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Evaluation of Primary and Secondary Health Care Services in the Erzurum Region Between 2002-2008

Year 2011, Volume: 2011 Issue: 1, 55 - 61, 01.01.2011

Yusuf Üstü Mehmet Uğurlu Muhammet Örnek , Selim Yavuz Sanisoğlu

https://doi.org/10.5174/tutfd.2009.02884.1

Abstract

Objective: Turkey has problems starting with manpower shortage and transportation problems to deliver health care services. In this study, it is intended to investigate and discuss the data of the eastern region of Turkey which is trailing in health care indicators. Material and Methods: In this cross-sectional study, the health data gathered through periodical field studies in the Erzurum Health Field during 2002-2008 are compared. Results: In the region, compared to year 2002 data, a 44% increase in general practitioner number and 65% increase in supporting medical personnel number have been achieved. Compared to year 2002 data, application to the health organisation has increased from 1.9 to 4.5 (33% to primary level and 67% to secondary level). The referrals from local health clinics to hospitals have been reduced from 20.2% to 2.7%. In the region in general, recording of birth ratio is 87% and recording of pregnancy ratio is 70%. DBT-1 vaccination ratio is 90%. Tuberculosis ratio is 14 per hundred thousand. Health care services have improved in the cities of the region. Referral ratios to secondary level frequency is still high. Even though the number of personnel is increased, it is observed that, to reach the set targets, starting with innoculation, the primary level health care services will take time. Conclusion: Family medicine practice is promising for the integration of services, institution of referral chain system and improvement of health level indicators. Turkish Başlık: 2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi Anahtar Kelimeler: Türkiye, aile hekimliği uygulaması, birinci basamak sağlık hizmeti, Erzurum sağlık bölgesi, saha ziyaretleri Amaç: Türkiye'de, sağlık hizmetlerinin verilmesinde başta insan kaynakları ve ulaşım sorunları olmak üzere çeşitli güçlüklerle karşılaşılmaktadır. Bu çalışmada ülkemizin sağlık göstergeleri açısından daha geri durumdaki doğu bölgelerindeki sağlık verilerinin incelenmesi ve tartışılması amaçlanmaktadır. Gereç ve Yöntemler: Bu kesitsel çalışmada Erzurum sağlık bölgesinde yapılan periyodik olarak yürütülen saha çalışmaları sonucunda 2002 -2008 tarihlerinde elde edilen sağlık verileri karşılaştırılmaktadır. Bulgular: Bölgede 2002 yılına göre pratisyen hekim sayısında %44, yardımcı sağlık personeli sayısında ise %65 artış sağlanmıştır. 2002 yılına göre yıllık başvuru sayısı 1.9'dan 4.5'e (%33'ü birinci basamak, %67'si ise ikinci basamak) yükselmiştir. Sevk oranı ise %20.2 ‘den %2.7'ye düşmüştür. Bölge geneli bebek tespit oranı %87, gebe tespit oranı ise %70'tir. DBT-1 aşı oranı ise %90'dır. Tüberküloz hasta insidansı yüz binde 14'tür. Bölge illerinde birinci basamak sağlık hizmetlerinde iyileşme mevcuttur. İkinci basamağa başvuru sıklığı ise halen yüksektir. Personel sayısındaki artışa rağmen aşılama başta olmak üzere birinci basamak sağlık hizmetlerinde hedefe ulaşmanın zaman alacağı gözlenmektedir. Sonuç: Hizmet entegrasyonunun sağlanması, sevk zincirinin tesisi ve sağlık düzeyi göstergelerinin artırılması açısından aile hekimliği uygulaması umut vermektedir.

Keywords

Turkey family medicine practice primary health care Erzurum health region field visits

