Health complaints in individual visiting primary health care: population-based national electronic health records of Iran

BMC Health Serv Res. 2022 Apr 14;22(1):502. doi: 10.1186/s12913-022-07880-z.


Background: The mission of medical schools is a sustainable commitment to orient education, research, and services based on the priorities and expectations of society. The most common complaints of patients from comprehensive health service centers (CHSCs) based on the data from electronic health records were assessed in order to determine primary health care (PHC) priorities for the educational planning of medical students in Iran.

Methods: A population-based national study was designed to assess clinical complaints of patients in all age groups who were referred to CHSCs at least once to be visited by physicians. All the data in the census were extracted from electronic health records in PHC system during 2015-2020, classified by the International Classification of Primary Care 2nd edition (ICPC-2e-English), and statistically analyzed. The total number of complaints that were recorded in the system was 17,430,139.

Results: 59% of the referring patients were women. The highest number of referrals was related to the age group of 18-59 years (56.9%), while the lowest belonged to the elderly people (13.3%). In all age and sex groups, the first ten complaints of patients with three top priorities in each category included process (follow-up, consultation, and results exam), digestive (toothache and gum complaint, abdominal pain, and diarrhea), respiratory (cough, sore throat, and runny nose), general (fever, pain, and weakness and fatigue), musculoskeletal (back pain, leg complaint, and knee injuries), endocrine and nutritional (weight gain, Feeding problem, and weight loss), cardiovascular (hypertension, palpitations, and Postural hypotension), neurological (headache, dizziness, and paralysis), sexual dysfunction (vaginal complaint, discharge, and irregular menstruation), and dermatological (pruritus, rash, and inflammation) problems.

Conclusion: High priorities in referring to PHC had a key role in assessing the country's health needs. Since this study was in line with the national pattern of complaints and patients' profile, the present findings can be helpful to amend policy-making, educational planning and curricula development in medical schools.

Keywords: Clinical complaint; Educational needs assessment; Electronic health record; Medical education; Primary care.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Delivery of Health Care*
  • Electronic Health Records*
  • Female
  • Humans
  • Iran / epidemiology
  • Male
  • Middle Aged
  • Primary Health Care
  • Referral and Consultation
  • Young Adult