Morbidity pattern of different primary care settings in Colombo district
Abstract
Objectives:Primary care health system plays an important role in patient care, undergraduate/postgraduate teaching. Information on morbidity pattern of patients seen at a primary care clinic is sparse in Sri Lanka. We set to determine the morbidity pattern in three different primary care settings in Colombo district
Method: Cross sectional descriptive study using every 20th patient attending out patient department of Colombo South Teaching Hospital(CSTH), all patients attending Preliminary Care Unit,Homagama(PCU) and Family Practice Center(FPC) on selected days from 8 to 12 in the morning. Data collected using an interviewer administered semi structured questionnaire with informed written consent from patients.
Results: The morbidity pattern of 661 new patients seen over this period is hereby reported. There was a female preponderance overall in all three settings. More than 1/3 of the patients were between 41-64 in all settings(CSTH-41.5%,FPC-39.8%,PCU-28.9%).
The Commonest symptom presentations were different in each setting;
CSTH :cold and cough(17.7%), fever(13.98%), Joint pain(11.01%), for investigations(9.3% ) and wound dressing(5.5% );
PCU: Fever(19.2%),abdominal pain(10.04%),accidental injuries(8.4%),chest pain(6.8%) and animal bites(6.02%) ;
FPC: follow up for diabetes(20.02%), cough and cold(12.5%), joint pains(10.7%), fever(7.9%) and skin rashes(6.7%).
Main management option was prescribing drugs.(CSTH-80.5%,FPC-71%,61.4%-PCU). Ordering investigations were different in three settings(CSTH-44.1%, PCU-71.5%, FPC-29%).
Explanation to the patients(60.5%), follow up(38.6%) and counseling(3.4%) are mostly seen in FPC. Referrals (25.3%), health promotion (5.2%) and emergency care(12.9%) mostly seen in Homagama.
Conclusion: The commonly observed pattern of diseases was different in this study, either due to the interventions adopted by different the primary care settings.
