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?

Prim Health Care Res Dev. 2018 Jan;19(1):1-6. doi: 10.1017/S1463423617000391. Epub 2017 Sep 13.

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.

Keywords: classification; family medicine; person-focused care; primary health care.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Family Practice / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Preference*
  • Patient-Centered Care / methods*
  • Primary Health Care / methods*
  • Young Adult