Evaluation of patient referrals to family physicians in Georgia
Languages of publication
Background. Adequate utilization of primary care directly reflects the health status of the population. In Georgia (Republic), many patients seek care without a referral by a primary-care provider, and as a result, patient referral rates to family physicians are low. A tendency of patient self-referral behavior may reduce the effectiveness of the healthcare system. Objectives. The purpose of the research is to study the problem of the low rate of patient referrals to family physicians in Georgia. Material and methods. Within the quantitative survey, 20 family physicians and 300 patients were interviewed through a semi-structured questionnaire in different regions of Georgia. Results. Patient referral rates to family physicians are low. 15% (n = 3) of family physicians recognize that patients often address them only for a referral to specialists. Only 5% (n = 3) of family physicians provide preventive consultations on occasion and 50% (n = 10) – in the case of need only. 70% (n = 14) of family physicians think that their remuneration is not adequate for their work and that they work more than they are paid. 35% (n = 105) of respondents in the case of a health problem address both a family physician and a specialist- -physician. 42% (n = 126) of patients visit a family physician once a year or do not visit at all, and 47% (n = 141) of patients believe that the family physician institute needs some changes. Conclusion. The result suggests that the low rate of patient referrals to family physicians is due to distrust towards family physicians, which is related to a lack of qualification of physicians and low public awareness of the competence of the family physicians. Due to inadequate reimbursement, family physicians do not have enough motivation to provide adequate service, and the lack of continuous professional education negatively affects their professional development. It is recommended to raise public awareness about primary care, to introduce effective methods for payment of family physicians and to increase the role and affordability of continuous professional education.
- Kurpas D, Kern JB, Jacquet JP, et al. Programs of health promotion and disease prevention – examples from Europe and the US. Fam Med Prim Care Rev 2015; 17(2): 152–156.
- Lionis C. Financial crisis and primary health care in Greece. Is it time for family medicine? Fam Med Prim Care Rev 2015; 17(3): 229–231.
- Põlluste K, Lember M. Primary health care in Estonia. Fam Med Prim Care Rev 2016; 18(1): 74–77.
- Paplicki M, Susło R, Dopierała K, et al. Systemic aspects of securing the health safety of the elderly. Fam Med Prim Care Rev 2018; 20(3):267–270, doi: 10.5114/fmpcr.2018.78272.
- Verulava T, Maglakelidze T. Health financing policy in the South Caucasus: Georgia, Armenia, Azerbaijan. Bull Georg Natl Acad Sci 2017;11(2): 143–150.
- Asatiani M, Verulava T. Georgian Welfare State: Preliminary study based on Esping–Andersen’s typology. Economics and Sociology 2017; 10(4): 21–28.
- Verulava T, Sibashvili N. Accessebility to psychiatric services in Georgia. Afr J Psychiatr (S Afr) 2015; 18(3): 1–5.
- Verulava T, Gabuldani M. Accessibility of urgent neurosurgery diseases by the state universal healthcare program in Georgia (country).GMJ 2015; 26(2): 42–45.
- Verulava T, Jorbenadze R, Dagadze B, et al. Access to ambulatory medicines for the elderly in Georgia. Home Health Care Manag Pract 2019; 31(1): 1–6.
- Verulava T, Maglakelidze T, Jorbenadze R. Hospitalization timeliness of patients with myocardial infarction. East J Med 2017; 22(3):103–109.
- Verulava T, Jincharadze N, Jorbenadze R. Role of primary health care in re-hospitalization of patients with heart failure. Georgian Med News 2017; 264(3): 135–139.
- Verulava T, Dangadze B. Health capital and economic growth: evidence from Georgia. Open Public Health J 2018; 11: 401–406.
- Chikovani I, Sulaberidze L. Primary health care systems, case study from Georgia. Geneva: World Health Organization; 2017.
- Ministry of Labor, Health and social affairs of Georgia. Health System Performance Assessment Report. Tbilisi: Ministry of Labor, Health and Social Affairs of Georgia; 2013.
- Verulava T, Jorbenadze R, Barkalaia T. Introduction of universal health program in Georgia: problems and perspectives. Georgian Med News 2017; 262(1): 116–120.
- Pollack CE, Rastegar A, Keating NL, et al. Is self-referral associated with higher quality care? Health Serv Res 2015; 50: 1472–1490.
- Verulava T, Jorbenadze R, Karimi L, at al. Evaluation of patient satisfaction with cardiology services. Open Public Health J 2018; 11:201–208.
- Tkachenko VI. Review of Ukrainian health care reformation on principles of family medicine. Fam Med Prim Care Rev 2017; 19(4):425–429, doi: 10.5114/fmpcr.2017.70820
Publication order reference