Diagnosis cluster frequency in a community-based family practice residency program. Comparison with large ambulatory data sets.

Ambulatory encounters in a community-based family practice residency program were analyzed using diagnosis clusters. During an 18-month period (July 1982 through December 1983), demographic information and clinical diagnoses for 44,453 successive patient visits were collected and stored in a computerized data base. The 30 most frequent diagnosis clusters accounted for 70% of all recorded clinical diagnoses. Comparison with NAMCS, USC-MAMP (Western Region) and Virginia studies revealed a younger, more indigent population with a higher frequency of visits for hypertension, prenatal and postnatal care, diabetes, chronic respiratory illness and congestive heart failure. Consistent with the other large ambulatory data sets, the general medical examination, hypertension and acute upper respiratory conditions were the most frequent diagnosis clusters. Differences with other reported data sets reflected the site-specific demographic characteristics of patients and providers, regional and environmental influences on the incidence of specific disease states and the relative abundance of other subspecialist physicians. Such local or regional data bases not only provide valuable information as to clinical content but also may help in identifying previously unrecognized health problems.