
DOI：
10.7196/samj.3427
发表时间：
2010-05-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
Brueton, Valerie;Yogeswaran, Parimalarani;Nazareth, Irwin
通讯作者：
Nazareth, Irwin
影响因子：
6.9
作者：
Williams, D. R.;Herman, A.;Kessler, R. C.
通讯作者：
Kessler, R. C.