Assessment of workload and human capacity of family physicians in Manisa province in 2011

Abstract

Objective: To perform a quantitative assessment of services and registered population in Manisa province in 2011; compare with regional and country data; investigate workload according to registered services and determine the necessary number of family physicians by considering ideal time necessary to perform each service.

Methods: The research is a crossectional study performed in 2012. Data on family physicians and their services were collected from Manisa-AHBS; php-Oracle media were used for counting and decision making. Annual workload and shortage of labor were computed considering average time for each service determined by Ministry of Health or by the researcher and annual actual working hours. SPSS for Windows 15.0 was used for analysis. The data were analyzed by chi-square and t-test for independent samples.

Results: Of family physicians (FPs), 74.9% (n=378) were men, average age was 44.5±5.7. Fifty three point two percent of Family Health Centers (n=154) and %28.8 of FPs were in rural areas. Fifty one point nine percent of FPs deliver services for mobile population (n=242,402) making up 18.4% of total population. FPs' average population number was 3486.6±465.9 (avarage number of infants 47.1±18.2; 15-49 year old women 915.4±176.4; 65 year and older people 324.2± 116.6). Of all services delivered by FPs in 2011 (n=6,272,831), 56.1% was physical examinations, 24.0% laboratory+physical examinations, 7.1% vaccinations and 12.8% follow-ups. Daily average number of physical examination was 60.2, 5.4 vaccinations, infant, child, antenatal, women/family planning, postpartum and obesity follow-ups were 1.4; 1.6; 1.3; 4.3; 0.4 and 0.7, respectively. In Manisa, average number of follow-ups for pregnant women was 5.1, 6.9 for infants, 1.5 for 1-5 year old children, 1.6 postpartum period, and 1.0 for, 15-49 year old women. Annual average number of polyclinic visits per capita was 4.3. Seventy five point seven percent of population used policlinic services and of those 40.0% got these services 1-5 times annually. Average use of policlinic services for under age one and 65 years and older were 3.2; 7.4, respectively. According to the delivered services, necessary number of FPs was calculated as 446 in the province.

Conclusions: Outpatient services constitute 80% of the workload of family physicians. This rate is higher than the rates of 76.8% in Decision Support System (DSS) 2011 Turkey and 70% in United Kingdom 2006/2007 survey data. In Manisa, family physicians examine approximately 60 persons daily. In the United Kingdom, this number is 35. Family physicians should take groups most in need of services into ccount while planning their registered population. For operational studies, evaluations of workload and performance, specific to health care workers including the personnel are needed.