References

  • Şahin B, Top M. Bigger Expectations at the Smaller World:Future Health Systems), Sağlık ve Toplum, 2002;12:3.
  • Figueras J, Menabde N, Busse R. The road to freedom. BMJ 2005;331:170-1. [CrossRef]
  • Boelen C, Haq C, Hunt V, Rivo M, Shahady E. Improvıng Health Sysems: The Contribution of Family Medicine, A Guidebook, WONCA 2002;11.
  • Hamzaoğlu O. The Interpretation of Health of Turkey, sted.2008;17:6.
  • Hogart J. “ Glossary of Health Care Terminology”, WHO, Copen- hagen, 1975.
  • Gümrükcüoğlu FO, Tosun N, Yol S, Septioğlu AS, Zırh H, Solak A, Ceylan D. The Report of the Ratio of Health Workers to Popula- tion in Turkey, Published by the Ministry of Health of Turkey, 1st ed. Uyum ajans, Ankara 2008, p.11
  • Law constitution of Republic of Turkey. 1982
  • Law to socialization of services, n.224, 1961. [CrossRef]
  • Öztek Z, Akdur R, Aycan S, Afşar Oz, Soydal T, Üner S et al. Health 21, health for all targets and strategies of Turkey, Published by the Ministry of Health of Turkey, 1st ed. Barok Matbaacılık, An- kara 2001;71-3.
  • Korukluoğulu S, Üstü Y, Kasım İ, Doğusan AR, Hacıimamağaoğlu A. Editor: Aydın S, Family Medicine, The Turkish Model, Published by the Ministry of Health of Turkey, 1st ed. Çetin Ofset, Ankara 2006, p.12-13-17-22-23-30-37-38-40-66- 74 -76-79-85-88-9.
  • Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development countries, 1970-1998. Health Serv. Res 2003;38: 831-65. [CrossRef]
  • Villalbi JR, Guarga A, Pasarin MI, Gil, Borrell C, Ferran M, Cirera E. (An evaluation of the impact of primary care reform on health). Aten Primaria 1999;24:468-74.
  • World Health Declaration. Fifty -first World Health Assembly, May, 1998.
  • Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Turkey Demo- graphic And Health Survey, 2003, Ankara, p:113.[in Turkish]
  • Ricketts, T.C., Johnson-Webb, K.D. & Taylor, P. (1998).Definitions of Rural: A Handbook for Health PolicyMakers and Researchers. (Working Paper 62). Chapel Hill, NC: North Carolina Rural Health Research and Policy Analysis Center; and Coburn, A.F., MacKin- ney, A.C., McBride, T.D., Mueller, K.J., Slifkin, R.T. & Wakefield, M.K. (2007). Choosing Rural Definitions: Implications for Health Policy. (Issue Brief no. 2). Columbia, MO: RUPRI Rural Policy Re- search Institute Health Panel.
  • M. Raffel (University Park and London: The Pennsylvania State Uni- versity Press, 1984); and Organization for Economic Cooperation and Development, The Reform of Health Care: A Comparative Analysis of Seven OECD Countries (Paris: OECD, forthcoming).
  • MoH of Turkiye, Local İnformation Documents and Reports of Re- search of Health System Of Finland 2003, p.2,3. [in Turkish]
  • Uğurlu M., Doğusan AR, Üstü Y, Korukluoğlu S, Kasım İ. Impla- mention of Family Medicine,Transition Period Course fo Family Doctors, Fırst Stage, Guidebook for Trainer, Published by the Ministry of Health of Turkey, 1st ed. Ata Ofset, Ankara 2004, p.197. [in Turkish]
  • Franks P, Clancy CM. Referrals of adult patients from primary care: demographic disparities and their relationship to HMO in- surance. J fam pract 1997; 45: 47-53.
  • Christensen Bo, Henrik Toft, Sorensen HT, Carl Erik Mabeck. Differences in referral rates from general practice. Fam Pract 1989;6:19-22. [CrossRef]
  • Chan BT, Austin PC: Patient, physician, and community factors affecting referrals to specialists in Ontario, Canada: a population-based, multi-level modelling approach. Med Care 2003;41:500-11.
  • Langley GR, Minkin S, Till JE. Regional variation in nonmedical factors affecting family physicians’ decisions about referral for consultation. CMAJ 1997;157:265-72.
  • Iverson GD, Coleridge ST, Fulda KG, Licciardone JC. What fac- tors influence a family physician’s decision to refer a patient to a specialist? Rural Remote Health 2005;5:413.
  • Evans A. A study of the referral decision in general practice. Fam Pract 1993;10:104-10. [CrossRef]
  • Armstrong D, Fry J, Armstrong P. Doctors’ perceptions of pressure from patients for referral. Br Med J 1991;302:1186-8. [CrossRef]
  • Bailey J, King N, Newton P. Analysing general practitioners’ refer- ral decisions. II. Applying the analytical framework: do high and low referrers differ in factors influencing their referral decisions? Fam Pract 1994;11: 9-14. [CrossRef]
  • Iverson GD, Coleridge ST, Fulda KG, Licciardone JC. What fac- tors influence a family physician’s decision to refer a patient to a specialist? Rural Remote Health 2005;5:413.
  • Langley GR, Minkin S, Till JE. Regional variation in nonmedical factors affecting family physicians’ decisions about referral for consultation. Can Med Assoc J 1997;157:265-72.
  • Peter Franks, Geoffrey C Williams, Jack Zwanziger, Cathleen Mooney, Melony Sorbero. Why do physicians vary so widely in their referral rates? J Gen Intern Med. 2000;15:163-8. [CrossRef]
  • Starfield B, Shi L, Grover A, Macinko J. The effects of specialist supply on populations’ health: assessing the evidence. Health Aff (Millwood) 2005;W5-97-W5-107. [CrossRef]
  • Hensher M, Price M, Adomakoh S, Disease Control Priorities Project Referral Hospital, Chapter 66.1229-42.
  • Grumbach K, Selby JV, Damberg C, Bindman AB, Quesenberry C Jr, Truman A et al. Resolving the gatekeeping conundrum. What patients value in primary care and referrals to specialist. JAMA 1999;282:261-6. [CrossRef]
  • Ferris TG, Perrin JM, Manganello JA, Chang Y, Causino N, Blumen- thal D. Switching to gatekeeping: changes in expenditures and uti- lization for children. Pediatrics 2001;108:283-90. [CrossRef]
  • artin DP, Diehr P, Price KF, Richardson WC. Effect of a gatekeeper plan on health services use and charges: a randomized trial. Am J Public Health 1989;79:1628-32.
  • Ferris TG, Perrin JM, Manganello JA, Chang Y, Causino N, Blumen- thal D: Switching to gatekeeping: changes in expenditures and uti- lization for children. Pediatrics 2001;108:283-90. [CrossRef]
  • Sjönell G. Relationship between use of increased primary health care and other out-patient care in a Swedish urban area. II. Utili- sation of out-patient hospital services, Scand J Prim Health Care 1984;2:77-83. [CrossRef]
  • Vehvilainen AT, Kumpusalo EA, Voutilainen SO, Takala JK. Does the doctors’ professional experience reduce referral rates? Evi- dence from the Finnish referral study. Scand J Prim Health Care 1996;14:13-20.
  • Elhayany A, Shvartzman P, Regev S, Reuveni H, Tabenkin H. Varia- tions in referrals to consultants: a study of general practitioners’ characteristics in southern Israel. J Ambul Care Manage 2000, 23:45-54.
  • Sanders D, Kravitz J, Lewin S, McKee M. Zimbabwe’s hospi- tal referral system: does it work? Health Policy and Planning, 1998:359-70.
  • Uğurlu M, Üstü Y, Doğusan AR. New Period in Health Care, 1. Basamakta Ruh Sağlığı, Published by the Ministry of Health of Turkey, 11.2003;1:12.
  • Doğusan A.R., Üstü Y., Kasım İ., Korukluoğlu S., Uğurlu M., “Was the Article 224 of Law to socialization of services successful?”, Temel Sağlık Dergisi,, 4-6.2004, 1(2):25-30.[in Turkish]
  • McColl K, War With Brain Drain, BMJ Türkiye, March 2009, Vol- ume 14; 3, p.26.
  • Hayran O, Sur H, Ed. Finance of Healthcare and Payment Mod- els to healthcare service providers, Handbook of Healthcare, İstanbul: Yüce, 1998: s: 91-112.
  • Akdağ R. Health Transformation Programme, Published by the Ministry of Health of Turkey, 1st ed. Ankara 2003; p. 2.[in Turkish]
  • Figueras J, McKee M, Cain J, Lessof S. Health systems in Transi- tion: Learning From Experience, WHO, 2004; p.3-8.

