WONCA International Classification Committee

N Bentzen (ed)

WONCA international glossary for general/family practice
Fam. Pract. 1995 12: 267

A, B, C, D, E-F, G-H, I-J-L, M-N, O-P, Q-R, S-T, U-Z


O & P





A study in which nature is allowed to take its course and changes or differences in one characteristic are studied in relation to changes or differences in another characteristic, without the intervention of the investigator(s).


Variation or error due to failure of the observer to measure or identify a phenomenon accurately. All observations are subject to variation. Discrepancies between repeated observations by the same observer (intraobserver variation) and between different observers (interobserver variation) cannot be eliminated completely, but can be diminished.


A general epidemiological term describing the frequency of a health problem or event in a population, without distinguishing between incidence and prevalence.


When used about a classification it means its ability to be organized in such a manner as to allow for contingencies and permit additional codes. The ICPC has these abilities.


The systematic study, by observations and experiment, of the health services or general practice, with the aim of improving some aspects of patient care.


A scale in which the numbers reflect levels ordered from "most" to "least" with respect to some attribute. The relative distance between each level differ, and the number assigned to each level does not reflect an exact quantity. For example : 'no, maybe, yes' or 'never, rarely, often, always' are ordinal scales.


The measurable result over time of the natural course of a health problem, or of an intervention to prevent, detect, or manage a health problem.


Times other than the usual scheduled working hours of the health care provider.


A patient who attends an outpatient clinic in a hospital. Patients are usually recently discharged inpatients or referrals from general practice or accident and emergency services.


The probability that a test would statistically be as extreme as or more extreme than observed if the null hypothesis were true. The letter P, followed by the abbreviation n. s. (not significant) or by the symbol < (less than) and a decimal number such as 0. 05, is a statement of the probability that the difference observed could have occurred by chance, if the groups are really the same.


A study in which a group of people undergo continuous or repeated cross-sectional studies. The group of people have agreed to take part in the study over a specific period of time.


A pattern of thought or conceptualization within which clinicians and scientists work and from which they try to explain and interpret their findings. Paradigms may change due to research and/or philosophy.


A statistical test that depends upon the assumption that the data are normally distributed.


The status of a woman with regard to the number of deliveries, including stillbirths but excluding miscarriages. The number of times she has been pregnant is referred to as Gravida eg Gravida 2, Para 1 (expecting her second baby).


A person who receives or contracts for medical advice or services from a health care provider with whom he/she may or may not be registered.
1. Registered patient : a patient who is enrolled with a practice, but may or may not be receiving ongoing health care.
2. Active patient : a patient who has received services from the practice at least once in the last two years.
3. Inactive patient : a patient who has received no services from the practice within the last two years.
4. Temporary patient : a patient who receives one or more services, but who is enrolled with, or usually receives health care from another practice.
5. Formerly registered patient : a patient other than a temporary or transient patient, who has been removed from the register either by the practice or by personal choice.


Patients from the practice population considered to be at greater risk of a specific health problem than other individuals in the same population.


A critical study of mutual performance by persons of equal standing. Review of research protocols, manuscripts submitted for publication, abstracts submitted for presentations at scientific meetings, whereby these are judged by colleges in the same field.


A felt need. It usually refers to need for health care that is felt by the person or community concerned, but which may not be perceived by health professionals.


The set of divisions that produce exactly 100 equal parts in a series of continuous values, such as children's heights and weights. The 50th percentile indicate the average height and weight of the children in that age group.


The sum of late fetal deaths and the deaths of liveborn infants aged under 1 week. The perinatal mortality rate refers to the number of deaths per 1,000 total births where the birthweight is 500 grammes or more.
1. Stillborn : are babies of 500 grams or more who are born dead.
2. Neonatal deaths : Deaths occurring in the first 28 days after birth.
3. Infant deaths : Liveborn infants surviving less than 1 year.


From 27th week of pregnancy to 7 days after birth.


Assessment of health status conducted at predetermined intervals. It usually follows a formal protocol with structured questions, themes to be discussed and laboratory tests to be undertaken.


Those services to individuals that are performed on a one-to-one basis by a health care worker, ie a general practitioner, for the purpose of maintaining or restoring health.


A measurement combining persons and time, used as denominator in instantaneous incidence rates eg patient-years. It is the sum of individual units of time over which the persons in the study population have been exposed to the condition of interest.


Professional person qualified by medical education and authorized by law to practice medicine.


The first physician seen by a patient during an episode of illness or injury, or for preventive and/or health education matters.


A small study, usually of a convenience sample, to test preliminary measurement decisions and identify unanticipated problems in fielding the instruments in a study.


The number of persons at risk of the health problem under consideration, but can also refer to the practice population.


Pertaining to a general population defined by geographical, political or other boundaries. This population is the denominator.


The total number of registered patients in a practice. In health care systems without registration of patient (ie patient lists) it is the estimated number of persons served by the practice.
Practice population may be further described :
1. Rural : A practice population where the majority are not located in a town with a population larger than 2,000.
2. Semiurban A practice population where the majority is located in a town or city with a population between 2,000 and 50,000.
3. Urban : A practice population with the majority is located in a town or city with a population of 50,000 or more.


The number of infant deaths between 28 days and one year in a given year per 1,000 live births that year. It is an important rate to monitor in developing countries where older infants frequently die of infections and malnutrition.


The professional work of a medical practitioner. Also used to describe organisational structure, the geographical area or the population which is served by one or more medical practitioners.


The list of all registered patients in the practice.


