Reasons for encounters, investigations, referrals, diagnoses and treatments in general practice in Sweden—a multicentre pilot study using electronic patient records

Figures & data

Table I. Subjective part: distribution of symptom codes (n = 1346) in 1055 encounters, with a frequency of > 1.0% across ICPC-2 chapters.

ICPC-2 chapter	% of symptom codes
Musculoskeletal (locomotion)	21.5
Respiratory	15.2
Circulatory	13.3
Psychological	8.0
Endocrine, metabolic and nutritional	7.1
Digestive	7.0
Skin	6.7
General and unspecified symptoms	6.0
Ear (hearing)	3.0
Standard process components of ICPC ^a	2.9
Neurological	2.5
Urological	2.4
Others	4.4
Total	100

^aIncluding medical examination, partial medical examination, clarification, medication, repair/fixation, therapeutic counselling, results tests/procedures and administrative procedure.

Table II. Physical examinations (n = 1816) performed in 1055 encounters, in descending frequency, and the proportion of abnormal findings.

Examination	Frequency of registered physical examinations in relation to encounters (%)	Proportion of abnormal findings in relation to registered physical examinations (%)
General condition	58	18
Local examination	25	88
Heart	23	12
Mouth and throat	15	58
Lymph nodes	11	14
Abdomen	9	32
Ears	9	46
Thyroid gland	4	11
Lungs	2	62
Rectal palpation	2	62
Neurology	2	32
Eyes	2	65
Sinuses	2	50
Breasts	<1	0

Table III. Distribution of diagnostic codes (n = 1534) in 1055 encounters, with a frequency of >1.0% across ICD-10 chapters.

ICD-10 chapter and diagnosis	Percentage of diagnostic codes
Diseases of the musculoskeletal system and connective tissue	17.2
Diseases of the respiratory system	12.4
Diseases of the circulatory system	11.6
Factors influencing health status and contact with health services e.g. observation for suspected diseases or for administrative purposes	9.8
Mental and behavioural disorders	9.3
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified	8.3
Endocrine, nutritional and metabolic diseases	5.7
Diseases of the genito-urinary system	4.6
Diseases of the skin and subcutaneous tissue	4.4
Injury, poisoning and certain other consequences of external causes	4.0
Diseases of the ear and mastoid process	3.5
Diseases of the digestive system	3.3
Certain infectious and parasitic diseases	3.1
Other	2.7
Total	100

Table IV. Distribution of prescriptions (n = 1687) in 1055 encounters, in descending frequencies across ATC main groups with a frequency of >1.0%

Main ATC group	Percentage of ATC codes in main group
Nervous system	17.7
Respiratory system	16.2
Circulatory system	15.7
Alimentary tract and metabolism	11.7
General anti-infectives for systemic use	10.1
Musculo-skeletal system	9.8
Dermatologicals	5.2
Blood and blood forming organs	4.5
Systemic hormonal preparations, excluding sex hormones	3.7
Sensory organs	2.6
Genito-urinary system and sex hormones	2.2
Other	0.6
Total	100

Table V. Differences in the six most common codes for first reported symptoms and diagnoses for each encounter, all prescriptions, radiological examinations and referrals in relation to gender, urban/rural PHCC location and socio-economic status (SES) (based on profession).

		Gender			Urban/rural PHC		SES
		n (%/χ)	♂ %	♀ %	Urban %	Rural %	High %	Low %
Symptom	Circulatory	213 (20)	22	33	28	31	21	38
codes	Musculoskeletal	173 (16)	27	22	20	31	31	22
(ICPC-2)	Respiratory	131 (12)	20	17	19	14	21	9
n = 1055	Psychological	83 (8)	10	12	14	6	10	12
	Digestive	75 (7)	12	9	10	11	11	11
	Endocrine	59 (6)	9	7	9	7	6	8
		734 (70)	100	100	100	100	100	100
			P = 0.02		P = 0.003		n.s.
Diagnostic	Musculoskeletal	262 (25)	22	30	26	29	21	33
codes	Respiratory	191 (18)	21	19	16	27	27	22
(ICD-10)	Circulatory	186 (18)	21	18	20	18	17	11
n = 1055	Mental/behavioral	112 (11)	11	12	12	10	6	13
	Factors infl. health	111 (11)	12	11	15	5	20	11
	Symptoms, signs	109 (10)	13	10	11	11	9	10
		971 (92)	100	100	100	100	100	100
			n.s		P = 0.001		P = 0.02
Prescription	Nervous	299 (28)	21	22	22	22	15	21
codes	Respiratory	273 (26)	20	20	22	17	21	20
(ATC)	Cardiovascular	265 (25)	19	20	18	21	15	8
n = 1687	Alimentary tract	197 (19)	16	14	13	17	7	12
	Anti-infective	171 (16)	15	10	11	14	30	18
	Musculoskeletal	165 (16)	9	14	14	9	12	21
		1370 (81)	100	100	100	100	100	100
			P = 0.03		P = 0.001		n.s.
X-ray		79	2	2	4	0	5	5
			n.s.		p < 0.0001		n.s.
Referrals to other specialists		130	4	3	7	0	7	7
			n.s.		P < 0.0001		n.s.

χ,consultation.