Abstract:
The general objective being to study morbidity patterns and utilization of out-patients
services in selected government hospitals and from the community in a defined area in a
district of Sri Lanka. The study also attempts to identify the factors associated with by
passing phenomenon which has been growing (or even increasing) problem in the outpatients departments of larger government health institutions in Sri Lanka. Finding of the
study show that the leading causes of morbidity of the community are diseases of respiratory
system, infectious and parasitic diseases and injuries and poisoning. This is similar to the
morbidity patterns observed in the hospital survey which shows that the community
morbidity patterns are reflected at the out patients department of government health
institutions. It is significant to note that injuries and poisoning ranked third in the disease
conditions which may have been due to the urban nature of the study area. The study of
utilization of out patients services indicate that the demand for private western medical
practitioners seem to be increasing where as the demand for government western health
sector is decreasing. The decline utilization of government health sectors needs further indepth studies. The community study showed that the infants were mainly cared by the
western private practitioners (85.2 per cent of those who fell ill) which may have been due
to priority given by parents. The finding of the survey show that the problems of by-passing
is significant. These institutional factors of the institution attended and institution by passed
were identified to be the other significant contributory factors which need further research to
study this phenomenon in depth
