Skip to main content Accessibility help
×
Home

Is it possible to register the ideas, concerns and expectations behind the reason for encounter as a means of classifying patient preferences with ICPC-2?

  • Diego Schrans (a1), Pauline Boeckxstaens (a1), An De Sutter (a1), Sara Willems (a1), Dirk Avonts (a1), Thierry Christiaens (a1), Jan Matthys (a1) and Thomas Kühlein (a2)...

Abstract

Background

Family practice aims to recognize the health problems and needs expressed by the person rather than only focusing on the disease. Documenting person-related information will facilitate both the understanding and delivery of person-focused care.

Aim

To explore if the patients’ ideas, concerns and expectations (ICE) behind the reason for encounter (RFE) can be coded with the International Classification of Primary Care, version 2 (ICPC-2) and what kinds of codes are missing to be able to do so.

Methods

In total, 613 consultations were observed, and patients’ expressions of ICE were narratively recorded. These descriptions were consequently translated to ICPC codes by two researchers. Descriptions that could not be translated were qualitatively analysed in order to identify gaps in ICPC-2.

Results

In all, 613 consultations yielded 672 ICE expressions. Within the 123 that could not be coded with ICPC-2, eight categories could be defined: concern about the duration/time frame; concern about the evolution/severity; concern of being contagious or a danger to others; patient has no concern, but others do; expects a confirmation of something; expects a solution for the symptoms without specification of what it should be; expects a specific procedure; and expects that something is not done.

Discussion

Although many ICE can be registered with ICPC-2, adding eight new categories would capture almost all ICE.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Is it possible to register the ideas, concerns and expectations behind the reason for encounter as a means of classifying patient preferences with ICPC-2?
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Is it possible to register the ideas, concerns and expectations behind the reason for encounter as a means of classifying patient preferences with ICPC-2?
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Is it possible to register the ideas, concerns and expectations behind the reason for encounter as a means of classifying patient preferences with ICPC-2?
      Available formats
      ×

Copyright

Corresponding author

Correspondence to: Diego Schrans, MD, Department of Family Medicine and Primary Health Care, Ghent University, Campus UZ-Ghent, De Pintelaan 185, 9000 Ghent, Belgium. Email: diego.schrans@ugent.be

