May 15, 2022 Journal article Open Access

Özarslan, Fatma; Özkara, Adem; Yastı, Ahmet Çınar

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        <foaf:name>Özarslan, Fatma</foaf:name>
        <foaf:givenName>Fatma</foaf:givenName>
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        <foaf:name>Özkara, Adem</foaf:name>
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            <foaf:name>Department of Family Medicine, Ankara City Hospital, University of Health Sciences, Ankara, Türkiye.</foaf:name>
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        <foaf:name>Yastı, Ahmet Çınar</foaf:name>
        <foaf:givenName>Ahmet Çınar</foaf:givenName>
        <foaf:familyName>Yastı</foaf:familyName>
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            <foaf:name>Department of General Surgery, Ankara City Hospital, University of Health Sciences, Ankara, Türkiye.</foaf:name>
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    <dct:title>Outcomes of Burn Management at the Primary Care: Social and Economical Aspects</dct:title>
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    <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#gYear">2022</dct:issued>
    <dcat:keyword>Primary care</dcat:keyword>
    <dcat:keyword>Family Physician</dcat:keyword>
    <dcat:keyword>Burn</dcat:keyword>
    <dcat:keyword>Cost</dcat:keyword>
    <dcat:keyword>Birinci basamak</dcat:keyword>
    <dcat:keyword>Aile hekimi</dcat:keyword>
    <dcat:keyword>Yanık</dcat:keyword>
    <dcat:keyword>Maliyet</dcat:keyword>
    <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#date">2022-05-15</dct:issued>
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    <dct:description>&lt;p&gt;&lt;strong&gt;Abstract&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Family physicians are supposed to be the first to face with patients at the acute or chronic terms of the illnesses as a primary care facility. In burn injuries, however, patients mostly seek medical attention at the health facilities other than the family physicians. We aimed to analyze the current situation in our country and its social and economic outcomes. Between July 1st and august 31st 2012, among 153 patients admitted to our burns outpatient clinic, 119 were included to the study. Twenty-one patients&amp;#39; family physicians and 21 family physicians not related to our study group were randomly sampled. Patient demographics, clinical course, and treatment cost were recorded. Patients&amp;#39; selection criterion in between primary care and us (tertiary referral hospital) is evaluated by a questionnaire. A survey carried out among family physicians to evaluate their backgrounds on burn management and attendance to postgraduate courses. The male to female ratio of the patients was 1.25 (66/55) and mean age was 29&amp;plusmn;18.1. Of the patients, 95% reached the hospital with a vehicle and 70.6% had an accompanier. Only 13.4% of the patients sought medical attention at the primary care. 52.4% (22/42) of the family physicians did never attend to a postgraduate course. During the prospective follow-up, there necessitated 501 visits and dressing changes. Total treatment cost for an average course was 109.4 $ or 26 $ for a visit. If the treatments were done at the primary care, a 42.2% reduction at costs could have been achieved. Even mostly conditions appropriate for management at the primary care, burn patients mostly bypass this stage. In addition, family physicians are not well updated on the current burn wound care. Bypassing the primary care add an extra physical, psychological, social, and economic burden to patient and also leads extra workload to the related health facilities. Bypassing causes additional economical cost to patients and insurance agencies. Policies should be settled for the management of outpatient burn patients at the primary care.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;&amp;Ouml;zet&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Akut veya kronik d&amp;ouml;nemlerinde hastalarla ilk karşılaşanların birinci basamak sağlık kuruluşlarındaki aile hekimleri olması&amp;nbsp;gerekir. Yanık durumlarında ise hastalar&amp;nbsp;&amp;ccedil;oğunlukla aile hekimleri dışındaki sağlık kuruluşlarına başvurmaktadır. Bu&amp;nbsp;&amp;ccedil;alışmada&amp;nbsp;&amp;uuml;lkemizdeki mevcut durumu ve bunun sosyal ve ekonomik sonu&amp;ccedil;larını&amp;nbsp;analiz etmeyi ama&amp;ccedil;ladık. 1 Temmuz-31 Ağustos 2012 tarihleri arasında yanık polikliniğimize başvuran 153 hastadan 119&amp;#39;u&amp;nbsp;&amp;ccedil;alışmaya dahil edildi.