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The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study

Year 2018, Volume: 2 Issue: 3, 82 - 87, 01.09.2018
https://doi.org/10.30621/jbachs.2018.420

Abstract

Purpose: Effective primary healthcare services may prevent unnecessary admissions to emergency care which help efficient operation in the emergency care units. The aim of this study is to evaluate the association between primary healthcare services and number of emergency service admission per person in public hospitals in 2013 in Turkey. Methods: This ecological study analysed data which data of 81 administrative regions. The data were obtained from Public Hospital Associations-2014 and Ministry of Health Annual Statistics 2013 Reports. Results: The number of emergency service admission has a negative weak correlation with the number of individuals registered for each primary care physician r=-0.228, p=0.040 . There was a negative weak significant correlation for the regions with large population r=-0.311, p=0.048 . When the populations of the cities were divided into two according to their size, no significant relationship was identified between the number of people per family physician and emergency service admission per person in both small and big cities p>0.05 . There was no significant correlation between the number of primary care examinations per person and the number of emergency service admission per person in all cities and small ones p>0.05 .Conclusion: In contrary to expectations, primary care services in Turkey is far from decreasing emergency service admissions. Reinforcement of primary care and implementation of an efficient referral system should be considered for better use of health care resources

References

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  • Kose A, Kose B, Oncu MR, Tugrul F. Admission appropriateness and profile of the patients attended to a state hospital emergency department. Gaziantep Med J 2011;17:57–62. [CrossRef]
  • Sun BC, Hsia RY, Weiss RE, et al. Effect of Emergency Department Crowding on Outcomes of Admitted Patients. Ann Emerg Med 2013;61:605–611.e6. [CrossRef]
  • Emery DP, Milne T, Gilchrist CA, et al. The impact of primary care on emergency department presentation and hospital admission with pneumonia: a case-control study of preschool-aged children. NPJ Prim Care Respir Med 2015;25. [CrossRef]
  • Vasileiou I, Giannopoulos A, Klonaris C, et al. The potential role of primary care in the management of common ear, nose or throat disorders presenting to the emergency department in Greece. Qual Prim Care 2009;17:145–8.
  • Mercier G, Georgescu V, Bousquet J. Geographic Variation In Potentially Avoidable Hospitalizations In France. Health Aff (Millwood) 2015;34:836–43. [CrossRef]
  • Bottle A, Gnani S, Saxena S, Aylin P, Mainous AG, Majeed A. Association Between Quality of Primary Care and Hospitalization for Coronary Heart Disease in England: National Cross-sectional Study. J Gen Intern Med 2008;23:135–41. [CrossRef]
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  • Üstü Y, Uğurlu M, Kasım İ, Egici MT. Sağlıkta Dönüşüm Projesi Sonrası Sağlık Kurumlarına Başvuru Sıklıklarının Değerlendirilmesi. Konuralp Tıp Dergisi 2012;2012:48–53.
  • Van Loenen T, Faber MJ, Westert GP, Van den Berg MJ. The impact of primary care organization on avoidable hospital admissions for diabetes in 23 countries. Scand J Prim Health Care 2016;34:5–12. [CrossRef]
  • O’Cathain A, Knowles E, Maheswaran R, et al. A system-wide approach to explaining variation in potentially avoidable emergency admissions: national ecological study. BMJ Qual Saf 2014;23:47–55. [CrossRef]
  • Çevik C. Manisa İline Ait Sağlık Düzeyi Göstergeleri: Yıllara göre Sağlık Ocağı ve Aile Hekimliği Dönemlerinin Karşılaştırılması (2003–2012). PhD, Dokuz Eylül Üniversitesi, İzmir, Turkey, 2013.
Year 2018, Volume: 2 Issue: 3, 82 - 87, 01.09.2018
https://doi.org/10.30621/jbachs.2018.420

