Abstract:

Objective: The aim of this study was to examine rural-urban differences in performance-based service data and evaluate the reasons family physicians are unable to provide service by performance exception forms. Methods: We retrospectively evaluated 4187 performance exception forms sent to the provincial health directorate by family physicians between 2019 and 2021. The preventive health service not provided, the reason specified by the family physician, the year, and whether the setting was rural or urban were noted. Results: Between 2019 and 2021, there were 2553 applications from urban areas and 1634 applications from rural areas. There were significantly fewer applications from rural areas. During this period, disruptions in immunization services were most frequent (61.1%), with a significantly greater frequency in urban (65.5%) than rural (54.3%) settings. Nearly one-third of service disruptions were attributed to migration out of the family physician’s service area. The most common reason reported for immunization service disruption was vaccine refusal (47.6%). Conclusion: Vaccine refusal and migration were identified as the main barriers to the provision of preventive health services. Although the global struggle against vaccine rejection continues, national legislative changes should be implemented to prevent a simple factor such as migration from interrupting health services in our country.

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