Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
BMC Health Serv Res. 2022 Apr 14;22(1):502. doi: 10.1186/s12913-022-07880-z.
The mission of medical schools is a sustainable commitment to orient education, research, and services based on the priorities and expectations of society. The most common complaints of patients from comprehensive health service centers (CHSCs) based on the data from electronic health records were assessed in order to determine primary health care (PHC) priorities for the educational planning of medical students in Iran.
A population-based national study was designed to assess clinical complaints of patients in all age groups who were referred to CHSCs at least once to be visited by physicians. All the data in the census were extracted from electronic health records in PHC system during 2015-2020, classified by the International Classification of Primary Care 2 edition (ICPC-2e-English), and statistically analyzed. The total number of complaints that were recorded in the system was 17,430,139.
59% of the referring patients were women. The highest number of referrals was related to the age group of 18-59 years (56.9%), while the lowest belonged to the elderly people (13.3%). In all age and sex groups, the first ten complaints of patients with three top priorities in each category included process (follow-up, consultation, and results exam), digestive (toothache and gum complaint, abdominal pain, and diarrhea), respiratory (cough, sore throat, and runny nose), general (fever, pain, and weakness and fatigue), musculoskeletal (back pain, leg complaint, and knee injuries), endocrine and nutritional (weight gain, Feeding problem, and weight loss), cardiovascular (hypertension, palpitations, and Postural hypotension), neurological (headache, dizziness, and paralysis), sexual dysfunction (vaginal complaint, discharge, and irregular menstruation), and dermatological (pruritus, rash, and inflammation) problems.
High priorities in referring to PHC had a key role in assessing the country's health needs. Since this study was in line with the national pattern of complaints and patients' profile, the present findings can be helpful to amend policy-making, educational planning and curricula development in medical schools.
医学院的使命是根据社会的优先事项和期望，持续致力于教育、研究和服务。为了确定伊朗医学生教育规划的初级保健（PHC）重点，对基于电子健康记录数据的综合保健服务中心（CHSCs）患者的常见投诉进行了评估。
本研究设计为一项基于人群的全国性研究，旨在评估至少一次被医生访问过的 CHSCs 就诊的所有年龄段患者的临床投诉。在 2015-2020 年期间，通过国际初级保健分类 2 版（ICPC-2e-English）对 PHC 系统中电子健康记录中的所有数据进行分类提取，并进行统计学分析。系统中记录的总投诉数为 17430139 例。
59%的转诊患者为女性。转诊人数最多的年龄段为 18-59 岁（56.9%），而老年人（13.3%）最少。在所有年龄和性别组中，前 10 位患者投诉中，每个类别的三个优先事项都包括流程（随访、咨询和结果检查）、消化（牙痛和牙龈投诉、腹痛和腹泻）、呼吸（咳嗽、喉咙痛和流鼻涕）、一般（发烧、疼痛和虚弱和疲劳）、肌肉骨骼（背痛、腿部投诉和膝盖受伤）、内分泌和营养（体重增加、喂养问题和体重减轻）、心血管（高血压、心悸和体位性低血压）、神经（头痛、头晕和瘫痪）、性功能障碍（阴道投诉、分泌物和月经不调）和皮肤病（瘙痒、皮疹和炎症）问题。
在 PHC 转诊中优先级较高，对评估国家的健康需求具有关键作用。由于本研究符合国家投诉模式和患者特征，因此本研究结果有助于修订政策制定、医学院教育规划和课程发展。