Abstract

References

  • Aydin T, Akkose Aydin S, Koksal O, Ozdemir F, Kulac S, Bulut M. Evaluation of Features of Patients Attending the Emergency Department of Uludag University Medicine Faculty Hospital and Emergency Department Practices. J Acad Emerg Med 2010;9:163–168. [CrossRef]
  • Kılıçaslan İ, Bozan H, Oktay C, Göksu E. Demographic properties of patients presenting to the emergency department in Turkey. Turkish Journal of Emergency Medicine 2005;5:5–13.
  • Ersel M, Karcıoğlu Ö, Yanturalı S, Yuruktumen Ünal A, Sever M, Tunç MA. Emergency Department utilization characteristics and evaluation for patient visit appropriateness from the patients’ and physicians’ point of view. Turk J Emerg Med 2006;6:25–35.
  • Kose A, Kose B, Oncu MR, Tugrul F. Admission appropriateness and profile of the patients attended to a state hospital emergency department. Gaziantep Med J 2011;17:57–62. [CrossRef]
  • Sun BC, Hsia RY, Weiss RE, et al. Effect of Emergency Department Crowding on Outcomes of Admitted Patients. Ann Emerg Med 2013;61:605–611.e6. [CrossRef]
  • Emery DP, Milne T, Gilchrist CA, et al. The impact of primary care on emergency department presentation and hospital admission with pneumonia: a case-control study of preschool-aged children. NPJ Prim Care Respir Med 2015;25. [CrossRef]
  • Vasileiou I, Giannopoulos A, Klonaris C, et al. The potential role of primary care in the management of common ear, nose or throat disorders presenting to the emergency department in Greece. Qual Prim Care 2009;17:145–8.
  • Mercier G, Georgescu V, Bousquet J. Geographic Variation In Potentially Avoidable Hospitalizations In France. Health Aff (Millwood) 2015;34:836–43. [CrossRef]
  • Bottle A, Gnani S, Saxena S, Aylin P, Mainous AG, Majeed A. Association Between Quality of Primary Care and Hospitalization for Coronary Heart Disease in England: National Cross-sectional Study. J Gen Intern Med 2008;23:135–41. [CrossRef]
  • Hunold KM, Richmond NL, Waller AE, Cuthin MP, Voss PR, Platts- Mills TF. Primary Care Availability and Emergency Department Use by Older Adults: A Population-Based Analysis. J Am Geriatr Soc 2014;62:1699–706. [CrossRef]
  • Brettell R, Soljak M, Cecil E, Cowie MR, Tuppin P, Majeed A. Reducing heart failure admission rates in England 2004–2011 are not related to changes in primary care quality: national observational study. Eur J Heart Fail 2013;15:1335–42. [CrossRef]
  • T. C. Sağlık Bakanlığı. Kamu Hastane Birlikleri 2014. Ses Reklam Baskı Hizmetleri. Ankara 2014.
  • T. C. Sağlık Bakanlığı. Sağlık İstatistikleri Yıllığı 2013. Sentez Matbaacılık ve Yayıncılık. Ankara 2014.
  • OECD. Health at a Glance 2015. OECD Publishing; 2015.
  • T. C. Kalkınma Bakanlığı. İllerin ve bölgelerin sosyo-ekonomik gelişmişlik sıralaması araştırması (SEGE-2011). Bölgesel gelişme ve yapısal uyum genel müdürlüğü. Ankara 2013.
  • T. C. Sağlık Bakanlığı. Sağlık İstatistikleri Yıllığı 2016. SAGEM. Ankara 2017.
  • https://yhgm.saglik.gov.tr/TR,12105/thsk-2013-yili-3donem-iller- arasi-sozlesmeli-aile-hekimligi-yerlestirme-kurasi.html
  • Pines JM, Mutter RL, Zocchi MS. Variation in Emergency Department Admission Rates Across the United States. Med Care Res Rev 2013;70:218–31. [CrossRef]
  • Palmer E, Leblanc-Duchin D, Murray J, Atkinson P. Emergency department use: is frequent use associated with a lack of primary care provider? Can Fam Physician Med Fam Can 2014;60:e223–229.
  • Ada D. Dokuz Eylül Üniversitesi Hastanesi’ne akut koroner sendrom nedeniyle yatan hastalarda katastrofik sağlık harcamaları ve buna etki eden etkenler. Tıpta Uzmanlık Tezi, Dokuz Eylül Üniversitesi, İzmir, Turkey, 2015.
  • Tuna GE, Akpınar E, Saatçi E. Factors affecting admissions to a university hospital. Turkish Journal of Family Practice 2006;10:103– 107.
  • Gunther S, Taub N, Rogers S, Baker R. What aspects of primary care predict emergency admission rates? A cross sectional study. BMC Health Serv Res 2013;13: 11. [CrossRef]
  • Çağlayan Ç, Hamzaoğlu O, Sevin E, Sondaş S. Kocaeli Üniversitesi Tıp Fakültesi Eğitim Sağlık Ocakları Bölgelerinde Yaşayanlarda Sağlık Hizmetlerine Başvurular Etkileyen Etmenler. Toplum Hekimliği Bülteni 2006;25:15–22.
  • İlhan MN, Tüzün H, Aycan S, Aksakal Fn, Ozkan S. Birinci Basamak Sağlık Kuruluşuna Başvuranların Sağlık Hizmeti Kullanma Özellikleri ve Bazı Sosyoekonomik Belirteçlerle Değişimi: Sağlık Reformu Öncesi Son Saptamalar. Toplum Hekimliği Bülteni 2006;25:33–41.
  • ÖSYM. 2015 TUS Sonbahar Dönemi. http://dokuman.
  • o s y m . g o v. t r / p d f d o k u m a n / 2 0 1 5 / T U S S O N B A H A R / 2 0 1 5 - TUSBASVURUKILAVUZU18082015y.pdf
  • Ustu Y, Ugurlu M, Ornek M, Sanisoglu SY. Evaluation of Health Care Services in Erzurum Health Region Prior to the Application of Family Medicine Practice. Med J Trak Univ 2009:55–61. [CrossRef]
  • Üstü Y, Uğurlu M, Kasım İ, Egici MT. Sağlıkta Dönüşüm Projesi Sonrası Sağlık Kurumlarına Başvuru Sıklıklarının Değerlendirilmesi. Konuralp Tıp Dergisi 2012;2012:48–53.
  • Van Loenen T, Faber MJ, Westert GP, Van den Berg MJ. The impact of primary care organization on avoidable hospital admissions for diabetes in 23 countries. Scand J Prim Health Care 2016;34:5–12. [CrossRef]
  • O’Cathain A, Knowles E, Maheswaran R, et al. A system-wide approach to explaining variation in potentially avoidable emergency admissions: national ecological study. BMJ Qual Saf 2014;23:47–55. [CrossRef]
  • Çevik C. Manisa İline Ait Sağlık Düzeyi Göstergeleri: Yıllara göre Sağlık Ocağı ve Aile Hekimliği Dönemlerinin Karşılaştırılması (2003–2012). PhD, Dokuz Eylül Üniversitesi, İzmir, Turkey, 2013.
There are 31 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Duran Ada This is me

