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The SASPREN primary care survey - who consults the family doctor?
Abstract
Objective. To describe selected characteristics of patients consulting general family practitioners in the Western Cape.
Design. A cross-sectional survey design was employed in which doctors completed a structured questionnaire during or immediately after each consultation.
Setting. Data were collected by family practitioners in private practice who were affiliated to the South African Sentinel Practitioner Research Network (SASPREN).
Participants. All patients who had a face-to-face encounter wrth the doctor at his/her surgery. A total of 2 473 such encounters was included. Main outcome measures. Age, sex, race, method of payment and smoking status.
Results. Females outnumbered males in all race groups except blacks, where they comprised 48% of patients. Most patients were under the age of 14 years (23.3%) or between 25 and 44 years (33.3%). However, after the demography of the ca1chment population was taken into account, the highest utilisation of general practitioner services was found to be at extremes of age. This utilisation pattern was demonstrated in both sexes and all races. In relation to their distribution in the population. whites and Indians are over~represented in private practice while blacks and coloureds are under-represented. The bulk of patients (67%) pay for general practitioner services via some form of insurance (medical aid or benefit fund). but significant differences exist across race groups. In the case of blacks and Indians, the majority (72% and 64% respectively) of consultations are funded 'out of pocket'. An alamingly high smoking prevalence was found in black and coloured men. In all race/sex groups smoking rates peak between 25 and 44 years. In this age group, 68.6% of black men and 73.3% of coloured men were current smokers.
Conclusions. This study provides essential information on patients seen in family practice. Access to family doctor selVices in the Western Cape should be improved for blacks and coIoureds. There is an urgent need for smoking cessation interventions in the region.
