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ÖZ Amaç: Bu çalışma, ikinci basamak sağlık hizmetlerine başvuru yapan hastaların birinci basamak sağlık hizmetlerini kullanma durumlarının belirlenmesi amacıyla yapılmıştır. Yöntem: Araştırma kesitsel tanımlayıcı olarak planlanmıştır. Veriler 2015-2016 tarihleri arasında Gaziantep’te bir devlet hastanesinin dahili polikliniklerine başvuru yapan hastalardan toplanmıştır. Çalışmaya hastaneye başvuran ve araştırmaya katılmayı kabul eden 302 hasta dahil edilmiştir. Bulgular: Çalışmaya katılanların %69'unun kadın, %35'inin 65 yaş ve üzeri, %71.5'nin evli, %96.6'sının düşük gelirli olduğu, %40.7'sinin okuma yazma bilmediği, %97.4'ünün sosyal güvencesinin bulunmadığı ve %66'sının sosyal güvencesinin hastane masraflarını karşılamadığı belirlenmiştir. Kronik hastalık oranları %54 olarak bulunmuş ve daha çok diyabet (%12.9), astım (%10.3) ve depresyon/anksiyete (%11.9) görüldüğü belirlenmiştir. Aile hekimlerini %87.7'sinin bilmediği ve aile hekimi tarafından %99.7'sinin hiç ziyaret edilmediği bulunmuştur. Birinci basamak sağlık hizmetlerini kullanma oranının %30.8 olduğu ve bunların %50.7'sinin sadece ilaç yazdırmak için kullandığı, %54'ünün bir yıl içinde sadece 1-5 kez gittiği belirlenmiştir. Devlet hastanesine gelmeden önce %91.1'inin aile hekimine başvurmadığı ve %54'ünün uzman doktor ve daha kapsamlı tetkik/tedavi için devlet hastanesine geldiği saptanmıştır. Devlet hastanesini %91.4'ü tercih etmektedir. Bunların %60'ı ciddi durumlarda, %37.7'si ciddi olmayan durumlarda gitmektedir. Sevk işleminin uygulanmasına ilişkin %81.5'inin uygulanmasını istemediği belirlenmiştir. Sonuç: Araştırmanın bulguları değerlendirildiğinde, birinci basamak sağlık hizmetlerin etkili bir şekilde kullanılmadığı, sağlık hizmetlerinde sevk sisteminin takip edilmediği görülmektedir.
This study was conducted with the aim of determining the conditions in which patients applying for second-level health care use first-level health care services. Method: The research is planned as a cutting-edge identification. The data was collected from patients applying to the internal clinics of a state hospital in Gaziantep between 2015-2016. The study included 302 patients applying to the hospital and agreeing to participate in the study. Results: 69% of the study participants were women, 35% were 65 years of age and older, 71.5% were married, 96.6% were low-income, 40.7% were unable to read and write, 97.4% were unable to have social security and 66% were unable to pay for hospital expenses. The rate of chronic diseases was 54% and more diagnosed with diabetes (12.%), asthma (10.3), and depression/anxiety (11.9). 87.7 percent of the family doctors did not know their family doctors and 99.7 percent did not visit their family doctors. The first stage medical services were 30.8 percent and 50.7 percent were used only to print medications, 54 percent went only 1-5 times in a year. 91.1 percent did not apply to a family doctor before they arrived at the state hospital, and 54 percent came to the state hospital for specialized doctors and for more comprehensive examination/treatment. 91.4% of people prefer state hospitals. 60% of them are in serious cases and 37.7% are in non-serious cases. 81% of the processing is carried out. 5 is not required to be implemented. Result: When the findings of the study are evaluated, it is found that first-stage health care services are not effectively used, the transmission system in health care services is not traced.
ABSTRACT Aim: This study was conducted to determine the use of primary health care services for patients who applied to secondary health care services. Methods: The research was designed as a cross-sectional descriptive study. The data were collected from patients who applied to the internal polyclinics of Gaziantep State Hospital between 2015-2016. The study was included 302 patients who applied to hospital and accepted to participate in the study. Results: It has been determined that 69% of the participants were women, 35% of 65 years of age and over, 71.5% married, 96.6% of low income, 40.7% of them are illiterate, 97.4% had no social security and for 66% of patients the social security does not cover the hospital expenses. The rate of chronic disease was determined as 54% and it was commonly observed diabetes (12.9%), asthma (10.3%) and depression/anxiety (11.9%). It was found that 87.7% of them the did not know their family physicians and 99.7% of patients were not visited by means of their family physicians. The rate of using the primary health care services is 30.8% and 50.7% of them use it only for prescribe drug, 54% of them apply only 1-5 times in a year. It was found that, before coming at the state hospital 91.1% did not apply to the family physician and 54% had come a state hospital for a specialist and further examination / treatment. 91.4% of them prefer the state hospitals. 60% of them are in serious conditions and 37.7% of them are in minor conditions apply hospital. It was determined that 81.5% did not want the implementation of the referral process. Conclusion: When the findings of the study are evaluated, it is seen that primary health care services are not used effectively and the step system in health services is not sustained.
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