Background
Methods
Study design
Settings
Study population
Procedures and variables
Countries | ||||||||
---|---|---|---|---|---|---|---|---|
Belgium | Denmark | Germany | Netherlands | Norway | Slovenia | Spain | Switzerland | |
Contacts (N)
| 1368 | 974 | 1076 | 2048 | 3000 | 2637 | 1402 | 649 |
Period of data collection
| 22-01-2010 until 22-02-2010 | 1-05-2009 until 30-06-2009 | 1-05-2009 until 30-06-2009 | 1-05-2009 until 30-06-2009 | 01-05-2009 until 30-06-2009 | 01-05-2009 until 30-06-2009 | 01-05-2009 until 10-06-2009 | Jan-Febr 2009, Aug-Sept 2009 |
Regions and population size
| 1: North, urban only, 110000 inhabitants (N = 679) 2: North, small town & rural, 77000 inhabitants (N = 689) | North West, urban & rural, 1250000 inhabitants (N = 974) | South West, rural, 50000 inhabitants (N = 1076) | 1. South East, urban, 315000 inhabitants (N = 1074) 2. Central, urban & rural, 175000 inhabitants (N = 974) | 1. West, urban & rural, 25000 (N = 1000) inhabitants 2. East, urban & rural, 100000 inhabitants (N = 1000) 3. East, urban & rural 63000 inhabitants (N = 1000) | 1. North West, urban & rural, 30000 inhabitants (N = 985) 2. Central, urban, 250000 inhabitants (N = 684) 3. East, urban & rural, 30000 in habitants (N = 968) | 1 and 2. North East, urban, 160000 + 136000 inhabitants (N = 1402) | North, urban, 400000 inhabitants (N = 649) |
Inclusion
| All patients | Computerised randomisation | Face to face and telephone contacts | According to criteria; computerised randomisation | Computerised randomisation | Only face to face contacts; computerised randomisation for region 1 and 3 | According to criteria; computerised randomisation | In 1st and 2nd period, all patient contacts were counted but further patient info was only documented for 1st , 2nd and last contact |
Exclusion
| Not applicable | Not applicable | Not applicable | Prescriptions; follow-up contacts | Not applicable | Telephone contacts (not systematically recorded); prescriptions | Not applicable | Almost all |
Missings
| No missings | Missings for diagnosis replaced by symptoms | ICPC code is not necessary for patients with private insurance; missings for diagnosis replaced by symptoms | Missings for diagnosis replaced by symptoms | No missings | No missings | No missings | Gender: this variable was not on the questionnaire in the 2nd period; Age: compliance of GP's filling out questionnaire |
ICPC
| ICPC2 | ICPC | ICPC, several codes per contact | ICPC 1, partly manual | ICPC 2, several codes per contact | ICD10, manually recoded into ICPC2 | ICD10, manually recoded into ICPC2 | ICPC, several codes per contact |
Recording symptoms/diagnosis
| By GP | By GP | Symptoms by nurse and GP; diagnosis by GP | Symptoms by triage nurse (telephone consult) and additional by GP; diagnosis by GP | Symptoms by triage nurse (telephone consult) and additional by GP; diagnosis by GP and sometimes by a nurse in telephone consultations | By GP | By GP | By GP |
Coding by
