ABSTRACT
RN Braun observed that frequencies of health disorders in general practice are so consistent that he called his discovery "Case Distribution Law". Our study compares morbidity data from methodologically similar surveys in primary care practices over a period of fifty years. Frequency ranks were determined for each observation period and the first 150 ranks were compared with Spearman's correlation coefficients. All correlations were consistently positive. Frequency ranks were strikingly similar for surveys carried out at approximately the same time, especially when nomenclatural matching had been carried out before data collection. Ranks were also very similar where clear disease classifications were possible, but less so for non-specific symptoms.The consistency of the distribution of health disorders helps develop diagnostic strategies (diagnostic protocols) and appropriate labeling for non-specific, diagnostically open symptom classifications. According to Braun's considerations, the regularity of case distribution plays an important role in the professionalization of primary care.
ABSTRACT
Family practices provide medical care for the majority of health problems. This already highlights the importance of primary health care with respect to quantity. A detailed five-year survey of cases in two rural practices gives insight into everyday practice. During the whole period of this year's prevalence survey, 24,541 or 32,605 episodes of care were recorded in a mean practice population of 1500 or 1700 persons, respectively. The frequency rates of more than 500 different health problems show a typical Pareto distribution. This distribution of the cases characterizes the subject of general practice/family medicine and essentially determines handling illness in practice. Lack of a common technical language, with regard to the classification of health disorders, becomes evident when comparing the practices. An issue whose impact on medical care, education and research should be further investigated.