Bypassing Primary Care? First Point of Contact Preferences Among Adults Presenting to a Tertiary Hospital in Türkiye

INTRODUCTION: Despite the expansion of family medicine in Türkiye, the absence of a mandatory referral system allows patients to bypass primary care. This study aimed to determine the first-point-of-contact preferences of adult patients presenting to a tertiary hospital and to evaluate factors associated with bypassing primary care, utilization patterns, and attitudes toward family medicine services.
METHODS: This descriptive and analytical cross-sectional study was conducted between December 2021 and February 2022. A researcher-administered questionnaire covering sociodemographic characteristics, health utilization habits, and 16 statements regarding family medicine attitudes was completed by 439 volunteers aged 18 or older at a tertiary hospital.
RESULTS: A total of 367 participants (mean age 42.3±14.1 years; 65.1% female) were analyzed; of the 439 individuals approached, 72 were excluded because they did not complete the interview. In non-emergency situations, only 31.1% (n=114) preferred Family Health Centers (FHC) as their first point of contact, while 35.7% (n=131) preferred state hospitals. Multivariate logistic regression revealed no independent predictors of FHC preference (p>0.05 for all). While 62.4% utilized FHCs primarily for prescriptions, 55% identified their family physician as their first point of contact, 70% were satisfied with staff attentiveness, and 56.4% reported effective problem resolution.
DISCUSSION AND CONCLUSION: Although patient satisfaction with FHC staff is high, only one in three patients utilizes primary care as their first point of contact.

Keywords: Family practice, referral and consultation, primary health care, tertiary care centers, patient satisfaction, Türkiye.