Patients’ perceptions about access to health care and referrals to family physicians in Georgia

Abstract

Introduction: 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.