General practice in St. Eustatius: II. Results - abstract

ABSTRACT

During the 1-year period, September 1, 1987 to August 31, 1988, the only 2 general practioners (GP) on the island of St. Eustatius recorded patient-based and episode-oriented data concerning 7,222 encounters with patients. The average population was 1,996 persons and the average encounter rate was 3.6 per person. The lower the social class of the patient the higher was the average encounter rate. Thirty-five per cent of the population was not seen at all. The special clinics for children, pregnant women and prostitutes, district calls and the 18-bed hospital accounted for 22 per cent, and the open morning clinic, 66 per cent of all encounters. Patients frequently visited the GP after hours (11 per cent). The most frequent patient-initiated reasons for encounter were of 2 kinds; requests for bloodpressure check (5 per cent), for contraception (3 per cent), for complaints such as cough (4 per cent), headache (3 per cent), fever, abdominal pain, injuries and tiredness (2 per cent each). "No disease" was an important diagnostic rubric (5 per cent). Other frequently occurring episodes were upper respiratory tract infection, influenza, other viral diseases and acute bronchitis (3 per cent each). Chronic diseases occurring frequently were uncomplicated hypertension (2 per cent, prevalence, 60/1,000 persons) and diabetes (1 per cent, prevalence, 36/1,000 persons). An average of 3.2 interventions per encounter was recorded, mainly partial examination (36 per cent), medication (25 per cent) and advice (23 per cent). In 3 per cent of encounters, a patient was referred to a specialist. Patient-based and episode-based morbidity recording provide useful data that describes the content of general practice on a small Caribbean island (AU)