Belgin Ünal This is me

Publication Date September 1, 2018
Published in Issue Year 2018 Volume: 2 Issue: 3

Cite

APA Ada, D., & Ünal, B. (2018). The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study. Journal of Basic and Clinical Health Sciences, 2(3), 82-87. https://doi.org/10.30621/jbachs.2018.420
AMA Ada D, Ünal B. The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study. JBACHS. September 2018;2(3):82-87. doi:10.30621/jbachs.2018.420
Chicago Ada, Duran, and Belgin Ünal. “The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study”. Journal of Basic and Clinical Health Sciences 2, no. 3 (September 2018): 82-87. https://doi.org/10.30621/jbachs.2018.420.
EndNote Ada D, Ünal B (September 1, 2018) The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study. Journal of Basic and Clinical Health Sciences 2 3 82–87.
IEEE D. Ada and B. Ünal, “The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study”, JBACHS, vol. 2, no. 3, pp. 82–87, 2018, doi: 10.30621/jbachs.2018.420.
ISNAD Ada, Duran - Ünal, Belgin. “The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study”. Journal of Basic and Clinical Health Sciences 2/3 (September 2018), 82-87. https://doi.org/10.30621/jbachs.2018.420.
JAMA Ada D, Ünal B. The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study. JBACHS. 2018;2:82–87.
MLA Ada, Duran and Belgin Ünal. “The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study”. Journal of Basic and Clinical Health Sciences, vol. 2, no. 3, 2018, pp. 82-87, doi:10.30621/jbachs.2018.420.
Vancouver Ada D, Ünal B. The Effect of The Primary Care Services on The Intensity of Emergency Care Admissions to Public Hospitals in Turkey: An Ecological Study. JBACHS. 2018;2(3):82-7.