Interview surveys of handicapped people: the accuracy of statements about the underlying medical conditions.
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Biomedical subjects
Publications and source records attributed to M D Warren.
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The organisation of general practice in England is outlined and the independent contractor basis of the family practioner emphasised. Data from family practice, like data from hospital practice, may be used for clinical management, practice management, or research. Examples of applications in each of these fields are given. The basic records used in family practice--the medical record envelope, the prescription form and the claim for sickness benefit--are described. Some practices record morbidity (E Book or Diagnostic Index), some record systematically details of their activities (L Book or Activities Ledger) and some maintain age and sex registers and other registers of their patients; all these developments are outlined. Attention is drawn to the introduction of problem orientated records and to the use of computers in family practice, but these innovations are not discussed. Outstanding issues are the same as those in hospital record systems--accuracy, definitions, coverage, confidentiality, clerical support and costs, and the use made of the information.
This study used the age-sex register of a group medical practice as the population base for a postal and follow-up interview enquiry to locate handicapped people and examined the possibility of the combined use of a practice diagnostic index and the patients' medical records for the same purpose. The age-sex register was found to contain deficiencies and inaccuracies despite the substantial efforts of members of the practice team to maintain it, for example, 13.5 per cent of the forms were returned as the addressee was unknown at the address.The 81.5 per cent of householders who responded identified 353 impaired people who were subsequently interviewed about the nature of their impairment, the underlying condition, and the range of their activities. Depending upon the answers to these questions, a proportion of these people were classified as handicapped and were asked further questions. The number of impaired people and their distribution in sex and age-groups were broadly similar to the findings from other surveys. The diagnoses of the underlying conditions given by the impaired people were discussed with the general practitioners and confirmed or otherwise by the use of the patients' notes or the recollections of the general practitioners.It was concluded that while the use of a diagnostic index would be helpful for some conditions, there would remain a substantial number of people with a disease that is potentially disabling who would have to be approached for further screening and also a substantial number of people who are handicapped, but who would be missed.
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