2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi

Year 2011, Volume: 2011 Issue: 1, 55 - 61, 01.01.2011

Yusuf Üstü Mehmet Uğurlu Muhammet Örnek , Selim Yavuz Sanisoğlu

https://doi.org/10.5174/tutfd.2009.02884.1

Abstract

Amaç: Türkiye’de, sağlık hizmetlerinin verilmesinde başta insan kaynakları
ve ulaşım sorunları olmak üzere çeşitli güçlüklerle karşılaşılmaktadır. Bu
çalışmada ülkemizin sağlık göstergeleri açısından daha geri durumdaki
doğu bölgelerindeki sağlık verilerinin incelenmesi ve tartışılması amaçlanmaktadır.

Gereç ve Yöntemler: Bu kesitsel çalışmada Erzurum sağlık bölgesinde
yapılan periyodik olarak yürütülen saha çalışmaları sonucunda 2002 -2008
tarihlerinde elde edilen sağlık verileri karşılaştırılmaktadır.
Bulgular: Bölgede 2002 yılına göre pratisyen hekim sayısında %44, yardımcı
sağlık personeli sayısında ise %65 artış sağlanmıştır. 2002 yılına göre
yıllık başvuru sayısı 1.9’dan 4.5’e (%33’ü birinci basamak, %67’si ise ikinci
basamak) yükselmiştir. Sevk oranı ise %20.2 ‘den %2.7’ye düşmüştür. Bölge
geneli bebek tespit oranı %87, gebe tespit oranı ise %70’tir. DBT-1
aşı oranı ise %90’dır. Tüberküloz hasta insidansı yüz binde 14’tür. Bölge
illerinde birinci basamak sağlık hizmetlerinde iyileşme mevcuttur. İkinci
basamağa başvuru sıklığı ise halen yüksektir. Personel sayısındaki artışa
rağmen aşılama başta olmak üzere birinci basamak sağlık hizmetlerinde
hedefe ulaşmanın zaman alacağı gözlenmektedir.
Sonuç: Hizmet entegrasyonunun sağlanması, sevk zincirinin tesisi ve sağlık
düzeyi göstergelerinin artırılması açısından aile hekimliği uygulaması umut
vermektedir.

Keywords

Türkiye aile hekimliği uygulaması birinci basamak sağlık hizmeti Erzurum sağlık bölgesi saha ziyaretleri

