1. Morbidity in Primary Care
Dr. Abdul Sattar Khan
MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK)
Assistant Professor
Family Medicine Department

2. Can we measure diseases?
ASK

3. 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
ASK

4. Definition Morbid: Morbidity: Morbidity Rate:
the discipline that applies mathematical and statistical methods to assess risk
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..
ASK

5. Measures of Disease Frequency
Prevalence Rate
Incidence rate
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6. Types of Fractions Used in Describing Disease Frequency
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7. 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)
ASK

8. Prevalence rate
ASK

9. 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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10. 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.

11. Incidence rate
ASK

12. 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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13. 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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14. Health Transformation Program in Turkey by Ministry of Health
New era in primary health care: Family medicine
ASK

15. Primary health care is on the rise
ASK
The Ministry of Health of Turkey
Health Statistics Yearbook

16. Referral Rate drop ASK The Ministry of Health of Turkey
2009
ASK
The Ministry of Health of Turkey
Health Statistics Yearbook

17. 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%.
ASK
The Ministry of Health of Turkey
Health Statistics Yearbook

18. Common problems encounter at primary health care
High Blood Glucose
High Blood Pressure
High cholesterol
Arthritis
Depression
Low back pain
Fatigue
Impaired memory
9. Anxiety
Eating disorders
Obesity
STI
Headache
Conjunctivitis
ASK

19. Distribution of Hospital Discharges by ICD-10 Main Diagnosis Codes and Gender, (%), Turkey, 2008
ICD10 Diagnosis
Codes
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
Endocrine, Nutritional and Metabolic
E00 E99
3.3
2.4
2.9
Circulatory system
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
ASK
The Ministry of Health of Turkey
Health Statistics Yearbook

20. Why primary care?
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21. System characteristics
Better health outcomes
Lower costs
Greater equity in health
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22. Practice Characteristics
First-contact
Longitudinality
Comprehensiveness
Coordination
Family-centeredness
Community orientation
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23. 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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24. Thanks Teşekkürler
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