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

Copyright © 2020 Balkan Medical Union. 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 of a primary-care provider; as a result, patient’s referral rate to the family physician is low. The tendency of patient’s self-referral behaviour may reduce the effectiveness of the health care system. The objective of the study was to assess the cause of the 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 have 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. Conclusions. The results suggest that the 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 the 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.