Üniversite hastanesine başvuran hastaların ilk başvuruda aile sağlığı merkezi veya üçüncü basamak sağlık kuruluşu tercihlerinin incelenmesi
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Tarih
2022
Yazarlar
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Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Birinci basamak sağlık hizmetleri; önleyici ve koruyucu sağlığı barındıran, erişilebilir ve uygun maliyetli sağlık hizmetleridir. Bu çalışmada; üniversite hastanesine başvuran hastaların ilk başvuruda aile sağlığı merkezi (ASM) veya üçüncü basamak sağlık kuruluşu tercihlerini etkileyen faktörler incelenerek sağlık sistemi basamaklarının etkin ve sevk zincirine uygun kullanımının değerlendirilmesi amaçlandı.
Gereç ve yöntem: Tanımlayıcı ve kesitsel tipte yapılan bu çalışmanın evrenini, Meram Tıp Fakültesi Hastanesi’ne başvuran 18 yaş ve üzeri erişkinler oluşturdu. Çalışmada; sosyodemografik bilgi formu, genel sağlık sistemi ile ilgili sorular ve aile hekimliği ile ilgili önermelerin olduğu beşli Likert tablo içeren bir anket formu kullanıldı. Anket formu, 28 Aralık 2021- 15 Şubat 2022 tarihleri arasında Meram Tıp Fakültesi Hastanesi’ndeki hastalara uygulandı.
Bulgular: Katılımcıların yaş ortalaması 41,5±15,84 yıl, %65,1’i (n=239) kadın ve %72,2’si (n=265) evliydi. Çalışmaya katılanların %41,4’ü (n=152) ev hanımı ve %62,4’ü (n=229) ise çalışmayan gruptaydı. Anketi cevaplayanların %31,1’i (n=114) acil durumlar dışında ilk başvuruda aile sağlığı merkezlerini tercih ederken %24,8’i (n=91) en sık ASM’den faydalandığını belirtti. Çalışmaya katılanların %62,4’ü (n=229) ASM’ye genellikle ilaç yazdırmak için başvururken %46,3’ü (n=170) muayene amaçlı başvurdu. “Bir sağlık sorunum olduğunda ilk aklıma gelen doktor aile hekimimdir” önermesine katılımcıların %55’i (n=202) katıldı ve bu önerme ile ASM’ye başvuru sıklığı arasında anlamlı fark vardı (p=0,026). “Aile hekimimle tüm sorunlarımı paylaşabilirim” önermesine katılımcıların %59,4’ü (n=218) katıldı. “ASM’de şikâyetimle ilgili etkin çözüm sunulmaktadır” önermesine katılımcıların %56,4’ü (n=207) katıldı. Katılımcıların %70’i (n=257) ASM’deki çalışanların ilgisinden memnundu.
Sonuç: Bu çalışma üç hastadan birinin acil durumlar dışında ilk başvuruda ASM’yi tercih etmesine rağmen üçüncü basamak hastaneye başvuranların neredeyse yarısının birinci veya
vi
ikinci basamakta çözülebilecek sorunlar için geldiğini göstermesi açısından önemlidir. Aile hekimliği sisteminin ve sevk zincirinin daha iyi uygulanması durumunda bu oranların değişeceği kesin gibi görülmektedir. Bu da sağlık maliyetini ve çıktılarını olumlu yönde destekleyeceği kanaatindeyiz.