References

Hide All
Bertakis, K.D. and Azari, R. 2011: Patient-centered care is associated with decreased health care utilization. The Journal of the American Board of Family Medicine 24, 229239.
Britt, H., Miller, G.C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., Pan, Y., Wong, C., Charles, J., Chambers, T., Gordon, J. and Pollack, A.J. 2014. A decade of Australian general practice activity 200405 to 2013–14 . Sydney: Sydney University Press.
Cassell, E. 2004. The nature of suffering and the goals of medicine. New York: Oxford University Press.
Cassell, E.J. 1985. Talking with patients: clinical technique . Cambridge: MIT Press.
Deveugele, M., Derese, A., Maesschalck, S.D., Willems, S., Driel, M.V. and Maeseneer, J.D. 2005: Teaching communication skills to medical students, a challenge in the curriculum? Patient Education and Counseling 58, 265270.
Di Blasi, Z., Harkness, E., Ernst, E., Georgiou, A. and Kleijnen, J. 2001: Influence of context effects on health outcomes: a systematic review. Lancet 357, 757762.
EURACT 2011. The European definition of general practice/family medicines, 2011 edition. Barcelona: WONCA Europe.
Green, L.A., Fryer, G.E., Yawn, B.P., Lanier, D. and Dovey, S.M. 2001: The ecology of medical care revisited. New England Journal of Medicine 344, 20212025.
Hartman, T.C.O., Van Ravesteijn, H., Lucassen, P., Van Boven, K., Van Weel-Baumgarten, E. and Van Weel, C. 2011: Why the ‘reason for encounter’ should be incorporated in the analysis of outcome of care. The British Journal of General Practice 61, e839e841.
Lincoln, Y. and Guba, E. 1985. Naturalistic inquiry. Newbury Park: Newbury Park Sage Publications.
Matthys, J., Elwyn, G., Van Nuland, M., Van Maele, G., De Sutter, A., De Meyere, M. and Deveugele, M. 2009: Patients’ ideas, concerns, and expectations (ICE) in general practice: impact on prescribing. The British Journal of General Practice 59, 2936.
Sackett, D.L. 1995: Evidence-based medicine, in its place. The Lancet 346, 785.
Schrans, D., Avonts, D., Christiaens, T., Willems, S., De Smet, K., Van Boven, K., Boeckxstaens, P. and Kühlein, T. 2016: The search for person-related information in general practice: a qualitative study. Family Practice 33, 9599.
Sheaff, R., Halliday, J., Byng, R., Ovretveit, J., Exworthy, M., Peckham, S. and Asthana, S. 2017: Bridging the discursive gap between lay and medical discourse in care coordination. Sociology of Health Illness, pp. 1–16. doi: 10.1111/1467-9566.12553.
Soler, J.K. and Okkes, I. 2012: Reasons for encounter and symptom diagnoses: a superior description of patients’ problems in contrast to medically unexplained symptoms (MUS). Family Practice 29, 272282.
Soler, J.K., Okkes, I., Oskam, S., Van Boven, K., Zivotic, P., Jevtic, M., Dobbs, F. and Lamberts, H. 2012: An international comparative family medicine study of the Transition Project data from the Netherlands, Malta and Serbia. Is family medicine an international discipline? Comparing incidence and prevalence rates of reasons for encounter and diagnostic titles of episodes of care across populations. Family Practice 29, 283298.
Starfield, B. 2009: Primary care and equity in health: the importance to effectiveness and equity of responsiveness to peoples’ needs. Humanity & Society 33, 5673.
Starfield, B. 2011: Is patient-centered care the same as person-focused care? The Permanente Journal 15, 6369.
Stewart, M. 2003. Patient-centered medicine transforming the clinical method. London: Radcliffe.
Stewart, M., Brown, J.B., Donner, A., Mcwhinney, I.R., Oates, J., Weston, W.W. and Jordan, J. 2000: The impact of patient-centered care on outcomes. The Journal of Family Practice 49, 796804.
Stewart, M. and Ryan, B. 2015: Ecology of health care in Canada. Canadian Family Physician 61, 449453.
Stewart, M., Ryan, B.L. and Bodea, C. 2011: Is patient-centred care associated with lower diagnostic costs? Healthcare Policy 6, 2731.
Verbeke, M., Schrans, D., Deroose, S. and De Maeseneer, J. 2006: The International Classification of Primary Care (ICPC-2): an essential tool in the EPR of the GP. Studies in Health Technology and Informatics 124, 809814.
Weiner, S.J., Schwartz, A., Sharma, G., Binns-Calvey, A., Ashley, N., Kelly, B., Dayal, A., PATEL, S., Weaver, F.M. and Harris, I. 2013: Patient-centered decision making and health care outcomes: an observational study. Annals of Internal Medicine 158, 573579.
White, K.L., Williams, T.F. and Greenberg, B.G. 1961: The ecology of medical care. New England Journal of Medicine 265, 885892.
WONCA 2005. ICPC-2-R: International classification of primary care. Oxford: Oxford University Press.
WONCA : ICPC-2 (two-pager English). Retrieved January 2017 from http://www.kith.no/upload/2705/icpc-2-english.pdf.

Keywords

Is it possible to register the ideas, concerns and expectations behind the reason for encounter as a means of classifying patient preferences with ICPC-2?

  • Diego Schrans (a1), Pauline Boeckxstaens (a1), An De Sutter (a1), Sara Willems (a1), Dirk Avonts (a1), Thierry Christiaens (a1), Jan Matthys (a1) and Thomas Kühlein (a2)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed