The use of ICPC in teaching and research in primary health care

1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. Epidemiology of Primary Care - june 2003 Socio-economic status:

10. Top 10: “Diagnoses” Epidemiology of Primary Care

11. 3. The use of ICPC in post-graduate teaching 3.1. Analysis from Flanders

12. 3. The use of ICPC in post-graduate teaching 3.2. Analysis from South-Africa

13. 3. The use of ICPC in post-graduate teaching 3.3. The core of family medicine: comparative analysis: Flanders - South-Africa

14. 4. The use of ICPC in research Analysis of drug prescription • ATC-classification ~ ICPC-Drug-classification • Episode-oriented analysis • Quality of drug-prescription

15. ATC-classification: levels 1st level: 14 main groups 2nd +3rd level: therapeutic/pharmacological subgroup 4th level: therapeutic/pharmacological/chemical subgroup 5th level: chemical substance

16. 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

25. 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