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The use of ICPC in teaching and research in primary health care. Prof. Dr. J. De Maeseneer, MD, PhD Family Physician, Community Health Centre Botermarkt, Ghent-Ledeberg Head of the Department of Family Medicine and Primary Health Care, Ghent University, Belgium. WONCA, Kos, 06.09.05.
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The use of ICPC in teaching and research in primary health care Prof. Dr. J. De Maeseneer, MD, PhD Family Physician, Community Health Centre Botermarkt,Ghent-Ledeberg Head of the Department of Family Medicine andPrimary Health Care, Ghent University, Belgium WONCA, Kos, 06.09.05
The use of ICPC in teaching and research in primary health care • Introduction • The use of ICPC in undergraduate teaching • The use of ICPC in post-graduate training • The use of ICPC in research • Conclusions
EPISODE OF CARE Perceived health problem Perceived need for care RFE, demand for care Diagnosis Process RFE, demand for care Diagnosis Process RFE, demand for care Diagnosis Process
ICPC • bi-axial structure • 17 alpha-coded chapters based on body systems/problem areas • 7 identical components, with rubrics bearing a two-digit numeric code
ICPC Chapters (Systems) A General and unspecified B Blood/bloodforming organs, lymphatics (spleen, bone marrow) D Digestive F Eye (Focal) H Ear (Hearing) K Circulatory L Musculoskeletal (Locomotion) N Neurological P Psychological R Respiratory S Skin T Endocrine, metabolic and nutritional (Thyroid) U Urological W Pregnancy, child bearing, family planning (Women) X Female genital (X-chromosome) Y Male genital (Y-chromosome) Z Social problems
ICPC Components Components (standard for each chapter) CODES 1. Complaints and symptoms 1-29 2. Diagnostic and preventive 30-49 3. Treatment, procedures and medication 50-59 4. Test results 60-61 5. Administrative 62 6. Referral and other reasons for encounter 63-69 (64!!) 7. Diagnoses/diseases: 70-99 - infectious diseases - neoplasms - injuries - congenital anomalies - other
TOOLS • ICPC-2 • 1404 terms including all process codes • Acts as ordering principle • Common entities have distinct codes • Surprisingly complete given small size • Context of episode adds specificity • ICD-10 • 14,000 terms • Adds clinical specificity to ICPC
2. The use of ICPC in undergraduate teaching at Ghent University • 4th year students • Clerkship Family Medicine and Primary Health Care • Epidemiology of primary care Process: - introduction - registration during consultations and home visits - coding
Epidemiology of Primary Care - june 2003 Socio-economic status:
Top 10: “Diagnoses” Epidemiology of Primary Care
3. The use of ICPC in post-graduate teaching 3.1. Analysis from Flanders
3. The use of ICPC in post-graduate teaching 3.2. Analysis from South-Africa
3. The use of ICPC in post-graduate teaching 3.3. The core of family medicine: comparative analysis: Flanders - South-Africa
4. The use of ICPC in research Analysis of drug prescription • ATC-classification ~ ICPC-Drug-classification • Episode-oriented analysis • Quality of drug-prescription
ATC-classification: levels 1st level: 14 main groups 2nd +3rd level: therapeutic/pharmacological subgroup 4th level: therapeutic/pharmacological/chemical subgroup 5th level: chemical substance
ATC system main groups The main groups of the ATC classification system are listed low. A survey of each main group is given in the beginning of each of the following chapters. A Alimentary tract and metabolism B Blood and blood forming organs C Cardiovascular system D Dermatologicals G Genito urinary system and sex hormones H Systematic hormonal preparations, excl. sex hormones and insulins J Antiinfectives for systematic use L Antineoplastic and immonomodulating agents M Musculo-skeletal system N Nervous system P Antiparasitic products, insecticides and repellents R Respiratory system S Sensory organs V Various
Conclusions • ICPC used in an episode oriented registration provides a powerfull tool for teaching the epidemiology of primary care in undergraduate and post-graduate training • ICPC helps to define the content of family medicine • ICPC contributes to research