TURKIYE KLINIKLERI TIP BILIMLERI DERGISI

Objective: In the following study, effect of social class and social security on reaching diagnostic and therapeutic health care services in Manisa is evaluated in both out-patient and in-patient basis. Material and Methods: The households were determined in proportion to targeting populations in health care facilities (health houses) by using cluster sampling method and 11284 people representing the population in Manisa city center (n:232760) was included in the study. The data was collected by pollsters using face to face technique. Crude risks were calculated in different social classes and in those with or without social security for history of health problems and access to diagnostic and therapeutic health care services on outpatient and the inpatient basis. Multivariable risks were revised in accordance with age, sex and chronic health problems. Results: In comparison to unemployed population, the health problems in last 15 days was 1.79 (1.17-2.75) times more common in upper social class and similar figures were also seen in middle social class and lower social class, being 1.51 (1.10 -2.06) and 1.44 (1.04-2.00), respectively. Moreover, reaching to diagnostictheraupetic health care services in last 15 days was 1.73(1.08-1.46) times more common in upper social class and this value was 1.46 (1.03-2.06) in middle social class and 1.53 (1.07-2.20) in lower social class. The revised risks of having diagnostic and therapeutic health care were similar in different social classes. In comparison to those without any social security, it was found that those with social security reported having health problems 1.58 (1.17-2.13) times more, and this was also true for out-patient diagnostictherapeutic medical care being 2.57 (1.75-3.78) and inpatient being 3.37 (2.11-5.40) times more. Conclusion: There are inequalities against those being unemployed and those without social securities with respect to accessing to health care services

Evaluation of specialist training in basic sciences in two university medical schools: Perspectives from both specialist residents and trainers [Ege ve dokuz eylül üniversitesi tip fakültelerinde temel tip bilimlerinde uygulanan uzmanlik egitiminin egitici ve egitilen bakiş açisi ile degerlendirilmesi]

PubMed ID: 17205691A questionnaire survey has been undertaken to evaluate the specialist training in basic sciences in view of both specialist residents (SpRs) and trainers of two university medical schools in İzmir, Turkey. Seventy four SpRs (39 from Dokuz Eylül and 35 from Ege Universities) and 15 basic science units (8 from Dokuz Eylül and 7 from Ege Universities) were joined in this survey. The response rate was 73% for SpRs and 86.7% for basic science units. Technical equipments, the number of trainers, education programmes and training equipments of basic science units have been found adequate both by SpRs and trainers. However, professional education has been found incapable. In basic science units, it was seen that the SpRs are permanently assessed and attended the investigation activities during educational process. The trainers expressed that the SpRs have got training knowledge, skills and attitute sufficiently, but SpRs answered that they have got them in moderate means. In conclusion, although the training programmes of SpRs in both of the university hospitals have been found competent, SpRs indicated that there is a need for development of trainers quality, assessing methods and rotational education programmes in basic science

Change from health center to family physician period in the Turkish health system: A qualitative study

Introduction Health care reforms in Turkey have been implemented resolutely in the last 12 years. The shift from health center (HC) to a family physician (FP) approach is 1 of the basic interventions of these reforms. The goal of the current study is to evaluate opinions of patients, health care workers, and managers, using qualitative methods. Methods In-depth interviews were conducted with patients who received health care services in both the FP and the HC periods, and with health care workers and managers in health care facilities that served in both periods. The interviews were recorded after obtaining permission, and then transcribed. Both health care staff that worked in the 2 periods and the patients that received health care services in the 2 periods reported that FP system was superior to HC system in attention showed by the family physicians, being followed by the same physician, and having confidence in physicians. Results The current FP period is superior to HC in facilities such as patient records, computer, internet, and phone. The strengths of HC period include home visits, environmental health studies, and family planning services. According to health care workers who worked in the 2 periods, HC was superior to FP in team spirit, public service delivery, and surveillance of communicable diseases. Conclusion Public service delivery and environmental health studies and primary care practice in rural areas must be scrutinized in the context of the FP approach