Investigation of complaints, diagnoses, preliminary diagnoses and their appropriateness in patients admitted to the Outpatient Clinics of Ordu University Training and Research Hospital

Objective: This study aimed to evaluate the appropriateness of patient admissions to eight different outpatient clinics of Ordu University Training and Research Hospital. In particular, it investigated whether these admissions could be managed at the family physician level and their compliance with the stepwise structure of the healthcare system. Materials and Methods: This descriptive and cross-sectional study was conducted between April 15, 2025, and August 15, 2025, in the outpatient clinics of Ordu University Training and Research Hospital, with a total of 522 participants. Data were collected through a 33-item questionnaire developed by the researcher and administered via face-to-face interviews. Statistical analyses were performed using R v4.4.1, and a significance level of p<0.05 was accepted. Results: The overall appropriateness rate of outpatient admissions was found to be 86.2%. A total of 72.2% of admissions (45.2% conditional and 27.0% definite) were determined to be manageable at the family physician level. By clinics, the rate of definitely manageable admissions was highest in Internal Medicine (53.4%) and Pediatrics (41.5%), whereas the rate of unmanageable admissions was higher in Ophthalmology (56.9%) and Otorhinolaryngology (40%). The appropriateness rate was 93.9% among patients who first consulted their family physician, compared to 84.4% among those who did not (p=0.021). Additionally, 59.8% of the admissions were self-initiated by patients, while only 1% were directed through the national appointment system (182). These findings indicate that referral mechanisms were found to be markedly underutilized and that there is a strong tendency for patients to directly seek tertiary care. Conclusion The study revealed that a significant proportion of tertiary care outpatient admissions could actually be resolved at the family physician level. The findings highlight the necessity of strengthening primary care services, enhancing referral mechanisms, and improving health literacy in the community. Such measures are expected to contribute to the efficiency and sustainability of the healthcare system. Keywords: Family Medicine, Outpatient Visits, Appropriateness Of Outpatient Visits, Levels Of Care, Health Literacy