Evaluation of the patients' diagnosis diagnosis application to the tertiary care center in denizli province

This study was planned as a descriptive study to evaluate the primary healthcare application statuses of patients diagnosed with dermatophytosis who applied to tertiary healthcare institutions in Denizli province. Dermatophytosis is a common fungal infection that can usually be easily diagnosed and treated in primary care. However, some patients directly applying to tertiary care leads to unnecessary workload in the healthcare system. The main purpose of the research is to examine the primary care application rates of these patients, their reasons for not applying, the services they received in primary care, and the treatment outcomes. Data were collected using a face-to-face survey method with volunteer patients aged 18 and over diagnosed with dermatophytosis who applied to Pamukkale University Hospital dermatology polyclinics. The survey consists of four sections: demographic characteristics, hygiene habits, knowledge about fungal diseases, primary care application status and services, satisfaction, and expectations. A total of 339 patients were included in the study. 75.8% of the participants stated that they first applied to primary care due to their complaints. Among those who applied to primary care, 62.6% applied for diagnosis, and 43.6% applied due to worsening of their symptoms. Physical examination (73.9%) and questions aimed at understanding complaints (70.8%) were the most frequently received services in primary care, and the prescription rate was 57.6%. The referral rate to a specialist dermatologist was 19.1%. Among the treatments recommended in primary care, topical antifungal drugs (91.8%) were in the first place, while oral antifungal drugs were recommended at a rate of 26.8%. The rate at which the treatment received in primary care completely resolved the complaints was 21.4%, while 46.7% reported partial improvement, and 31.9% reported no change. 85.6% of the patients who applied to tertiary care came on their own request, and only 14.4% came with a referral. The general satisfaction rate of patients with primary healthcare services was found to be high (42.2% very satisfied, 43.1% satisfied). However, patients demand specialized personnel (51.0%) and improved diagnosis-treatment facilities (49.9%) regarding dermatological diseases. These results show that the vast majority of dermatophytosis patients applied to primary care, but full success in treatment was not always achieved, and they turned to tertiary care on their own demand. Strengthening primary healthcare services in the field of dermatological diseases, especially improving diagnosis, treatment competency, and patient education processes, is important for the effective use of healthcare resources. Keywords: Dermatophytosis, Primary Healthcare Services, Tertiary Healthcare Services, Patient Application, Family Medicine.