Use of primary health care in Spili, Crete, and in Dalby, Sweden

Scand J Prim Health Care. 1991 Dec;9(4):297-302. doi: 10.3109/02813439109018536.


A computerized medical record system was introduced in Greek primary health care (PHC) in the village of Spili in Crete. The present study was carried out to study similarities and differences in the pattern of PHC use in Dalby Health Centre, Sweden (DHC), and Spili Health Centre, Greece (SHC). In both Dalby and Spili more than half the population contacted their respective health centre during 1989. Patients contacted DHC more often than SHC, 3.33 vs 2.30 times. Relatively more females than males used the health services in Dalby (64% vs 50%) but not in Spili (57% vs 55%). More visits were made by appointment at DHC than SHC (36.0% vs 12.6%). There were great similarities in the two areas in the ten most common diagnoses, analysed in four age-groups. In both areas, acute upper respiratory infections dominated in the youngest age-groups, and hypertension and diabetes in those aged 45 years and above.

PIP: In 1989, researchers from Crete University in Crete and Lund University in Dalby, Sweden examined similarities and differences in the health care use pattern at the Spili Health Center (SHC) in Crete and at the Dalby Health Center (DHC) in Sweden. They also needed to establish a computerized medical record system in Greek primary health care. Essentially the same proportion of the population visited the 2 health centers (56% for SHC and 57% for DHC), but DHC patients made more frequent visits than did SHC patients (3.33 vs. 2.3). Yet there were more physicians per person in Spili than in Dalby (10.1 vs. 5.2/10,000 population). The mountainous terrain in an near Spili may have made it more difficult for people to go to the health center. Another possible explanation for the differences in number of visits for each patient in 1989 was that Swedes are perhaps more willing to go the health center for medical advice than the Cretes. 36% of visits to DHC were appointments compared with only 12.6% at SHC. In Crete, males were just as likely to visit the health center as females (55% vs. 57%), but females were more likely to visit the health center than males in Sweden (64% vs. 50%). People 65 years of age or older were more common in Spili than in Dalby (28% vs. 11%). Acute upper respiratory infections were the most common diagnoses in the 0-14 and 15-44 age groups. Head injuries were more common among 0-14 year old patients at SHC than their DHC counterparts (5% vs. 1.3%). Ear inflammation was the 2nd most common diagnosis at DHC but it was not 1 of the 10 most common diagnoses at SHC. This may have been due to better diagnostic abilities and modern equipment at DHC. Hypertension and diabetes mellitus predominated among 45 year old people.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Greece
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Medical Records Systems, Computerized
  • Middle Aged
  • Morbidity
  • Primary Health Care / statistics & numerical data*
  • Sex Factors
  • Sweden