References

  • Şahin B, Top M. Bigger Expectations at the Smaller World:Future Health Systems), Sağlık ve Toplum, 2002;12:3.
  • Figueras J, Menabde N, Busse R. The road to freedom. BMJ 2005;331:170-1. [CrossRef]
  • Boelen C, Haq C, Hunt V, Rivo M, Shahady E. Improvıng Health Sysems: The Contribution of Family Medicine, A Guidebook, WONCA 2002;11.
  • Hamzaoğlu O. The Interpretation of Health of Turkey, sted.2008;17:6.
  • Hogart J. “ Glossary of Health Care Terminology”, WHO, Copen- hagen, 1975.
  • Gümrükcüoğlu FO, Tosun N, Yol S, Septioğlu AS, Zırh H, Solak A, Ceylan D. The Report of the Ratio of Health Workers to Popula- tion in Turkey, Published by the Ministry of Health of Turkey, 1st ed. Uyum ajans, Ankara 2008, p.11
  • Law constitution of Republic of Turkey. 1982
  • Law to socialization of services, n.224, 1961. [CrossRef]
  • Öztek Z, Akdur R, Aycan S, Afşar Oz, Soydal T, Üner S et al. Health 21, health for all targets and strategies of Turkey, Published by the Ministry of Health of Turkey, 1st ed. Barok Matbaacılık, An- kara 2001;71-3.
  • Korukluoğulu S, Üstü Y, Kasım İ, Doğusan AR, Hacıimamağaoğlu A. Editor: Aydın S, Family Medicine, The Turkish Model, Published by the Ministry of Health of Turkey, 1st ed. Çetin Ofset, Ankara 2006, p.12-13-17-22-23-30-37-38-40-66- 74 -76-79-85-88-9.
  • Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development countries, 1970-1998. Health Serv. Res 2003;38: 831-65. [CrossRef]
  • Villalbi JR, Guarga A, Pasarin MI, Gil, Borrell C, Ferran M, Cirera E. (An evaluation of the impact of primary care reform on health). Aten Primaria 1999;24:468-74.
  • World Health Declaration. Fifty -first World Health Assembly, May, 1998.
  • Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Turkey Demo- graphic And Health Survey, 2003, Ankara, p:113.[in Turkish]
  • Ricketts, T.C., Johnson-Webb, K.D. & Taylor, P. (1998).Definitions of Rural: A Handbook for Health PolicyMakers and Researchers. (Working Paper 62). Chapel Hill, NC: North Carolina Rural Health Research and Policy Analysis Center; and Coburn, A.F., MacKin- ney, A.C., McBride, T.D., Mueller, K.J., Slifkin, R.T. & Wakefield, M.K. (2007). Choosing Rural Definitions: Implications for Health Policy. (Issue Brief no. 2). Columbia, MO: RUPRI Rural Policy Re- search Institute Health Panel.
  • M. Raffel (University Park and London: The Pennsylvania State Uni- versity Press, 1984); and Organization for Economic Cooperation and Development, The Reform of Health Care: A Comparative Analysis of Seven OECD Countries (Paris: OECD, forthcoming).
  • MoH of Turkiye, Local İnformation Documents and Reports of Re- search of Health System Of Finland 2003, p.2,3. [in Turkish]
  • Uğurlu M., Doğusan AR, Üstü Y, Korukluoğlu S, Kasım İ. Impla- mention of Family Medicine,Transition Period Course fo Family Doctors, Fırst Stage, Guidebook for Trainer, Published by the Ministry of Health of Turkey, 1st ed. Ata Ofset, Ankara 2004, p.197. [in Turkish]
  • Franks P, Clancy CM. Referrals of adult patients from primary care: demographic disparities and their relationship to HMO in- surance. J fam pract 1997; 45: 47-53.
  • Christensen Bo, Henrik Toft, Sorensen HT, Carl Erik Mabeck. Differences in referral rates from general practice. Fam Pract 1989;6:19-22. [CrossRef]
  • Chan BT, Austin PC: Patient, physician, and community factors affecting referrals to specialists in Ontario, Canada: a population-based, multi-level modelling approach. Med Care 2003;41:500-11.
  • Langley GR, Minkin S, Till JE. Regional variation in nonmedical factors affecting family physicians’ decisions about referral for consultation. CMAJ 1997;157:265-72.
  • Iverson GD, Coleridge ST, Fulda KG, Licciardone JC. What fac- tors influence a family physician’s decision to refer a patient to a specialist? Rural Remote Health 2005;5:413.
