الفهرس | Only 14 pages are availabe for public view |
Abstract Patients visit family physicians for skin conditions that range from athlete’s foot, to eczema, to precancerous lesions. Most skin conditions managed by family physicians improve and most patients are satisfied with the care they receive for their skin lesions. The main aim of this work is to improve the health status of skin of Patients attending the family health care facilities and empower the role of family physician in dermatological care of their patients versus the specialists. This study was conducted to : Assess the prevalence of various skin diseases managed by family physician and factors related to patient utilization of primary, rather than alternative health care for these conditions. Also to determine the patient satisfaction, as well as diagnostic concordance between family physicians and dermatologists in diagnosing and treating skin lesions. The study is a hospital based study. It was completed in three months (from the first of December, 2012 to the end of February, 2013).in both Al-Batanoon family health unit representing the primary health care services and the outpatient clinic of the dermatological department of Menoufia university hospital representing the secondary health care services. The target population of the study were Out of all the patients No. 522) who attending the primary health care clinic ( Al-batanoon family health unit) during the period of the study ,only 252 were suffering from dermatological disorders (Rate – 48%) .<Out of all patients who attending the secondary health care facility (out-patient clinic of the dermatological department , Menoufia university hospital ) during three visits per week along the period of the study , 100 adult patients who can give a consent and has the ability to fill the questionnaire (group B) together with a similar number of adult patients who attend the primary health care facility health care facility>(No.100)(Group A)were included in a comparative study. where the were subjected to Discussion of the study aims and designs for taking a formal written consent. - Full history taking - Dermatological examination Prescriptions of all patients will be checked according to its compliance to the clinical practice guide line and evidence based medicine . 2. Filling the questionnaires for: - An assessment of the patient satisfaction (Questionnaire -A) - An assessment of the patient compliance (Questionnaire -B) - An assessment of the patient rights (Questionnaire -C) - An assessment of patient’s ideas, expectations and concerns (IECs) (Questionnaire -D) Comparing both groups as regard the socioeconomic level showing that there is no significant difference between the studied groups. Studying the prevalence of different skin disease in both sites of the study showing that infective skin disease were more significantly higher in primary health care clinics than the secondary one which may be attributed to the easy accessibility of family health services than the secondary one. Also it may be due to lake of healthy waste and sewage disposal resulting in increase of the infectious diseases including the dermatological ones in rural residency of most of the attendance to the family health clinic. The patients attending the primary health care clinics were more satisfied by the health care services with more compliance with the prescribed medications Revising the prescribed medications in both groups revealed that there a significant increase of adherence of the prescribed medications to the clinical guidelines in the patients attending the primary health care facility The patients attending the primary health care clinics were significantly more educated about their disease and its management plan, utilize their patient rights and informed about their plan of continuity of care and follow up. At the end of the study we can conclude that ; For better health care utilization patient with skin diseases should firstly visit the primary health care sites , where they will subjected to complete comprehensive examination and treated properly or referred to the Dermatologist for management of difficult conditions as immunological and cancerous lesions and recur again for a well-constructed continuity of care. |