| GP, an administrator, reviews all reports (RFE recoded by GP of group) | Coding afterwards by a medical student | Nurses coded symptoms at the beginning. GP/physician coded diagnosis at the end | GP at the end of the contact; a trained nurse filled in the blanks | GP at the end of the contact; sometimes by a nurse at the end of a telephone consultation | Manual by researcher from the Netherlands; checked by national researcher | Manual by researcher from the Netherlands; checked by national researcher | Two researchers (MD) |
Data analysis
Results
Patient characteristics
Countries | ||||||||
---|---|---|---|---|---|---|---|---|
Belgium (N = 1368) | Denmark (N = 974) | Germany (N = 1076) | Netherlands (N = 2048) | Norway (N = 3000) | Slovenia° (N = 2637) | Spain (N = 1402) | Switzerland* (N = 649) | |
Gender (male; %) | 44.3 | 48.3 | 33.7 | 47.5 | 46.7 | 46.9 | 43.3 | 36.5 |
Age (mean; year) | 36.2 | 34.1 | 42.5 | 35.2 | 35.4 | 51.2* | n.a. | 58.9 |
Age in categories (years)
| ||||||||
0-4 | 15.0 | 19.6 | 9.1 | 13.4 | 15.9 | 5.6 | 4.7 | 0 |
5-11 | 9.4 | 8.1 | 9.9 | 10.2 | 9.7 | 5.4 | 7.6 | 0.5 |
12-17 | 4.6 | 5.6 | 6.9 | 7.0 | 5.3 | 2.8 | 5.6 | 1.4 |
18-24 | 8.2 | 11.4 | 8.6 | 9.9 | 10.1 | 7.9 | 12.3 | 5.1 |
25-34 | 15.1 | 11.6 | 7.1 | 13.2 | 12.3 | 14.6 | 21.5 | 13.5 |
35-44 | 12.4 | 9.3 | 10.5 | 13.0 | 12.3 | 13.6 | 17.1 | 14.2 |
45-54 | 10.4 | 8.8 | 12.8 | 9.1 | 7.9 | 15.2 | 9.2 | 10.3 |
55-64 | 7.1 | 8.4 | 7.7 | 8.1 | 9.4 | 13.3 | 8.3 | 9.0 |
65-74 | 5.4 | 5.9 | 10.6 | 6.4 | 5.6 | 10.6 | 7.3 | 10.0 |
75 and more | 12.4 | 11.2 | 16.8 | 9.8 | 11.5 | 11.0 | 6.3 | 36.1 |
Diagnoses per country: ICPC chapters
Belgium (N = 1368) | Denmark (N = 974) | Germany (N = 1076) | Netherlands (N = 2048) | Norway (N = 3000) | Slovenia (N = 2637) | Spain (N = 1402) | Switzerland (N = 649) | |
---|---|---|---|---|---|---|---|---|
A. General and unspecified
|
11.6
|
19.1
|
13.4
|
15.3
|
17.8
| 7.2 | 7.6 |
13.7
|
B. Blood, blood forming organs and immune mechanism
| 0.4 | 0.0 | 0.7 | 0.2 | 0.4 | 0.4 | 0.1 | 0 |
D. Digestive
|
21.1
| 11.3 | 6.6 | 9.4 | 9.7 |
11.3
|
10.0
|
13.7
|
F. Eye
| 2.2 | 3.3 | 3.6 | 4.6 | 4.6 | 6.2 | 4.2 | 0.7 |
H. Ear
| 6.0 | 3.8 | 4.6 | 2.5 | 2.3 | 3.0 | 6.4 | 3.4 |
K. Cardiovascular
| 3.7 | 3.0 | 10.8 | 3.5 | 3.1 | 7.7 | 0.4 | 9.2 |
L. Musculoskeletal
|
10.3
|
14.5
|
11.7
|
23.3
|
14.1
|
19.8
|
12.3
|
13.9
|
N. Neurological
| 2.0 | 3.6 | 2.9 | 3.2 | 3.7 | 4.1 | 2.0 | 3.4 |
P. Psychological
| 1.2 | 3.4 | 2.2 | 1.9 | 5.9 | 3.1 | 3.2 | 6.4 |
R. Respiratory
|
27.5
|
15.7
|
18.7
|
10.8
|
14.8
|
14.6
|
38.5
|
22.4
|
S. Skin
| 7.7 |
12.7
|
15.5
|
18.6
|
13.9
|
15.1
|
11.3
| 4.9 |
T. Endocrine/metabolic and nutritional
| 0.4 | 0.7 | 3.4 | 0.6 | 1.4 | 0.5 | 0.2 | 1.2 |
U. Urological
| 4.1 | 4.2 | 5.1 | 4.3 | 5.3 | 4.7 | 3.0 | 5.3 |
W. Pregnancy, childbearing, family planning
| 0.2 | 2.1 | 0 | 0.8 | 1.2 | 1.0 | 0.0 | 0.3 |
X. Female genital
| 0.7 | 1.7 | 0.3 | 0.6 | 0.9 | 0.6 | 0.5 | 0.4 |
Y. Male genital
| 0.8 | 0.8 | 0.4 | 0.3 | 0.6 | 0.3 | 0.3 | 0.4 |
Z. Social problems
| 0.1 | 0.2 | 0 | 0 | 0.3 | 0 | 0 | 0.7 |