Reasons for Encounter in Outpatient Clinic of a Tertiary Hospital in South Eastern Nigeria

Background: Reasons for Encounter (RFEs) are the main aim of a clinic visit that often goes unexplored by health practitioners especially when fixated on making a clinical diagnosis. Most patients present with one or more RFEs at the clinic visit. The traditional medical model unduly emphasizes the need for a biomedical diagnosis, hence the routine use of the traditional International Classification of Diseases (ICD-10), but with the recent introduction and adoption of International Classification of Primary Care (ICPC) by the World Health Organization, there is need for a paradigm shift by primary care physicians to embrace the use of ICPC. Considering the immense benefits and practicability of ICPC, we undertook this study to get a bird’s eye view of our patients RFEs to create the necessary awareness about the use of ICPC and also to use the result in making necessary health policy recommendation and training of resident doctors in our hospital.

Objective: The aim of this study is to identify the reason for outpatient encounter in Federal University Teaching Hospital in Southern East Nigeria.

Methods: A cross-section of patients aged 16 years and above presenting at our outpatient clinic was recruited consecutively until a sample size of 325 patients was attained. There was 100% response rate among the respondents. The reasons for encounter were assessed using an interviewer administered questionnaire where they were requested to “say” in their own words their reasons for coming to see the doctor.

Results: The five commonest reason for encounter was A: general/unspecific(43.4%), X:femalegenitalia(14.2%), M: musculoskeletal(8.5%), D: digestive(6.5%) and R: respiratory(6.5%); while the least are U:urogenital(0.9%) and Y:male genital(0.9%). Incidentally none of the patients presented with substance abuse or social problems. The geriatric age group accounted for less than 20% of the total number of patients seen within the period.

Conclusion: This study identified the common reasons for encounter amongst our patients at the general outpatient. This will assist in the training of our medical students and resident doctors and effective planning of the general outpatient.

Recommendation: This study also brings to the fore the need to look into the challenges of the elderly to improve their health seeking behavior.