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
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