Withana S S, Mendis K, Liyanage U P, Nandasena S, Wickremasinghe A R
Department of Family Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Department of Primary Care and Family Medicine, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, P.O. Box 02, Belihuloya, Sri Lanka.
BMC Health Serv Res. 2025 Aug 23;25(1):1123. doi: 10.1186/s12913-025-13337-w.
The 55 million visits to government outpatient departments (OPD) in Sri Lanka in 2014, is estimated to increase to 100 million in 2027. The private OPD visits in 2014 was estimated at 50 million per annum. In primary care, there is a paucity of medical records, research on symptoms and healthcare seeking behaviour. We aimed to determine the symptom prevalence and healthcare seeking pattern of residents in Gampaha district, Sri Lanka.
A community-based prospective study using a participant-held symptom diary and interviews were conducted in two areas, Ragama (urban) and Mirigama (rural), in the Gampaha district of Sri Lanka during May-June 2018. For each area, three midwife areas were randomly chosen. Clusters of 15-20 households were selected from 5-6 random locations from each midwife area.
2046 individuals from 557 households participated. Majority were females (n = 1127, 55.1%). There were 1207 (59%) from Mirigama area. Among participants, 1919 (93.8%) reported symptoms. Phlegm (n = 4200, 7.0%), leg pain (n = 3943, 6.6%) and cough (n = 3153, 5.3%) were top symptoms among all symptoms reported; the musculoskeletal group (n = 18,081, 30.4%) predominated. 924 (45.1%) participants sought treatment, 763 out of 2046 participants (37.3%) sought allopathic treatment. Private sector visits were more (n = 515, 25.2%). The decision to seek private or public healthcare services was influenced by income. Persons with higher income preferred a private institution. Of the 46 (2.3%) hospital admissions, 42 (91.3%) were to public hospitals, of which, 19 (41.3%) were to teaching hospitals, and 4 (0.9%) to a private institution.
The population had a high prevalence of symptom reporting (93.8%) and a high healthcare seeking behaviour (45.2%). Among those who sought allopathic treatment, the majority preferred private ambulatory care. 90% of hospital admissions (42/47) were to public hospitals. Provision of ambulatory care services should be prioritized in further development of the health services.
2014年，斯里兰卡政府门诊部门的就诊人次达5500万，预计到2027年将增至1亿。2014年私立门诊部门的就诊人次估计为每年5000万。在初级保健中，医疗记录、症状研究及就医行为方面的研究匮乏。我们旨在确定斯里兰卡甘巴哈地区居民的症状患病率及就医模式。
2018年5月至6月期间，在斯里兰卡甘巴哈地区的两个区域，即拉贾马（城市）和米里加马（农村），开展了一项基于社区的前瞻性研究，采用参与者持有的症状日记并进行访谈。对于每个区域，随机选择三个助产士区域。从每个助产士区域的5至6个随机地点选取15至20户家庭组成群组。
来自557户家庭的2046人参与了研究。多数为女性（n = 1127，55.1%）。来自米里加马地区的有1207人（59%）。在参与者中，1919人（93.8%）报告有症状。在所有报告的症状中，痰液（n = 4200，7.0%）、腿痛（n = 3943，6.6%）和咳嗽（n = 3153，5.3%）是主要症状；肌肉骨骼类症状（n = 18081，30.4%）占主导。924名（45.1%）参与者寻求治疗，2046名参与者中有763名（37.3%）寻求西医治疗。前往私立部门就诊的更多（n = 515，25.2%）。寻求私立或公立医疗服务的决定受收入影响。收入较高者更倾向于私立机构。在46例（2.3%）住院病例中，42例（91.3%）入住公立医院，其中19例（41.3%）入住教学医院，4例（0.9%）入住私立机构。
该人群症状报告患病率高（93.8%）且就医行为频繁（45.2%）。在寻求西医治疗的人群中，多数倾向于私立门诊护理。90%的住院病例（42/47）入住公立医院。在卫生服务的进一步发展中，应优先提供门诊护理服务。
