EpiDARC-an epidemiological study of British Defence Primary Healthcare (DPHC) demand by the Defence Audit and Research Collaborative (DARC).

Abstract

Introduction: Understanding the workload in military primary care is essential to inform policy making, resource allocation and training for the general practitioners of tomorrow. Due to well-recognised limitations with coding in primary care and additional barriers within UK Armed Forces (UKAF) Defence Primary Healthcare (DPHC), the understanding of reasons for visit (RFV) is difficult to ascertain from a top-down perspective.

Methods: A multicentre, cross-sectional study to describe the frequency of patient RFV over a 2 week period in general practices across the DPHC network was undertaken. RFV was documented using the International Classification of Diseases 11 (ICD-11) tier one codes, with specific conditions highlighted based on published literature and Defence needs.

Results: 18 medical centres, representing all DPHC regions and 26% of the Defence population, were included. A total of 6693 RFV were recorded, which differed from the published literature for primary care in developed countries, cementing the function of DPHC as an occupationally focused service with musculoskeletal injuries and mental health presentations being most common.

Conclusions: DPHC can better understand the RFV across its service and intelligently target service delivery, pathway development and managed clinical networks based on this study, which differs from some previous evidence.This study also is a proof of concept for a network of researchers, collaborating with a Defence-wide perspective, allowing grassroots data collection outside of overburdened centralised systems and developing interest and engagement in research, audit and collaboration among our clinicians.