نظرات پزشكان عمومي داراي مطب خصوصي در شمال و شرق تهران در مورد مشكلات و موانع گزارش دهي بيماريهاي واگير

The Viewpoints of General Practitioners Owning a Private office in North and East of Tehran about Barriers and Problems of Reporting of Communicable Diseases in 2011

Abstract Background and objective: Effective Prevention and control of infectious diseases requires the surveillance system for developing efficient procedures for the priority infectious diseases. According to the less than expected reports and lack of studies on problems and barriers of reporting, this study was done with the aim of identifying the barriers and problems of surveillance system, the suitable way and time of education, the believes, the requirements and the expectations in order to improve the quality and quantity of surveillance system in the viewpoint of general practitioners (GPs) who have privet office in the north and east metropolitan area of Tehran. Materials and methods: This cross sectional study was performed with the participation of GPs undertaking their private practices around the Shahid Beheshti University in the north and east of Tehran in 2011. The sample size was 336 GPs and the sampling method was simple random. Data was collected by questionnaire and interview. Result: A total of 336 GPs participated in the study. 131(39%) of them were male, and 205 (61%) were female. The mean age of females was 36.6 ± 6 years and for males was 41.1 ± 8.6 years. The barriers to reporting included: lack of patients consent for report (26.5%), lack of adequate information by heath centers (23.8%), uncertainty of diagnosis (22%), lack of feedback of health centers (21.7%) and lack of sufficient time (21%), conflict over patient privacy (18.5%), lack of knowledge to reporting, not clearly defined reporting necessity, feeling the reports as useless 12.5%, not known identity of report giver 11.5%, not proper working time of health centers (9.8%), inappropriate behavior with referred patients (8.6%), disconnected or busy phone (8.6%), concern for missing patients (7.4%), to avoid adverse consequences of reporting (7.1%) and long distance between private office and health center (3.3%). Except uncertainty of diagnosis between two sex, which the number of female were mentioned more than male (p=0.014), there were not seen statistically significant for other options. Conclusion: The study showed that mentioned problems and barriers by GPs owning a private office who participated in this study indicate the inadequate understanding of the objectives of surveillance system and reporting activities. It seems that the most important reason of the above situation is the lack of a systematic education and an insufficiency of the activities of health centers.