The vacancy of the family practice units openıng for the inter-provincial placement and the factors affecting vacancies in Turkey

Abstract

Objectives: There are on going initiatives to reduce the number of registered population per family physician in Turkey. In order to reach this aim new family practice units are opened, and family physicians are transferred between the units based on their preference. The aim of this study is to determine the variables that affect the vacancy of the units that are opened for inter-province placements.

Materials and Methods: In this cross-sectional study; the online data on the positions opened for family practice inter-province placements by the Ministry of Health between the end of 2017 and throughout 2018 were used. The units that is opened for the following inter-province placement is considered as a vacant unit in the studied placement. The units that are opened for the placement are classified, by means of their provinces, in accordance with the first level of the Nomenclature of Territorial Units for Statistics (NUTS) region. The odds ratio (OR) of an open position remaining vacant was calculated with the 95% confidence interval. The odds ratios (OR) adjusted for population size and the NUTS regions were estimated using logistic regressions analysis.

Results: It is found out that registered population size, mobile service population, number of rooms for service, lack of family health worker in the family practice were the significant determinants of the family practice vacancies. Having five or more physicians (units) in the opened family health center increases the probability of occupancy when compared to having less physicians. Units opened for placement have a higher risk of remaining vacant if they are in either a private or virtual family health center, having a rent of either above 1000 Turkish Liras, or an indefinite amount. After the adjustments acording to population size and NUTS region, it was observed that unit’s mobile service population, number of rooms for service and the rental situation didn’t show any statistical significance,never the less lack of family health worker and groups and having less than five units in the family health centers till remained significant for the increased probability of being vacant.

Conclusion: In the context of family medicine practice, initiatives to reduce the registered population size to family practice unit do have a significant contribution to the quality of service and public health; however there are some flaws in planning. Thus more actions are required in order to increase the preference of newly opened units by detecting the deficient aspects which can be done by conducting more comprehensive studies.