Primary health care services are accessible and cost-effective that involves preventive and protective health. In this study, it is aimed that evaluation of using healthcare system properly to referral chain and effectively by investigating the factors affecting the family health center (FHC) or tertiary health care institution preferences of the patients who applied to the university hospital. Materials and Methods: The population of this study, which was planned as a descriptive and cross-sectional study, consisted of adults aged 18 and over who applied to Meram Medical Faculty Hospital. In the study, a questionnaire consisting of a sociodemographic information form, questions about general health system and a questionnaire form containing a five-point Likert table with suggestions about family medicine were used. The questionnaire was applied to the patients in Meram Medical Faculty Hospital between 28 December 2021 and 15 February 2022. Results: The mean age of the participants was 41.5±15.84 years, 65.1% (n=239) were female, 72.2% (n=265) were married, 41.4% (n=152) were housewives and 62.4% (n=229) were in the non-working group. While 31.1% (n=114) of the respondents stated that they preferred family health centers in the first application, except for emergencies, 24.8% (n=91) stated that they mostly benefited from FHC. While 62.4% (n=229) of the study participants applied to the FHC to prescribe medication, 46.3% (n=170) applied for examination purposes. The rate of those who thought of family physicians first when they had a health problem was 55% (n=202), and there was a significant difference between this rate and the frequency of admission to the FHC (p=0.026). While 59.4% (n=218) of the participants agreed with the statement "I can share all my problems with my family doctor", 56.4% (n=207) of the participants agreed with the proposition "An effective solution is provided regarding my complaint in FHC". The rate of the Participants who were satisfied with the attention of the employees in the FHC was 70% (n=257). viii Conclusions: This study is important in that it shows that almost half of the patients who apply to the hospital come for problems that can be solved in primary or secondary care. In countries where the family medicine system and referral chain are well implemented, the healthcare system is considered to be sustainable and effective. The family medicine system should be strengthened, the number of family physician specialists should be increased, and the referral chain should be put into practice when sufficient infrastructure is provided.
Primary health care services are accessible and cost-effective that involves preventive and protective health. In this study, it is aimed that evaluation of using healthcare system properly to referral chain and effectively by investigating the factors affecting the family health center (FHC) or tertiary health care institution preferences of the patients who applied to the university hospital. Materials and Methods: The population of this study, which was planned as a descriptive and cross-sectional study, consisted of adults aged 18 and over who applied to Meram Medical Faculty Hospital. In the study, a questionnaire consisting of a sociodemographic information form, questions about general health system and a questionnaire form containing a five-point Likert table with suggestions about family medicine were used. The questionnaire was applied to the patients in Meram Medical Faculty Hospital between 28 December 2021 and 15 February 2022. Results: The mean age of the participants was 41.5±15.84 years, 65.1% (n=239) were female, 72.2% (n=265) were married, 41.4% (n=152) were housewives and 62.4% (n=229) were in the non-working group. While 31.1% (n=114) of the respondents stated that they preferred family health centers in the first application, except for emergencies, 24.8% (n=91) stated that they mostly benefited from FHC. While 62.4% (n=229) of the study participants applied to the FHC to prescribe medication, 46.3% (n=170) applied for examination purposes. The rate of those who thought of family physicians first when they had a health problem was 55% (n=202), and there was a significant difference between this rate and the frequency of admission to the FHC (p=0.026). While 59.4% (n=218) of the participants agreed with the statement "I can share all my problems with my family doctor", 56.4% (n=207) of the participants agreed with the proposition "An effective solution is provided regarding my complaint in FHC". The rate of the Participants who were satisfied with the attention of the employees in the FHC was 70% (n=257). viii Conclusions: This study is important in that it shows that almost half of the patients who apply to the hospital come for problems that can be solved in primary or secondary care. In countries where the family medicine system and referral chain are well implemented, the healthcare system is considered to be sustainable and effective. The family medicine system should be strengthened, the number of family physician specialists should be increased, and the referral chain should be put into practice when sufficient infrastructure is provided.
Açıklama
Anahtar Kelimeler
Aile hekimliği, Sevk zinciri, Birinci basamak, Üçüncü basamak, Hasta memnuniyeti, Family medicine, Referral chain, Primary care, Tertiary care, Patient satisfaction
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
İlhan, Ö. A. (2022). Üniversite hastanesine başvuran hastaların ilk başvuruda aile sağlığı merkezi veya üçüncü basamak sağlık kuruluşu tercihlerinin incelenmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Aile Hekimliği Anabilim Dalı, Konya.
