Keywords: Primary healthcare, health system, referral system
Aim:
The annual number of physician-contact/persons in Turkey-2019 was 9.8. Only 42.2% of applications were made to primary healthcare institutions, and 57.8% to secondary and tertiary healthcare institutions. The probability of an individual utilizing services depends on their perceptions of their needs, social and cultural norms and expectations, and previous experiences of utilizing care.
In this study, the healthcare institutions preferred by adults to receive healthcare services and the factors affecting their preferences were investigated.
Method:
Ethical approval was obtained (23.03.2022-09.2021.1374, Marmara University), and informed consent was obtained from the participants.
Patients, coming to the hospital for any reason between April and May 2022, agreed to participate in in-depth interviews that were taken until saturation was 28. Content analysis was applied to identify the themes for qualitative data.
Results:
Interviews were conducted with 15 male and 13 female volunteers (median age: 43.9, range:19-75). Most of them stated that they could reach any healthcare institution when they needed it although there were difficulties with appointments. They mostly preferred secondary and tertiary healthcare institutions. They said the reason for the density of hospitals and appointments was the insufficient number of physicians, huge number of patients, and unnecessary applications to the healthcare institution.
The reasons why preferred primary healthcare institutions were explained as satisfactory, were easy accessibility to appointments, being less crowded, closer distance, and familiarity of the family physician with the patients. The reason why secondary and tertiary healthcare institutions are preferred is having chronic diseases and thinking of the need for comprehensive hospital care, but feeling satisfaction and trust were rarely referred.
Conclusions:
Gaps in the information about patients’ circumstances, values, and needs are often unnoticed. We believe that this study will highlight them and thus have a profound impact on the solution to the overuse of healthcare services through patient-reported experiences.
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