  • Evans A. A study of the referral decision in general practice. Fam Pract 1993;10:104-10. [CrossRef]
  • Armstrong D, Fry J, Armstrong P. Doctors’ perceptions of pressure from patients for referral. Br Med J 1991;302:1186-8. [CrossRef]
  • Bailey J, King N, Newton P. Analysing general practitioners’ refer- ral decisions. II. Applying the analytical framework: do high and low referrers differ in factors influencing their referral decisions? Fam Pract 1994;11: 9-14. [CrossRef]
  • Iverson GD, Coleridge ST, Fulda KG, Licciardone JC. What fac- tors influence a family physician’s decision to refer a patient to a specialist? Rural Remote Health 2005;5:413.
  • Langley GR, Minkin S, Till JE. Regional variation in nonmedical factors affecting family physicians’ decisions about referral for consultation. Can Med Assoc J 1997;157:265-72.
  • Peter Franks, Geoffrey C Williams, Jack Zwanziger, Cathleen Mooney, Melony Sorbero. Why do physicians vary so widely in their referral rates? J Gen Intern Med. 2000;15:163-8. [CrossRef]
  • Starfield B, Shi L, Grover A, Macinko J. The effects of specialist supply on populations’ health: assessing the evidence. Health Aff (Millwood) 2005;W5-97-W5-107. [CrossRef]
  • Hensher M, Price M, Adomakoh S, Disease Control Priorities Project Referral Hospital, Chapter 66.1229-42.
  • Grumbach K, Selby JV, Damberg C, Bindman AB, Quesenberry C Jr, Truman A et al. Resolving the gatekeeping conundrum. What patients value in primary care and referrals to specialist. JAMA 1999;282:261-6. [CrossRef]
  • Ferris TG, Perrin JM, Manganello JA, Chang Y, Causino N, Blumen- thal D. Switching to gatekeeping: changes in expenditures and uti- lization for children. Pediatrics 2001;108:283-90. [CrossRef]
  • artin DP, Diehr P, Price KF, Richardson WC. Effect of a gatekeeper plan on health services use and charges: a randomized trial. Am J Public Health 1989;79:1628-32.
  • Ferris TG, Perrin JM, Manganello JA, Chang Y, Causino N, Blumen- thal D: Switching to gatekeeping: changes in expenditures and uti- lization for children. Pediatrics 2001;108:283-90. [CrossRef]
  • Sjönell G. Relationship between use of increased primary health care and other out-patient care in a Swedish urban area. II. Utili- sation of out-patient hospital services, Scand J Prim Health Care 1984;2:77-83. [CrossRef]
  • Vehvilainen AT, Kumpusalo EA, Voutilainen SO, Takala JK. Does the doctors’ professional experience reduce referral rates? Evi- dence from the Finnish referral study. Scand J Prim Health Care 1996;14:13-20.
  • Elhayany A, Shvartzman P, Regev S, Reuveni H, Tabenkin H. Varia- tions in referrals to consultants: a study of general practitioners’ characteristics in southern Israel. J Ambul Care Manage 2000, 23:45-54.
  • Sanders D, Kravitz J, Lewin S, McKee M. Zimbabwe’s hospi- tal referral system: does it work? Health Policy and Planning, 1998:359-70.
  • Uğurlu M, Üstü Y, Doğusan AR. New Period in Health Care, 1. Basamakta Ruh Sağlığı, Published by the Ministry of Health of Turkey, 11.2003;1:12.
  • Doğusan A.R., Üstü Y., Kasım İ., Korukluoğlu S., Uğurlu M., “Was the Article 224 of Law to socialization of services successful?”, Temel Sağlık Dergisi,, 4-6.2004, 1(2):25-30.[in Turkish]
  • McColl K, War With Brain Drain, BMJ Türkiye, March 2009, Vol- ume 14; 3, p.26.
  • Hayran O, Sur H, Ed. Finance of Healthcare and Payment Mod- els to healthcare service providers, Handbook of Healthcare, İstanbul: Yüce, 1998: s: 91-112.
  • Akdağ R. Health Transformation Programme, Published by the Ministry of Health of Turkey, 1st ed. Ankara 2003; p. 2.[in Turkish]
  • Figueras J, McKee M, Cain J, Lessof S. Health systems in Transi- tion: Learning From Experience, WHO, 2004; p.3-8.
There are 45 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Yusuf Üstü This is me