&amp;nbsp;&amp;Ccedil;alışmamıza katılan 21 hastanın aile hekimi ve kontrol grubu olarak da&amp;nbsp;&amp;ccedil;alışmamızla ilişkili olmayan 21 aile hekimi rastgele &amp;ouml;rneklemle alındı. Hasta demografisi, klinik seyri ve tedavi maliyetleri kaydedildi. Hastaların bizi (&amp;uuml;&amp;ccedil;&amp;uuml;nc&amp;uuml;&amp;nbsp;basamak sevk hastanesi) ve birinci basamağı&amp;nbsp;se&amp;ccedil;me kriterleri bir anket ile değerlendirildi. Aile hekimleri arasında yanık y&amp;ouml;netimi ve mezuniyet sonrası&amp;nbsp;kurslara devam etme konusundaki ge&amp;ccedil;mişlerini değerlendirmek i&amp;ccedil;in bir anket yapıldı. Hastaların erkek-kadın oranı&amp;nbsp;1.25 (66/55), yaş&amp;nbsp;ortalaması&amp;nbsp;29&amp;plusmn;18.1 idi. Hastaların %95&amp;#39;i ara&amp;ccedil;la, %70.6&amp;#39;sı&amp;nbsp;refakat&amp;ccedil;i ile hastaneye ulaşmıştı&amp;nbsp;ve sadece %13.4&amp;#39;&amp;uuml;&amp;nbsp;birinci basamakta tıbbi yardım istemişti. Aile hekimlerinin %52.4&amp;#39;&amp;uuml; (22/42) mezuniyet sonrası&amp;nbsp;hi&amp;ccedil;&amp;nbsp;eğitim almamıştı. Prospektif izlem s&amp;uuml;resince 501 hasta ziyareti ve pansuman değişikliği gerekti. Ortalama bir k&amp;uuml;r i&amp;ccedil;in toplam tedavi maliyeti 109.4 $ veya bir ziyaret i&amp;ccedil;in 26 $ idi. Tedaviler birinci basamakta yapılsaydı, maliyetlerde %42.2&amp;#39;lik bir azalma sağlanabilirdi. Birinci basamakta tedavi i&amp;ccedil;in koşullar&amp;nbsp;&amp;ccedil;oğunlukla uygun olsa bile, yanık hastaları&amp;nbsp;genellikle bu aşamayı&amp;nbsp;atlarlar. Bunun yanında aile hekimleri mevcut yanık yarası bakımı konusunda yeterince g&amp;uuml;ncel bilgiye sahip değildir. Birinci basamak sağlık hizmetinin atlanması&amp;nbsp;hastaya ekstra fiziksel, psikolojik, sosyal ve ekonomik y&amp;uuml;k getirmekte ve ayrıca ilgili sağlık kuruluşlarına ekstra iş&amp;nbsp;y&amp;uuml;k&amp;uuml;&amp;nbsp;getirmektedir. Bypass, hastalara ve sigorta acentelerine ekstra ekonomik maliyete neden olmaktadır. Birinci basamakta ayaktan yanık hastalarının y&amp;ouml;netimi i&amp;ccedil;in politikalar belirlenmelidir.&lt;/p&gt;</dct:description>
    <dct:description>Birinci Basamakta Yanık Tedavisinin Sonuçları: Sosyal ve Ekonomik Yönler</dct:description>
    <dct:description>{"references": ["\u200e1. The World Organization of Family Doctors (WONCA), Brussels, Belgium. The European Definition of General Practice / \u200eFamily Medicine. Available at: https://www.woncaeurope.org/file/3b13bee8-5891-455e-a4cb-\u200ea670d7bfdca2/Definition%20EURACTshort%20version%20revised%202011.pdf [Accessed January 11, 2022]. \u200e", "\u200e2. Republic of T\u00fcrkiye Ministry of Health, General Directorate of Public Health, Ankara, T\u00fcrkiye. Aile Hekiminin Tan\u0131m\u0131. \u200eAvailable at: https://hsgm.saglik.gov.tr/tr/ailehekimligi/aile-hekiminin-\u200etan%C4%B1m%C4%B1.html#:~:text=Aile%20hekimleri%2C%20ki%C5%9Fiye%20y%C3%B6nelik%20koruyucu,g%C3\u200e\u200e%BCn%20esas%C4%B1na%20g%C3%B6re%20%C3%A7al%C4%B1%C5%9Fan%20aile [Accessed January 11, 2022]. \u200e", "\u200e3. Purdue GF, Hunt JL, Burris AM. Pediatric burn care. Clinical Pediatric Emergency Medicine 2002; 3(1): 76-82.\u200e", "\u200e4. Holmes HJ, Heimbach DM. Burns. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE (eds), \u200ePrinciples of Surgery (8th edition). 2005, McGraw-Hill, New York. pp.189-221. \u200e", "\u200e5. Vercruysse GA, Ingram WL, Feliciano DV. The demographics of modern burn care: should most burns be cared for by \u200enon-burn surgeons? Am J Surg 2011; 201(1): 91-6.\u200e", "\u200e6. Stokes MAR, Johnson WD. Burns in the Third World: an unmet need. Ann Burns Fire Disasters 2017; 30(4): 243-6.\u200e", "\u200e7. Yast\u0131 A\u00c7, \u015eenel E, Saydam M, \u00d6zok G, \u00c7oruh A, Kaya Yorganc\u0131 K. Guideline and treatment algorithm for burn injuries. \u200eUlus Travma Acil Cerrahi Derg 2015; 21(2): 79-89.\u200e", "\u200e8. Yasti AC, Tumer AR, Atli M, Tutuncu T, Derinoz A, Kama NA. A clinical forensic scientist in the burns unit: necessity or \u200enot? A prospective clinical study. Burns 2006; 32(1): 77-82.\u200e", "\u200e9. Delgado J, Ram\u00edrez-Cardich ME, Gilman RH, Lavarello R, Dahodwala N, Baz\u00e1n A, et al. Risk factors for burns in \u200echildren: crowding, poverty, and poor maternal education. Inj Prev 2002; 8(1): 38-41.\u200e", "\u200e10. Tarim A, Nursal TZ, Yildirim S, Noyan T, Moray G, Haberal M. Epidemiology of pediatric burn injuries in southern \u200eTurkey. J Burn Care Rehabil 2005; 26(4): 327-30.\u200e"]}</dct:description>
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