May 15, 2022 Journal article Open Access

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

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    "description": "<p><strong>Abstract</strong></p>\n\n<p>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&#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&#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&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.</p>\n\n<p><strong>&Ouml;zet</strong></p>\n\n<p>Akut veya kronik d&ouml;nemlerinde hastalarla ilk kar\u015f\u0131la\u015fanlar\u0131n birinci basamak sa\u011fl\u0131k kurulu\u015flar\u0131ndaki aile hekimleri olmas\u0131&nbsp;gerekir. Yan\u0131k durumlar\u0131nda ise hastalar&nbsp;&ccedil;o\u011funlukla aile hekimleri d\u0131\u015f\u0131ndaki sa\u011fl\u0131k kurulu\u015flar\u0131na ba\u015fvurmaktad\u0131r. Bu&nbsp;&ccedil;al\u0131\u015fmada&nbsp;&uuml;lkemizdeki mevcut durumu ve bunun sosyal ve ekonomik sonu&ccedil;lar\u0131n\u0131&nbsp;analiz etmeyi ama&ccedil;lad\u0131k. 1 Temmuz-31 A\u011fustos 2012 tarihleri aras\u0131nda yan\u0131k poliklini\u011fimize ba\u015fvuran 153 hastadan 119&#39;u&nbsp;&ccedil;al\u0131\u015fmaya dahil edildi.&nbsp;&Ccedil;al\u0131\u015fmam\u0131za kat\u0131lan 21 hastan\u0131n aile hekimi ve kontrol grubu olarak da&nbsp;&ccedil;al\u0131\u015fmam\u0131zla ili\u015fkili olmayan 21 aile hekimi rastgele &ouml;rneklemle al\u0131nd\u0131. Hasta demografisi, klinik seyri ve tedavi maliyetleri kaydedildi. Hastalar\u0131n bizi (&uuml;&ccedil;&uuml;nc&uuml;&nbsp;basamak sevk hastanesi) ve birinci basama\u011f\u0131&nbsp;se&ccedil;me kriterleri bir anket ile de\u011ferlendirildi. Aile hekimleri aras\u0131nda yan\u0131k y&ouml;netimi ve mezuniyet sonras\u0131&nbsp;kurslara devam etme konusundaki ge&ccedil;mi\u015flerini de\u011ferlendirmek i&ccedil;in bir anket yap\u0131ld\u0131. Hastalar\u0131n erkek-kad\u0131n oran\u0131&nbsp;1.25 (66/55), ya\u015f&nbsp;ortalamas\u0131&nbsp;29&plusmn;18.1 idi. Hastalar\u0131n %95&#39;i ara&ccedil;la, %70.6&#39;s\u0131&nbsp;refakat&ccedil;i ile hastaneye ula\u015fm\u0131\u015ft\u0131&nbsp;ve sadece %13.4&#39;&uuml;&nbsp;birinci basamakta t\u0131bbi yard\u0131m istemi\u015fti. Aile hekimlerinin %52.4&#39;&uuml; (22/42) mezuniyet sonras\u0131&nbsp;hi&ccedil;&nbsp;e\u011fitim almam\u0131\u015ft\u0131. Prospektif izlem s&uuml;resince 501 hasta ziyareti ve pansuman de\u011fi\u015fikli\u011fi gerekti. Ortalama bir k&uuml;r i&ccedil;in toplam tedavi maliyeti 109.4 $ veya bir ziyaret i&ccedil;in 26 $ idi. Tedaviler birinci basamakta yap\u0131lsayd\u0131, maliyetlerde %42.2&#39;lik bir azalma sa\u011flanabilirdi. Birinci basamakta tedavi i&ccedil;in ko\u015fullar&nbsp;&ccedil;o\u011funlukla uygun olsa bile, yan\u0131k hastalar\u0131&nbsp;genellikle bu a\u015famay\u0131&nbsp;atlarlar. Bunun yan\u0131nda aile hekimleri mevcut yan\u0131k yaras\u0131 bak\u0131m\u0131 konusunda yeterince g&uuml;ncel bilgiye sahip de\u011fildir. Birinci basamak sa\u011fl\u0131k hizmetinin atlanmas\u0131&nbsp;hastaya ekstra fiziksel, psikolojik, sosyal ve ekonomik y&uuml;k getirmekte ve ayr\u0131ca ilgili sa\u011fl\u0131k kurulu\u015flar\u0131na ekstra i\u015f&nbsp;y&uuml;k&uuml;&nbsp;getirmektedir. Bypass, hastalara ve sigorta acentelerine ekstra ekonomik maliyete neden olmaktad\u0131r. Birinci basamakta ayaktan yan\u0131k hastalar\u0131n\u0131n y&ouml;netimi i&ccedil;in politikalar belirlenmelidir.</p>", 
    "language": "eng", 
    "title": "Outcomes of Burn Management at the Primary Care: Social and Economical Aspects", 
    "license": {
      "id": "CC-BY-4.0"
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    "journal": {
      "volume": "1", 
      "issue": "3", 
      "pages": "94-101", 
      "title": "Life and Medical Sciences"
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    "version": "v2", 
    "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", 
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      "\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"
    ], 
    "keywords": [
      "Primary care", 
      "Family Physician", 
      "Burn", 
      "Cost", 
      "Birinci basamak", 
      "Aile hekimi", 
      "Yan\u0131k", 
      "Maliyet"
    ], 
    "publication_date": "2022-05-15", 
    "creators": [
      {
        "orcid": "0000-0003-4136-2668", 
        "affiliation": "\u00c7ankaya Number 3 Family Health Center, Ankara, T\u00fcrkiye.", 
        "name": "\u00d6zarslan, Fatma"
      }, 
      {
        "orcid": "0000-0003-1658-3071", 
        "affiliation": "Department of Family Medicine, Ankara City Hospital, University of Health Sciences, Ankara, T\u00fcrkiye.", 
        "name": "\u00d6zkara, Adem"
      }, 
      {
        "orcid": "0000-0002-1281-3549", 
        "affiliation": "Department of General Surgery, Ankara City Hospital, University of Health Sciences, Ankara, T\u00fcrkiye.", 
        "name": "Yast\u0131, Ahmet \u00c7\u0131nar"
      }
    ], 
    "notes": "Birinci Basamakta Yan\u0131k Tedavisinin Sonu\u00e7lar\u0131: Sosyal ve Ekonomik Y\u00f6nler", 
    "resource_type": {
      "subtype": "article", 
      "type": "publication", 
      "title": "Journal article"
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