morbidity in primary care dr. abdul sattar khan mbbs, mph, mcps, dchm, mrcgp (uk), friph (uk)...
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Morbidity in Primary Care
Dr. Abdul Sattar KhanMBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK)
Assistant Professor Family Medicine Department
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Can we measure diseases?
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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
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Measures of Disease Frequency
Prevalence RateIncidence rate
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Types of Fractions Used in Describing Disease Frequency
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• 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)
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Prevalence rate
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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)
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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.
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Incidence rate
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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.
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2. Incidence density
Number of new cases of disease occurring over a specified period
of time in a population at risk throughout the interval.
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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
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Referral Rate drop
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2009
The Ministry of Health of TurkeyHealth Statistics Yearbook - 2008
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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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The Ministry of Health of TurkeyHealth Statistics Yearbook - 2008
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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
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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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The Ministry of Health of TurkeyHealth Statistics Yearbook - 2008
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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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