Primary care multidimensional model: a framework for formulating health problems in a primary care setting

There is a need to develop a systematic method for integrating organic, emotional, personal, and environmental data of a patient's lifestyle into the management of health problems. The Primary Care Multidimensional Model (PCMM) was developed to assist in the formulation of an individual's health problem, whether categorized as biological, psychological or social. The PCMM was applied to 276 health problems attended in a consecutive sample of 84 adult patients cared for in an inner city primary care setting. Seventy-five percent of the problems were categorized as primarily biological, 14% as psychological, and 9% as social. Sixty-seven percent of the "biological" problems were found to have emotional, personal, or environmental variables from the patient's lifestyle considered relevant at the time of the study visit. All psychological and social problems were likewise multidimensional. In the population studied, over 75% of the health problems attended in a primary care practice fulfilled the biopsychosocial model of illness as defined by the PCMM. The heuristic value of this study is discussed.