Characteristics of the Visits to a Family Heath Center in a District of Istanbul During Covid -19 Pandemics

Bengisu Olgun Bekman, Abdullah Ozan Polat, Pemra C. Unalan

Keywords: Primary care, Family Medicine, follow up, preventive medicine, COVID -19

Background:
The organization of primary care practice depends primarily on the needs of the community, the availability of resources and the structure of service delivery.

Research questions:
To evaluate the reasons of the peoples visits, needs, diagnoses, follow-up and vaccination status of all patients who applied to the Family Medicine Health Center.

Method:
Of the 7871 population registered to the FMHC of all age groups who received health service between 01.07.2021 and 15.01.2022 was included in this retrospective, cross-sectional, and descriptive designed study.

Results:
We evaluated 8203 visits. The majority included in the study (65.2%; n=5371) were female, with a mean age of 39 years (0 min, 99 max) Distribution by months, the visits increased in winter and highest number was in December (22.9%; n=1879). 15-64 age group comprised 53.7% (n=4404) of the visits and age of 65 and over followed by 19.9% (n=1633). Only 25% of all applications were preventive medicine with a ratio of 16% vaccination, 3.5% infant follow-up, 3% pediatric follow up We found no significant difference in admission to FMHC (p>0.05) between age and gender, it was observed that women were more likely to apply than men and older people than younger people. In order of frequency, the five most common diagnoses are; Acute upper respiratory tract infections 16.82 %, general medical examination 10.4%, Hypertension with Diabetes M. 7.8%, Pain 7%, Gastroesophageal Reflux % 6.5.   Infant and child vaccines accounted for 51.7% of 1314 vaccines administered, while COVID-19 mRNA 30.4%, COVID-19 Inactive 7% seasonal influenza vaccine was 9.4%. Adult vaccination rates increased in individuals with advanced age and without chronic disease.

Conclusions:
It is defined that in primary care health services in our region acute problem management is higher than the preventive medicine,periodic examinations and follow-up visits which is not ideal. We concluded preventive medicine and follow-up should be given more weight.

Points for discussion:
How much time do you spend on preventive medicine in you daily clinic practice?

Considering the additional financial burdens that the preventive medicine disruption will bring to the health system ,what can be done to improve the preventive medicine in primary care ?