Investigation of the manageability of the reasons for admission of patients who applied to the orthopedics and traumatology outpatient clinic in primary health care services

INTRODUCTION AND AIM: Family medicine is at the center of primary health care and has a fundamental role in the creation of a sustainable health system. Musculoskeletal diseases are common reasons for outpatient clinic visits in our country. In this study, we aimed to evaluate the manageability of patients applying to orthopedics and traumatology clinics at the primary care level. MATERIALS AND METHODS: This study, which is part of a medical specialty thesis, was conducted on a total of 473 patients who applied to Sakarya Yenikent State Hospital Orthopedics and Traumatology Clinic between October 1, 2022 and February 1, 2023. Information was obtained from the patients themselves or their relatives. Our study was carried out through face-to-face interviews with patients using survey questions. Patients under the age of 18 whose parents consented to participate and those aged over 18 who voluntarily participated were included in our study. A 28-question survey created by researchers was used as the data collection tool. RESULTS: In our study, it was found that 53.5% (n:253) of the patients participating preferred PHCC as their first choice for any health issue. The rate of those who initially applied to family medicine for their current complaints was determined as 33.4% (n:158). When asked about the reasons for not preferring PHCC, a response of "I did not go because there is no imaging method at PHCC" was received in 33.3% (n:105) cases. While 51.4% of the applicants were considered unmanageable due to lack of imaging and 27.7% requiring interventional procedures, it was determined that 17.3% could be diagnosed and managed at the primary level . The average age of patients applying to PHCC has been significantly higher compared to those applying to hospitals (p<0.05). Patients without laboratory tests requested, without imaging studies performed, without interventional procedures carried out or with no history of trauma had significantly higher frequency rates in being manageable at primary care level (p<0.05). CONCLUSION: Despite most participants in our study mentioning PHCC as their first point of contact, they applied to upper-level facilities when orthopedic complaints were present. It was seen that the most important reason for patients to apply to orthopedics and traumatology outpatient clinics instead of PHCC was the lack of imaging tests in PHCC. We believe that it would be appropriate to plan the necessary infrastructure for imaging in PHCC in order to minimize inappropriate applications to orthopedic outpatient clinics.