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Aim: Family health centers (FHCs) are reimbursed for their current expenditures based on a classification of four clusters in Turkey. This study compared the coordination, comprehensiveness, continuity, accessibility, and the first contact of care among different reimbursement FHC groups. Methods: The data were obtained from the Turkish data of the Quality and Costs of Primary Care in Europe study. Data was collected in provinces from six geographical regions. Physicians and patients from Classes A and B FHCs were called the first group, and others were called the second group. Results: A total of 296 physicians and 2623 patients were enrolled. According to the reimbursement groups, 593 (22.6%) patients received services from the first group and 2012 (77.4%) patients from the second group. The first contact with care and the admission frequency of 3 or more in the last six months were higher in the first group (respectively, 99.2% vs. 97.7%, p=0.027; 55.4% vs. 49.6%, p=0.015). Conclusion: The reimbursement classification did not make a difference in coordination, comprehensive care, continuity, accessibility, and being the first contact of care. Therefore, the current classification does not contribute to improving the quality of primary care in terms of service provision. [ABSTRACT FROM AUTHOR]

Strong primary care does not develop spontaneously but requires a well-developed organizational planning between levels of care. Primary care-oriented health systems are required to effectively tackle unmet health needs of the population, and efficient primary care organization (PCO) is crucial for this aim. Via strong primary care, health delivery, health outcomes, equity, and health security could be improved. There are several theoretical models on how primary care can be organized. In this position paper, the key aspects and benchmarks of PCO will be explored based on previously mentioned frameworks and domains. The aim of this position paper is to assist primary care providers, policymakers, and researchers by discussing the current context of PCO and providing guidance for implementation, development, and evaluation of it in a particular setting. The conceptual map of this paper consists of structural and process (PC service organization) domains and is adapted from frameworks described in literature and World Health Organization resources. Evidence we have gathered for this paper shows that for establishing a strong PCO, it is crucial to ensure accessible, continuous, person-centered, community-oriented, coordinated, and integrated primary care services provided by competent and socially accountable multiprofessional teams working in a setting where clear policy documents exist, adequate funding is available, and primary care is managed by dedicated units. [ABSTRACT FROM AUTHOR]

Objective: Coordination function of primary care (PC) enables continuous, efficient, and cost-effective health care provided to patients with chronic disease and multimorbidity (MM). The aim of this study was to identify the most common chronic diseases and to determine the prevalence of MM in PC registries. Methods: Our study is a cross-sectional study. All the individuals aged 40 and over who were registered to the primary care units (PCUs) of the Uskudar district of Istanbul have formed the population of the study. A systematic cluster sampling was used. The patient list of each family physician in Uskudar district was accepted as a cluster and an equal number of patients from each cluster were enrolled. Only the information on the patients' MM data was requested from the primary care physicians. Results: The 108 physicians of the Uskudar district (response rate: 73.4%) gave consent to participate in the study. The 1187 (40.3%) of registered patients of all PCUs were 40 years old and over. The multimorbid patients were found as 330 (27.8%). Conclusions: Approximately, one of four patients have multimorbidity. So, the policy of primary care services should be redesigned for the management of MM patients including the 'goal-oriented care' approach. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the breast-feeding profiles and the factors that affect breast-feeding and weaning attitudes among mothers of 0-12 month old babies in a baby-friendly primary care unit. Material and Method: The study was conducted in a Mother and Child Health Centre in ıstanbul in May-October 2006. All 364 mothers who were registered in the health centre were enrolled. A total of 358 mothers were included in the study. Results: The frequencies of breastfeeding initiation and of breastfeeding within the first hour were 98.9 %and 62.3 %respectively. Among the babies older than 6 months (n=200), 52.5 %were weaned before 6 months. Pacifier use (OR 3.01, 95 %CI: 1.35-6.69), being preterm (OR: 3.36, 95 %CI: 1.04-10.79), having a job (OR: 2.83, 95%CI:1.14-7.04) or smoking (OR: 2.27, 95 %CI: 1.01-5.14) werefound to be risk factors for early weaning. Conclusion: Although the frequency of initiating breastfeeding is very high, the continuation duration is below the World Health Organization (WHO)'s recommendations. Physicians and other health workers should strongly recommend against smoking during, prenatal and postnatal visits. Physicians should not support pacifiers, until we have sufficient data to support its benefits. In order to increase the duration of breast feeding, health professionals should focus on preterm babies, smoking or working mothers. [ABSTRACT FROM AUTHOR]