Emmanuel Nwabueze AGUWA, Susan Uzoamaka ARINZEONYIA, Theodora OKEKE, Elias Chikee ANIWADA

Excessive and ınappropriate utilization of a tertiary health center in South-East Nigeria

AMAÇ: Bu çalışma; hastaların birinci basamak sağlık kurumları yerine üçüncü basamak sağlık tesislerini tercih etme nedenlerini ve demografik özelliklerini belirlemek için yapılmıştır. YÖNTEM: Tanımlayıcı nitelikte olan bu çalışma; Itukku-Ozalla, Enugu eyaletinde bulunan Nijerya Üniversitesi Eğitim Hastanesi Ayaktan Tedavi bölümüne Temmuz-Eylül 2008 tarihleri arasında başvuran kişilerde gerçekleştirilmiştir. BULGULAR: Çalışmaya 158’i (%42,7) erkek, 212’si (%57,3) kadın toplam 370 kişi katılmıştır. Katılımcıların çoğunda, basit baş ağrılarının ve sıtmanın üçüncü basamak hastanelerde tedavi edilmesi gerektiği görüşü hâkim olduğu izlenmiştir. Hastalığın şiddetinin, hastalık süresinin ve hastanenin mevcut ekipman durumu hastaların tedavi için başvuracakları yere karar vermelerinde etkili olmaktadır. Kadınların (x2=85,64, P

Güney-Doğu Nijerya’da bir üçüncü basamak sağlık merkezinin aşırı ve uygunsuz kullanımı

AIM: To identify the patients’ demographic characteristics and reasons for preferring to receive treatment in a tertiary health facility instead of first level of health care. METHOD: A descriptive study of patients reporting for treatment at General Out-Patient Department of University of Nigeria Teaching Hospital, Itukku-Ozalla, Enugu State was carried out between July and September, 2008. RESULTS: Three hundred and seventy people were studied; males were 158 (42.7%) while females were 212 (57.3%). Many have the opinion that illnesses like uncomplicated headache and malaria should be managed in the tertiary hospital. Severity of ailment, presence of equipment and duration of ailment are the most compelling factors to making a patient decide where to receive care. Significantly more females (x2=85.64, P<0.001), more educated persons (x2=106.78, P < 0.001) and skilled workers (x2=61.48, P<0.001) access tertiary health care. Of all the patients who were interviewed, 231 (62.4%) were not referred. Presence of doctor and diagnostic equipments are some of the suggestions that could improve utilization of primary health care. CONCLUSION: Tertiary health facilities manage many cases that can be managed at the primary health centers. To improve utilization of primary health centers improved manpower and diagnostic equipments should be in place at these centers.

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