Mehmet Uğurlu This is me

Muhammet Örnek

Selim Yavuz Sanisoğlu This is me

Publication Date January 1, 2011
Published in Issue Year 2011 Volume: 2011 Issue: 1

Cite

APA Üstü, Y., Uğurlu, M., Örnek, M., Sanisoğlu, S. Y. (2011). 2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi. Balkan Medical Journal, 2011(1), 55-61. https://doi.org/10.5174/tutfd.2009.02884.1
AMA Üstü Y, Uğurlu M, Örnek M, Sanisoğlu SY. 2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi. Balkan Medical Journal. January 2011;2011(1):55-61. doi:10.5174/tutfd.2009.02884.1
Chicago Üstü, Yusuf, Mehmet Uğurlu, Muhammet Örnek, and Selim Yavuz Sanisoğlu. “2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci Ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi”. Balkan Medical Journal 2011, no. 1 (January 2011): 55-61. https://doi.org/10.5174/tutfd.2009.02884.1.
EndNote Üstü Y, Uğurlu M, Örnek M, Sanisoğlu SY (January 1, 2011) 2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi. Balkan Medical Journal 2011 1 55–61.
IEEE Y. Üstü, M. Uğurlu, M. Örnek, and S. Y. Sanisoğlu, “2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi”, Balkan Medical Journal, vol. 2011, no. 1, pp. 55–61, 2011, doi: 10.5174/tutfd.2009.02884.1.
ISNAD Üstü, Yusuf et al. “2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci Ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi”. Balkan Medical Journal 2011/1 (January 2011), 55-61. https://doi.org/10.5174/tutfd.2009.02884.1.
JAMA Üstü Y, Uğurlu M, Örnek M, Sanisoğlu SY. 2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi. Balkan Medical Journal. 2011;2011:55–61.
MLA Üstü, Yusuf et al. “2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci Ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi”. Balkan Medical Journal, vol. 2011, no. 1, 2011, pp. 55-61, doi:10.5174/tutfd.2009.02884.1.
Vancouver Üstü Y, Uğurlu M, Örnek M, Sanisoğlu SY. 2002-2008 Yılları Arasında Erzurum Bölgesinde Birinci ve İkinci Basamak Sağlık Hizmetlerinin Değerlendirilmesi. Balkan Medical Journal. 2011;2011(1):55-61.