Outcomes of Burn Management at the Primary Care: Social and Economical Aspects

Abstract

Family physicians are supposed to be the first to face with patients at the acute or chronic terms of the illnesses as a primary care facility. In burn injuries, however, patients mostly seek medical attention at the health facilities other than the family physicians. We aimed to analyze the current situation in our country and its social and economic outcomes. Between July 1st and august 31st 2012, among 153 patients admitted to our burns outpatient clinic, 119 were included to the study. Twenty-one patients' family physicians and 21 family physicians not related to our study group were randomly sampled. Patient demographics, clinical course, and treatment cost were recorded. Patients' selection criterion in between primary care and us (tertiary referral hospital) is evaluated by a questionnaire. A survey carried out among family physicians to evaluate their backgrounds on burn management and attendance to postgraduate courses. The male to female ratio of the patients was 1.25 (66/55) and mean age was 29±18.1. Of the patients, 95% reached the hospital with a vehicle and 70.6% had an accompanier. Only 13.4% of the patients sought medical attention at the primary care. 52.4% (22/42) of the family physicians did never attend to a postgraduate course. During the prospective follow-up, there necessitated 501 visits and dressing changes. Total treatment cost for an average course was 109.4 $ or 26 $ for a visit. If the treatments were done at the primary care, a 42.2% reduction at costs could have been achieved. Even mostly conditions appropriate for management at the primary care, burn patients mostly bypass this stage. In addition, family physicians are not well updated on the current burn wound care. Bypassing the primary care add an extra physical, psychological, social, and economic burden to patient and also leads extra workload to the related health facilities. Bypassing causes additional economical cost to patients and insurance agencies. Policies should be settled for the management of outpatient burn patients at the primary care.