Manisa merkez yarı kentsel bölgede bir aile sağlığı birimine kayıtlı kadınlarda bazı birinci basamak sağlık hizmet özelliklerinin değerlendirilmesi

Ozet Amac: Birinci basamak saglik hizmet ozellikleri kaynakca dogrultusunda bilimsel olarak olculebilir niteliktedir ve ilk basvuru, sureklilik, kapsayicilik ve koordinasyon gibi temel hizmet ozellikleri uzerinden degerlendirilir. Yontem: Ornek seciminde cok asamali kume ornekleme yontemi kullanilmis, veriler yuz yuze gorusme teknigine gore yapilandirilmis anketle toplanmistir. Arastirma bolgesindeki toplam hane sayisi 870’tir. Kume ornekleme yontemi ile 376 haneden 318 kadina ulasilmistir. Arastirmanin ulasilabilirlik orani % 84.6’dir. Arastirmanin bagimli degiskenleri; Ilk basvuru, Sureklilik, Kapsayicilik ve OHS (Olagan Hizmet Surekliligi) gibi hizmet ozellikleridir. Bagimsiz degiskenler ise kadinin ve esinin yasi, kadin ve esinin egitimi, medeni hal, kadinin calisma durumu, sosyal sinif (esin isine gore), gelir algisi, bolgede yasama yili, goc edilen bolge, saglik guvencesi, aile tipi, bes yasindan kucuk cocuk varligi ve hanedeki cocuk sayisi kullanilmistir. Bulgular: Katilimcilarin yas ortalamasi 38.3±15.3’tur. Bir saglik sorunu nedeniyle aile hekimine basvurma % 61.0, ondan bir onceki saglik sorununda AH’ne (Aile Hekimi) basvuru %55,2 oranindadir. Bu sorularin her ikisine de “ayni aile hekimine basvururum” cevabini verenlerin (OHS) orani  %40.1 olmustur. Aile Sagligi Birimini yakin, normal mesafe bulanlarin orani %93.1’dir. Aile hekiminin ismini bilme %84, ebenin ismini bilme %36.2, her turlu sorununuzla surekli ilgilenen bir hekim veya saglik kurulusuna kayitli oldugunu soyleyenlerin %74.5’tir. Son bir yilda evime ebe ziyareti aldim diyenler %40.6 oranindadir. Sonuc: Arastirmanin yapildigi ASB’de gecen bir yillik ilk AH uygulama doneminde sosyallestirme donemiyle karsilastirildiginda, tedavi edici hizmet oruntusunun degismedigi buna karsin gezici ebe hizmetlerinin azaldigi gorulmustur. Anahtar Kelimeler: Aile sagligi birimi, ilk basvuru, sureklilik, kapsayicilik, olagan hizmet sunucu surekliligi Abstract Aim: The capability of primary care services can be scientifically measured and assessed via basic elements of these services such as accessibility, longitidunality, comprehensiveness and coordination.  Methods: A multistage cluster sampling method was used and the data were collected by face to face interviews with a structured questionnaire. An overall 870 households which were recorded in  a Family Practice Unit (FPU) consisted of the universe of this study and 318 women were identified from a sample of 376 households by cluster sampling method. The response rate was of 84.6%. The dependent variables in the study were, the First contact care, Continuity (Usual provider continuity), Comprehensiveness; whereas independent variables were, the women’s and husband's age, the women's and husband's education, marital status, women's occupational status, family social class, perception of income, years of residency in the region, the area of emigration, health insurance status, family type, existence of children under five years of age. Results: The average age of participants was 38.3 ± 15.3. The percentage of women who preferred FPU services for their most recent health problem was 61.0%, whereas this percentage was 55.2% for the previous experienced health problem. The Usual Provider Continuity (UPC) rate was 40.1%. 93.1 percent of women stated that FPU is quite close to their house. The proportion of the women who knew the name of their family physician was 84.0% and 36.2% them knew the name of their midwife. Of the respondents, 74.5% had been registered with a PHC facility or a primary care physician.  Midwives visited 40.6% of the respondents at least once during the last year. Conclusion: This research indicates that, the pattern of therapeutic services was not changed in the new FPU system, compared to the previous socialized health organization in the Primary Care services. Besides this fact, mobile midwife services might be said to have decreased in the new FPU system. Key Words: Family health unit, the first contact, continuity, comprehensiveness, usual provider continuity.