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Browsing Article by Author "Karimi, Leila"
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Item The Gatekeeper Model: patient’s view on the role of the family physician(Family Medicine & Primary Care Review, 2020) Verulava, Tengiz; Dangadze, Beka; Jorbenadze, Revaz; Lordkipanidze, Ana; Karimi, Leila; Eliava, Ekaterine; Maglakelidze, TamarBackground. An adequate primary healthcare system substantially determines quality of population health and effective spending of healthcare resources. The family physician serving as a ‘gatekeeper’ can make judicious decisions about the appropriate use of medical services. Objectives. The goal of this study was to find out patients’ characteristics, preferences and behavior in regards to the role of the family physician as the gatekeeper in The Republic of Georgia. Materials and Methods. As part of a cross-sectional quantitative study, respondents were interviewed using a structured questionnaire. Results. Majority of the respondents (53.7%, n=245) had a permanent family physician, but were not satisfied with a level of family physician’s professionalism (56.6%, n=258) and preferred self-referral to specialists (55%, n=253). Only 19.5% (n=89) referred to specialists upon family physician’s advice who would coordinate all services and 23% (n=103) have used both family physicians and self-referral. Private health insurance companies were more interested in implementing cost reducing mechanisms rather than the Social Service Agency (which is responsible for Universal Health Care Program). Conclusions. It is appropriate to share private health insurance experiences for developing a model of gatekeeper in the UHCP. In order to improve a family physician institute and increase confidence in it, it is recommended to raise the level of family physicians’ skills of relations with patients as it has a significant effect on the patient preferences. It is advisable to develop a flexible and voluntary gatekeeper model which will better suit the needs of both patients and physicians.Item Patients’ perceptions about access to health care and referrals to family physicians in Georgia(Balkan Medical Union, 2020) Verulava, Tengiz; Jorbenadze, Revaz; Karimi, LeilaIntroduction: Adequate utilization of primary health care directly reflects the health status of a population. In the Republic of Georgia many patients seek care without a referral by a primary-care provider; as a result, patient’s referral rate to a family physician is low. The tendency of patient’s self-referral behavior may reduce the effectiveness of the healthcare system. The objective of the study. The research aims to study the cause of low referral rate to a family physician in Georgia. Material and methods. An analytic cross-sectional study was conducted. Within the quantitative survey 300 patients and within the qualitative research 20 family physicians from different cities and regions of Georgia were interviewed. Results: Patient’s referral rate to a family physician was low. 55% of family physicians revealed that patients had often addressed them only for the referral to specialists. 42% of patients visited the family physician once or did not visit at all and 57% did not consult with a family physician for preventive purpose. Conclusion: The result suggested that patient’s low referral rate was due to distrust towards family physicians, which was related to the lack of qualification of physicians and the low public awareness of the family doctor’s competence. Due to an inadequate reimbursement, family physicians do not have enough motivation to provide adequate service and lack of continuous education negatively affects their professional development. It is recommended to raise public awareness about the primary care, to introduce effective methods for payment of family doctors, to increase the role and affordability of continuous professional education.