Investigation of the manageability of the reasons for patients applying to the physical medicine and rehabilitation clinic in the primary care setting

AIM: Family medicine plays a central role in the primary healthcare system, as well as in the coordinated functioning of the secondary and tertiary levels of care, contributing significantly to the establishment of a sustainable healthcare system. This study aims to evaluate the factors determining patient referrals to the physical medicine and rehabilitation (PMR) outpatient clinic in an educational and research hospital and assess the manageability of these patients at the primary care level. MATERIALS AND METHODS: Our study is a descriptive cross-sectional research conducted through face-to-face interviews using a questionnaire with 500 patients who visited the PMR clinic at Sakarya Training and Research Hospital from October 1, 2022, to February 1, 2023. Patients aged 18 and above who volunteered to participate were included in our study. A 32-item questionnaire, created by the researchers, was used as the data collection tool. RESULTS: It was observed that 74% (n: 370) of the participating patients preferred secondary or tertiary hospitals as their first choice for any health problems. The rate of those who initially sought primary care for their current complaints was determined as 19.4% (n: 97). When participants were asked about their reasons for not preferring Primary Healthcare Centers (PHC), 31% (n: 125) of them responded with "I didn't go because there were not enough tests available or couldn't be performed in PHCs." According to the opinions of PMR specialists, it was determined that 57% of the patients who visited the clinic could be managed in PHCs. It was statistically significant that the elderly, women, primary and middle school graduates, unemployed individuals, individuals with chronic diseases, those living in rural areas, and those with lower economic status preferred PHC over hospitals. (p<0.05) It was also statistically significant that patients who did not require laboratory tests, imaging procedures, or interventional procedures could be managed in PHCs compared to other patients. (p<0.05) CONCLUSION: In our study, we observed low rates of patients' initial preference for PHCs when it comes to seeking healthcare for their health problems, and one significant reason for this is the lack of knowledge among patients regarding the authorities and capabilities of their family physicians. It was found that more than half of the patients visiting the PMR outpatient clinic in our study could be managed by primary care physicians. We think that improving the physical facilities in PHCs and having health insurance cover the medications used in the treatment of diseases diagnosed at the primary care level would help reduce the patient burden on secondary and tertiary levels of care.