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International classification of primary care in the European Community


The objectives of the project were

(1) to introduce ICPC as a tool for the standardization of data collection and data management, supported by coding rules and defined terminology for use in general practice settings in the European Community;
(2) to promulgate a common knowledge base allowing for the translation of ICPC into the different languages of the European Community, to support the comparability of data collected in health care settings under different conditions in different countries;
(3) to compare encounter- and episode-based clinical information collected and classified with ICPC by general practitioners in different countries, and to initiate a change in the orientation of health statistics in the European Community towards episode oriented databases.
In the Concerted Action 'ICPC in the European Community', 4 major achievements can be distinguished.
The International Classification of Primary Care (ICPC), a reliable, feasible and valid instrument for coding the patient's reasons for encounter, the doctor's diagnoses and the interventions, has been translated and published as a free standing publication in 6 languages (Danish, Dutch, Greek, French, Norwegian and Spanish). Moreover, translations into 9 other languages (Basque, Finnish, German, Hebrew, Hungarian, Italian, Japanese, Portuguese and Swedish) have been prepared and are included in the multilanguage layer, which consequently contains ICPC in 16 languages. All translations will shortly be available on a floppy disk for use in computerized information systems.

A complete computerized conversion between ICPC and International Classification of Diseases-10 (ICD-10) has been established, which together with the multilanguage layer makes a European patient record for routine use now a realistic option.

Data collection in 207 300 encounters by 339 general practitioners (GP) in 9 countries, and coded with ICPC are included in the Concerted Action. These data confirmed both the feasibility of ICPC in encounter and episode based studies, and the validity of the reason for encounter, indicating a high degree of patient physician agreement. Several studies concentrate on the use of ICPC together with other instruments, on Functional Status indicators, on the prescription of drugs and more formal aspects of episode oriented databases.

In addition to this, several studies have resulted in publications that support and illustrate ICPC's widespread acceptance.
To execute this project the following steps were proposed:

(1) appointing one or two co-investigators from each of the participating European countries and involving general practitioners with similar interest from other countries;
(2) organizing workshops to formulate both the general objectives and the specific requirements, to train participants in the use of ICPC, to develop a strategy for the preparation of translations of ICPC and to select countries where a comparative study could be performed.

More precise definitions of the main objectives of the first phase of the ICPC project in the European Community are
(1) to investigate the feasibility, reliability, and relevance of ICPC for the harmonization and standardization of patient-oriented information in primary care in the EC; and
(2) to integrate research on classification systems in primary care within the EC.


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University of Amsterdam
Meibergdreef 15
1105 AZ Amsterdam

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