Family Summit 2014

Community Health –

A Family Doctor for Every Family

每家一個家庭醫生

Cindy L K Lam

Danny D. B. Ho Professor in Family Medicine

The University of Hong Kong

clklam@hku.hk

Health and the Family

Family values

& beliefs

Illness in an

Individual

Family

relationship

Genetics

Family

stress

Family

behaviour

Impact of Illness on Quality of Life

0.84 0.79 0.78 0.76 0.76 0.74 0.73 0.73

0.7 0.68 0.68

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

SF-6D Preference Index

No Chr Dx

HK norm

Age 60+

Any Chr Dx

HT

Arthritis

DM

Dyspepsia

Heart Dx

Pulmonary

Mental Dx

Lam & Brazier et. al. Quality of Life Research 2007

Problems of Living Frequency (N=119)

(%)

Ill health 28 23.5

Financial hardship 20 16.8

Problems of family members 20 16.8

Poor family relationship 17 14.3

Loneliness / boredom 14 11.8

Worries 14 11.8

Health problems of family 13 10.9

Depression / psychological

trauma

10 8.4

Poor social relationship 4 3.4

Aging / feeling of uselessness 5 4.2

Others 5 4.2

None 36 30.3

Lam CLK, et al. Int J Geriatr Psychiatry 2009; 24:979-989.

Monthly Illnesses & Consultations in HK Lam et al , HKMJ 2011; 17: S28-S32.

12 ( 3.6%)

hospitalized

39 (11.6%)

consulted

specialists

1000 persons

in the general population

353 reported

illnesses

336

consulted

247(73.5%)

consulted

primary care

Illness & Utilization Rates Lam et al, HKMJ 2011; 17 : S28-S32

Population

Survey

FD

(N=1150)

ORD

(N=746)

NRD

(N=1157)

Last 4 weeks

Gen health good 53.2% # 41.3% ^ # 50% ^

Illness episodes 0.51*# 0.68 # ^ 0.57 * ^

Consultations 0.85 * 0.85 ^ 0.49 * ^

Last Illness

Hospitalization 1.7*# 3.6# 4.0*

Attended A&E 4.3*# 7.8# 9.6*

Significant difference by Univariate logistic regressions

* FD & NRD, ^ ORD & NRD, # FD & ORD

Life Style & Preventive Care Lam et al, HKMJ 2011; 17 : S28-S32

% Subjects FD

(N=1150)

ORD

(N=746)

NRD

(N=1157)

Smoking 17.6* 19.2^ 24.1*^

Drinking 37* 40.1 41.1*

Reg exercise 68.4*# 62.6# 63.3*

BP (>30-yr-old) 85.3* 81.5 ^ 69.6*^

Pap smear 88.2* 88.0 ^ 82.9*^

Preventive care 52.5*# 41.6# 37.3*

Significant difference by Univariate logistic regressions * FD & NRD, ^ ORD & NRD, # FD & ORD

Health Benefits of Having a Family Doctor Lam C.L.K. et al HKMJ 2011; 17: S28-S32.

• Better general health & fewer illnesses

• Better accessibility & continuity of care

• Fewer A&E visits or hospital admissions

• Healthier life style

• Have more preventive care & screening

• Receive more explanation & reassurance

• More global health improvement &

enablement after doctor consultation

Family-centred Health Care Doherty WJ et al, Family Medicine 1986; 18:153-156

Family history of major diseases

Working with the families

Empathy & support to family

Family assessment

Family counselling

A Family Doctor for Every Family

每家一個家庭醫生

www.pcdirectory.gov.hk