RESUMEN
OBJECTIVE: Turkey has implemented family practice on a pilot basis as part of the reform in health care, since 2005. This paper aims to understand and describe the prevalent practice patterns and clinic characteristics during the transition period. DESIGN: A cross-sectional descriptive study design was used. SUBJECTS: An online survey was conducted among Turkish GPs working as primary care doctors (without vocational training) during the reform period. Clinic and GP characteristics are analysed with descriptive statistics. RESULTS: List size is an important factor; larger lists lead to shorter consultation time and a longer wait for patients. GPs are generally satisfied with the reform. CONCLUSION: During the transition to family practice access of patients to health care has improved and GPs are satisfied with their job. KEY POINTS: Patients in Turkey have adequate access to primary health care services. The waiting time for consultation is relatively short. Basic prevention activities occupy the majority of the GPs' time. Reducing the panel size and introducing appointment systems may be useful.
Asunto(s)
Actitud del Personal de Salud , Medicina Familiar y Comunitaria , Médicos Generales , Accesibilidad a los Servicios de Salud , Pautas de la Práctica en Medicina , Atención Primaria de Salud , Adulto , Estudios Transversales , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Proyectos Piloto , Derivación y Consulta , Encuestas y Cuestionarios , Turquía , Listas de Espera , Carga de TrabajoRESUMEN
INTRODUCTION: Turkey's primary health care (PHC) system was established in the beginning of the 1960s and provides preventive and curative basic medical services to the population. This article describes the experience of the Turkish health system, as it tries to adapt to the European health system. It describes the current organization of primary health care and the family medicine model that is in the process of implementation and discusses implications of the transition for family physicians and the challenges faced in meeting the needs for health care staff. In Turkey a trend toward urbanization is evident and more staff positions in rural PHC centers are vacant. Shortages of physicians and an ineffective distribution of doctors are seen as a major problem. Family medicine gained popularity at the beginning of the 1990s, as a specialty with a 3-year postgraduate training program. Medical practitioners who are graduates of a 6-year medical training program and are already working in the PHC system are offered retraining courses. Better working conditions and higher salaries may be important incentives for medical practitioners to sign a contract with the social security institution of Turkey. DISCUSSION: The lack of well-trained primary care staff is an ongoing challenge. Attempts to retrain medical practitioners to act as family physicians show promising results. Shortness of physician and health professionals and lack of time and resources in primary health care are problems to overcome during this process.
Asunto(s)
Medicina Familiar y Comunitaria , Médicos/provisión & distribución , Atención Primaria de Salud , Educación Médica Continua , Reforma de la Atención de Salud , Humanos , Turquía , Urbanización , Recursos HumanosRESUMEN
This work is motivated by the recent changes in the health system in Turkey, which is a consolidation of health insurance funds, and its implications on the resource allocations and the flow of patients in the system. Our aim is to provide a model to find the best reallocation of resources between the hospitals and the best patient-hospital match to minimize the costs.