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首页> 外文期刊>BMC Family Practice >Correlation between patients’ reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC)
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Correlation between patients’ reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC)

机译：日本患者遭遇疾病/健康问题的原因与人口密度之间的关系：对国际基层医疗卫生问题分类（ICHPPC）和国际基层医疗分类（ICPC）编码的观察性研究的系统评价

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Background The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients’ reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients’ RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system. Methods We conducted a systematic review in which we searched six databases (PubMed, the Cochrane Library, Google Scholar, Ichushi-Web, JDreamIII and CiNii) for observational studies in Japan coded by International Classification of Health Problems in Primary Care (ICHPPC) and International Classification of Primary Care (ICPC) up to March 2015. We employed population density as index of accessibility. We calculated Spearman’s rank correlation coefficient to examine the correlation between the proportion of “non-internal medicine-related” RFEs and health problems in each study area in consideration of the population density. Results We found 17 studies with diverse designs and settings. Among these studies, “non-internal medicine-related” RFEs, which was not thought to be covered by internists, ranged from about 4% to 40%. In addition, “non-internal medicine-related” health problems ranged from about 10% to 40%. However, no significant correlation was found between population density and the proportion of “non-internal medicine-related” RFEs and health problems. Conclusions This is the first systematic review on RFEs and health problems coded by ICHPPC and ICPC undertaken to reveal the diversity of health problems in Japanese primary care. These results suggest that primary care physicians in some rural areas of Japan need to be able to deal with “non-internal-medicine-related” RFEs and health problems, and that curriculum including practical non-internal medicine-related training is likely to be important.
机译：背景技术日本的卫生保健系统尚未为初级保健医生建立结构化的培训。因此，接受过内科基础培训计划的医生在基层医疗环境中继续发挥主要作用。为了促进发展更有效的初级卫生保健系统，从患者的遭遇原因（RFE）和健康问题方面评估其当前状态是重要的一步。认识到内科医生通常不会涵盖患者的RFE和健康问题的比例，这可以提供有价值的信息，以促进以初级保健医师为中心的系统的发展。方法我们进行了系统的综述，在其中检索了六个数据库（PubMed，Cochrane图书馆，Google Scholar，Ichushi-Web，JDreamIII和CiNii），以进行由日本国际初级卫生保健问题分类（ICHPPC）和国际截至2015年3月的初级保健分类（ICPC）。我们使用人口密度作为可及性指标。我们计算了Spearman的等级相关系数，以考虑人口密度，研究每个研究区域中“非内部药物相关” RFE的比例与健康问题之间的相关性。结果我们发现17个研究具有不同的设计和设置。在这些研究中，“非内部医学相关” RFE的范围在4％到40％之间，而RFE并未被内科医师涵盖。此外，“与非内科医学无关”的健康问题约占10％至40％。但是，在人口密度与“与非内部药物相关”的RFE与健康问题的比例之间没有发现显着相关性。结论这是首次由ICHPPC和ICPC编写的关于RFE和健康问题的系统评价，旨在揭示日本初级保健中健康问题的多样性。这些结果表明，日本某些农村地区的初级保健医生需要能够应对“与非内部医学相关”的RFE和健康问题，并且包括实用的与非内部医学相关的培训在内的课程很可能是重要。

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