The Effect of Family Medicine Implementation on Primary Health Care Services: Northeast Anatolia Region Evaluation

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Bağcı H., Egici M. T., Öztaş D., Gençer M. Z., Nizamoğlu Mercan G.

Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi, vol.61, no.2, pp.209-216, 2021 (Peer-Reviewed Journal) identifier

Abstract

Introduction: Eastern region of Turkey faces challenges in the provision of health-care services due to insufficient human resources and geographical difficulties. In our study, periodic changes and effects of family medicine (FM) practice on the parameters of first step health-care of Northeast Anatolia Region (NAR) are examined. Methods: In the descriptive and cross-sectional retrospective study, basic health data of NAR obtained from open sources between 2008 and 2018 were compared within the scope of Nomenclature of Territorial Units for Statistics. Microsoft Excel 2016 was used for calculations. Results: In the region, access to Primary Health-Care (PHC) got easier, the number of doctors and nurses-midwives rose by 24.6% and the number of applications for PHC increased by 42% in 2018 compared to 2008. In Turkey, while the average per capita population of 3405 family physicians, the NAR’s population has been in the family physician per 3252 people as top average. The monitoring numbers recorded even higher increases with a 45% increase in pregnancy monitoring, 166% rises in post-puerperal monitoring, 57% growth in average monitoring per baby, and an average increase of 29% in monitoring per child were recorded. Whereas maternal death rate was 22.9 in the region for every one hundred thousand births versus a countrywide average of 19.4 in 2008, these rates were recorded as 24.9 and 13.6, respectively, in 2018. It could be argued that maternal rates fell by one third compared to 2006 and the approximately same rate was maintained between 2008 and 2018 but it was higher than the average of Turkey. Compared to 2008, the infant mortality rate in the region was 17.8 per thousand live births, but decreased by 40% and fell to 10.6. While the rate of Quinary Composit Vaccination (DaBT+IPA+Hib) was 74% in 2002, it was observed as 96% in 2008 and exceeded the Turkey average with 100% in 2010 when FM practice became widespread, this rate fell back down to 93% in 2018. The pace of Measles, Rubella, and Parotitis vaccination pace slowed by 6% as well. Fall in vaccination rates contrary to the general improvement in parameters could be attributed to vaccination reluctances, administrative changes, geographical difficulties, the high turnover rate among the health professionals, and difficulty to detect the target population before FM Practice.