1. Private office :
The premises in which a physician conducts his practice. More than one practitioner and paramedical services may be accommodated in these premises.
2. Residential office : An office which is located in a physician's home.
3. Satellite office : An office located at a distance from the main practice site. Staffing and the provision of health services is the responsibility of the main practice administration.
4. Health centre : A centre which emphasizes both total medical care and preventive personal health services. Staffing is varied and may include a group of family physicians/general practitioners, a multidisciplinary team, ancillary staff, specialist, and other health care providers. The centre may be owned by private physicians, government or public agencies.
5. Polyclinic : A clinic with a medical staff largely comprised of GPs and/or specialists, often working independently, rather than as a team. It can be attached to a hospital.
6. Day hospital : A health care facility, providing day health care and monitoring facilities, with medical and paramedical services available.


An early indicator of a health problem preceding pathological onset of a disease; sometimes detectable by screening.


The extent to which a measure is capable of detecting small differences.
1. The quality of being sharply defined. This can be indicated by the number of significant digits in the measurement or the standard deviation of a series of measurements.
2. In statistics, precision is defined as the inverse of variance of measurements or estimate.


In screening and diagnostic tests, the probability that a person with a positive test is a true positive (ie has the disease) is referred to as the "predictive value of a positive test". The predictive value of a negative test is the probability that a person with a negative test does not have the disease. The predictive value of a screening test is determined by the sensitivity and specificity of the test, and by the prevalence of the condition for which the test is used. This explains why the predictive value of the same test is very different in general practice and in hospital.


Patient characteristics and conditions, which precede a health problem, and which enable a health care encounter.


The number of all events (eg : patients with a specific health problem) in a defined population at one point in time (POINT PREVALENCE) or during a defined period of time (PERIOD PREVALENCE). Usually expressed per 1,000 or 10,000 persons. The period may be 1 year, 4 years or a lifetime.


Action to prevent occurrence or development of a health problem and/or its complications. Can be divided into three categories :
1. Primary prevention : action taken to avoid or remove the cause of a health problem in an individual or a population before it arises (ie immunisation).
2. Secondary prevention : Action taken to prevent development of a health problem from an early stage in an individual or a population, by shortening its course and duration (ie screening for hypertension).
3. Tertiary prevention : Action taken to reduce the effect and prevalence of a chronic health problem in an individual or a population by minimizing the functional impairment consequent to the acute or chronic health problem (ie prevent complications of diabetes).


The application of preventive measures by clinical practitioners. A specialized field of medical practice composed of distinct disciplines that utilize skills focusing on the health of defined populations in order to promote and maintain health and well-being and prevent disease, disability, and premature death.


These include immunisations, screening tests, risk assessment, education, pre- and post-natal checkups, well baby care, family planning and other similar services.


WHO (Alma Ata 1978) defined primary health care as follows : "Primary health care is essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost that the community and country can afford. It forms an integral part of the country's health care system, of which it is the nucleus, and of the overall socioeconomic development of the community". Primary health care can be delivered by PHC nurses, doctors or health professionals with a shorter medical training (ie barefoot doctors).


Throughout the world most primary medical care is delivered by general practitioners/family physicians. In their work they assume responsibility for the patient, beginning at the time of the first encounter and continuing thereafter. This includes overall management and coordination of health care, such as the appropriate use of specialists, and other health care resources. Maintenance of continuity is also included.


A group of health care providers and ancillary staff serving the same population or geographical area, sometimes occupying the same building, working together to provide different, but complementary services, which are directly available on demand.


The extent to which an event is likely to occur, measured by the ratio of the favourable cases to the total number of cases possible. Expressed as a measure ranging from 0 to 1.


Any concern in relation to the health of a patient as determined by the patient and/or the health care provider. Problems should be recorded at the highest level of specificity determined at the time of an encounter.
1. New problem : The first presentation of a problem, including the first presentation of a recurrence of a previously resolved problem but excluding the presentation of a problem first assessed by another provider.
2. Continuing problem : A previously assessed problem which requires ongoing care. It includes followup for a problem or an initial presentation of a problem previously assessed by another provider.


A medical record in which the patient's history, physical findings, laboratory results, etc. are organised to give a cumulative record of problems. This distinguishes it from the chronological record where encounters are organised in a time sequence. The record includes information which is subjective (S), objective (O) including significant negative information and an assessment (A) which includes a discussion and conclusion. This is followed by diagnostic and treatment plans (P). This format (SOAP) is applied to each problem the patient presents.


The activities of a health care system or practitioners in the provision of care.


An organized response to eliminate or reduce one or more problems where the response includes one or more objectives, performance of one or more activities, and expenditures of resources.


A type of ratio in which the numerator is included in the denominator. By definition, a proportion (p) must be in the range 0. 0<p<1. 0 and is a dimensionless quantity.


A plan or set of steps to be followed in a study, investigation or an intervention programme.


A person to whom a patient has access when contacting the health care system. In the majority of instances this will be a professional such as a general practitioner, a nurse, a midwife, a physician assistant, a medical social worker, a physiotherapist, or other allied health personnel. In some cultures, the provider may be a lay person with limited or no medical training but with health care responsibility.


Part of the health care service aimed at protection, promotion and restoration of health in the population through collective and social actions.


The use of test or scales to measure an attribute of an individual or object.


'P' comes from probability. The P-VALUE is the theoretical chance to find a difference as actually met in this study (or a greater difference) under the presumption that groups are equal with regard to the chosen parameter.