Abstract
BackgroundThe role of family physicians (FPs) in the metropolitan area is critical in identifying risk factors for disease prevention/control and health promotion in various age groups. Understanding patients’ preferences and interests in choosing a FP can be an effective and fundamental step in the success of this program. In this study factors affecting the FP selection by Iranian patients referred to health centers in the most populous areas in the south of Tehran were assessed and ranked.MethodsA sequential mixed-method (qualitative-quantitative) triangulation approach was designed with three subject groups of patients, physicians, and health officials. The Framework method was used to analyze interviews transcribed verbatim. After implementing an iterative thematic process, a 26-item quantitative questionnaire with high validity and reliability was drafted to evaluate the different factors. A convenient sampling method was used to select 400 subjects on a population-based scale to quantitatively rank the most critical selection factors as a mean score of items.ResultsThe selection factors were divided into six centralized codes, including FPs’ ethics, individual, professional and performance factors; patients’ underlying disease and individual health, and disease-related factors, office’s location and management factors, democracy factors, economic factors, and social factors. After filling out the questionnaires, the most important factors in selecting FP were a specialist degree in family medicine (FM) (4.49 ± 0.70), performing accurate examinations with receiving a detailed medical history (4.43 ± 0.68), and spending enough time to visit patients (4.28 ± 0.75), respectively. However, the parameters such as being a fellow-citizen, being the same gender, and physician’s appearance were of the least importance.ConclusionThere is a possibility to screen the most important factors affecting the FP choice through the combination of qualitative and quantitative studies. The first and last patients’ priority was physicians’ specialty in FM and being a fellow-citizen with them, respectively. The clinical and administrative healthcare systems should schedule the entire implementation process to oversee the doctor’s professional commitment and setting the visit times of FP.
Highlights
The role of family physicians (FPs) in the metropolitan area is critical in identifying risk factors for disease prevention/control and health promotion in various age groups
The selected strategy of interviewees was purposive that included three groups of physicians, health system managers (HSMs), and patients referring to the healthcare centers, who were selected with a triangulation method
The most important factors affecting the choice of an FP by patients out of 26 items were the specialist degree in family medicine (FM), followed by careful examination and history, and assigning sufficient time to visit
Summary
The role of family physicians (FPs) in the metropolitan area is critical in identifying risk factors for disease prevention/control and health promotion in various age groups. Health is the foundation of the social, political, and cultural development of all human societies As it is of particular importance in the formation of infrastructure in different parts of society, the ultimate goal of any country’s healthcare system is to improve the health of individuals so that they can participate in social and economic activities with adequate health [1]. The EPHS in primary care in Iran includes: (i) prevention: immunization, prevention, and control of communicable and non-communicable diseases, prevention of unwanted pregnancies, oral hygiene, and mental health, (ii) health promotion: health education, and learning healthy lifestyles and life skills, (iii) early treatment and emergency management: visiting the office, diagnosing and treating diseases, performing simple surgeries such as stitches, vasectomy or circumcision, injections, dressing, home visits, and cardio-respiratory resuscitation, (iv) referral: eligible patients for secondary or third level specialty care, and (v) health management: the record of population’s health information, advocacy, and monitoring the work of health team members [3, 7]
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