Lehto Mika T, Kauppila Timo, Kautiainen Hannu, Laine Merja K, Rahkonen Ossi, Pitkälä Kaisu H
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Vantaa Health Centre, Vantaa, Finland.
BJGP Open. 2025 Jan 2;8(4). doi: 10.3399/BJGPO.2023.0234. Print 2024 Dec.
BACKGROUND: It can be impossible to assign a definitive diagnosis for symptoms reported or observed by primary health care patients. In these situations, symptomatic diagnoses are often used. AIM: The aim of the present study was to examine the proportion of symptomatic diagnoses among primary health care patients. We also explored which symptomatic diagnoses were most frequently recorded, as well as their distribution by age and sex. DESIGN & SETTING: This is a register-based study carried out in the public primary health care service of the city of Vantaa, Finland. METHOD: Diagnoses were entered according to the 10th revision of the International Classification of Diseases (ICD-10). The data consisted of every diagnosis entered into the electronic health record between 1 January 2016 and 31 December 2018. Both absolute numbers and relative proportions of various symptomatic diagnosis recordings (chapter 'R') were reported. RESULTS: Of all the recorded diagnoses ( = 503 001), the proportion of R-diagnoses was 13.5% ( = 67 905). Diagnoses of symptoms and signs involving the digestive system and abdomen (R10-19) (3.7% of all; = 18 550), the circulatory and respiratory systems (R00-09) (3.5%; = 17 426), general symptoms and signs (R50-69) (3.0%; = 15 165), and the skin and subcutaneous tissue (R20-23) (2.0%; = 9812) were most prevalent. Age was also a major factor determining how symptomatic diagnoses were distributed between men and women. Overall, symptomatic diagnoses were more common among women than men (14.1% and 12.4%, respectively). The major categories of symptoms and signs involving the digestive system and abdomen, the skin and the subcutaneous tissue, and general symptoms and signs, were more predominant among women, while symptoms and signs involving the circulatory and respiratory systems were more common among men. CONCLUSION: A symptomatic diagnosis code was recorded in about one eighth of GP appointments, although there were significant sex differences in the prevalence within and between diagnosis groups.
背景：对于基层医疗保健患者报告或观察到的症状，可能无法做出明确诊断。在这些情况下，通常会使用症状性诊断。 目的：本研究的目的是调查基层医疗保健患者中症状性诊断的比例。我们还探讨了哪些症状性诊断记录最为频繁，以及它们在年龄和性别上的分布情况。 设计与背景：这是一项基于登记册的研究，在芬兰万塔市的公共基层医疗保健服务机构中开展。 方法：诊断依据《国际疾病分类》第10版（ICD - 10）录入。数据包括2016年1月1日至2018年12月31日期间录入电子健康记录的所有诊断。报告了各种症状性诊断记录（“R”章）的绝对数量和相对比例。 结果：在所有记录的诊断中（n = 503001），R诊断的比例为13.5%（n = 67905）。涉及消化系统和腹部的症状和体征诊断（R10 - 19）（占所有诊断的3.7%；n = 18550）、循环系统和呼吸系统诊断（R00 - 09）（3.5%；n = 17426）、一般症状和体征诊断（R50 - 69）（3.0%；n = 15165）以及皮肤和皮下组织诊断（R20 - 23）（2.0%；n = 9812）最为常见。年龄也是决定症状性诊断在男性和女性之间分布情况的一个主要因素。总体而言，症状性诊断在女性中比在男性中更为常见（分别为14.1%和12.4%）。涉及消化系统和腹部、皮肤和皮下组织以及一般症状和体征的主要症状和体征类别在女性中更为突出，而涉及循环系统和呼吸系统的症状和体征在男性中更为常见。 结论：在大约八分之一的全科医生预约中记录了症状性诊断代码，尽管在诊断组内和诊断组之间的患病率存在显著的性别差异。
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