Morbidity pattern in private and public sectors of family medicine/general practice in a dual health care system

Abstract

Objective: To study the differences and their implication on the morbidity pattern in family medicine (FM)/general practice (GP) in the private and public sectors of a dual health care system. Design: A survey on morbidity of patients diagnosed by family physicians (FPs)/general practitioners (GPs) in Hong Kong. A convenient sample of FPs/GPs in private practice and a random sample of doctors in government outpatient clinics were recruited for the study. Subjects: All patients seen by the recruited FPs/GPs in 4 one-week periods over the four seasons in 1994. Main outcome measures: The diagnoses or problems identified by FPs/GPs at each patient encounter. Results: The patients in the public sector were mostly from the lower social classes, of older age, more females, with more chronic illnesses, and with more problems per consultation. Public-sector FPs/GPs could afford less time for each patient, made less psycho-social diagnoses, had to tolerate more diagnostic uncertainty, and had more difficulty in thorough understanding of their patients' background. Apart from acute primary care health problems, private FPs/GPs encountered more health problems requiring thorough evaluation and explanation. Conclusion: Morbidity pattern differs in the private and public sectors. The difference may be related to the job nature and work load of the respective physicians.