Application Frequencies to Health Institutions after the Health Transformation Project

Purpose: The aim of this study is to evaluate patients’ frequency of approaching family practitioners under the transformation to practicing Family Practitioning under the Health Transformation Project. The study debates to contribute to the consolidation, reconstruction and invigoration of primary care.Method: In this cross sectional study, application frequencies to primary and secondary healthcare institutions before and after the initiation of family practicing where still there is no gatekeeping system in place in the six pilot provinces from 15.09.2005 to 01.08.2008 are compared.Results: According to data obtained from 81 allocation units of 6 provinces, applications to outpatient clinics increased 26,3% in 2008 compared to the previous year and this was found significant (t=3,401; p=0,001). The increase between 2005 to 2008 were more precisely seen as follows: 38,6% in primary health care services, 131,6% in secondary health care services, and a 91,3% increase in all patient polyclinic applications. In the institutions that the study was carried out, yearly increase in the application frequencies to the secondary care services was 22% after family practicing had started. The applications to the hospitals were 10% more than the applications to primary care services.Conclusion: For the time being, applications to secondary care institutions are still high. Newly developing family practicing is promising for integration of health services and for the establishment of the gate keeping. Factors in turning the approach into practice which are contributing failure must be abolished for the success of the gate keeping. Although the last changes carried out in the context of Health Transformation Project have been generally favorable, lack of integration between health institutions and insufficient performance of the referral system in the current system are causing several problems.