Changes in causes of admission to tertiary health care center with family medicine implementation

Abstract

Aim: Our study attempted to assess whether any changes have occurred in the reasons for patients’ hospital applications with regard to family medicine implementation (FMI), which is one of the changes that the Ministry of Health carried out within the scope of the Health Transformation Project. Efforts were made to determine the direction of any changes in disease groups, especially those patients whose family physicians can manage their problems with the physician’s range of examinations and tests.

Methods: For the study assessment period, two periods before and after the FMI in Istanbul were selected. The period before the FMI was taken as the four years between 2007 and 2010 and the period after the FMI was the four-year period from 2011 and 2014. Our assessments included the diagnoses most frequently made in eight clinics, including the branches in which compulsory rotations are conducted within the scope of the specialty training in family medicine and emergency department.

Results: The number of diagnoses groups assessed in different medical areas and the number of diagnoses that were made were significantly less in the post-FMI period when compared with the pre-FMI period after an adjustment was made in terms of population: 1) Five of 10 diagnoses were in internal medicine; 2) one of 10 in cardiology; 3) none of 12 in psychiatry; 4) three of 14 in general surgery; 5) five of nine in chest diseases; 6) two of nine in gynecology and obstetrics; 7) one of 11 in pediatrics, and; 8) two of 12 in emergency.

Conclusion: After this study, it appears that FMI, which is one of the fundamental steps within the scope of the health transformation project in Turkey, will be a more efficient and satisfying system for evaluating the system in other countries that perform the FMI. Taking the opinions of the health care personnel and the public community within that system and making up any deficiencies through an adaptation suitable for Turkey will be of top priority.