Health indicators in Manisa: A yearly comparison between health center and family physician periods (2003-2012)

Objective: There are very few studies in Turkey, comparing two periods of practice through Health Centers (HC) and Family Physicians (FP). This study aims to compare health indicators in the city of Manisa during the period of HCs (2003-2007) and FPs (2008-2012) to determine the changes on a yearly basis. Method: This study is an analytical study with quantitative and qualitative (mixed) methodologies both utilized. Health indicators have been gathered from Manisa?s Provincial Health Directorate through their yearly statistics as well as Family Physicians? Information DataBank. Through use of Stata 11.0 statistical software, a segmented regression analysis has been completed to establish the intersections between regression lines from both periods as well as beta values of the regression line slopes with statistically significant results. Qualitative portion of the study included in depth interviews completed in 2012, with the HC and FP staff, managers and users (patients) who are able to compare both periods. Results: When we compare the staff and patient impressions with experiences in both systems, HC period was more successful in teamwork, home visits, environmental health, family planning and filiation of communicable diseases than the FP period. However, FP period seems to be better in terms of dealing with patients, ability to see the same physician, and computer and internet access (for the staff). In urban area , the public is happy with the shorter wait times and ability to see the same physician. Segmented regression analysis showed that infant, child, women and pregnancy care under the FP system is negatively segmented and this change is statistically significant (p<0.05). However number of outpatients under the HC system is positively segmented and this is statistically significant (p<0.05). Vaccinations and mortality rates changes between the two periods were similar both in terms of the segmentation and the slope of the regression lines (p>0.05). Conclusion: Study concludes that the HC period was better in terms of community health services while FP period made it easier to reach the family physicians. Key words: Health Center, Family Physician, Health Policy