Family Medicine System Research Articles

Development of a minimum data set for a blockchain-based personal health records (PHRs), for patient/physician interaction in family medicine

BACKGROUND: The primary requirement for a capable patient health record (PHR) that can interact appropriately with the family medicine system and collect and share qualified data is a minimum data set (MDS) aligned with family medicine’s functions and goals. The aim of this research was to determine the MDS for a blockchain-based PHR system that can effectively interact with family medicine providers and collect and share qualified data. This MDS is intended to be applicable to all members of the community covered by family medicine. MATERIALS AND METHODS: This applied study was conducted in 2022 in a cross-sectional and descriptive approach in three phases. In the first phase, a content analysis related to the research objectives was conducted in scientific databases, search engines, and websites of the centers and scientific research organizations with publications and policy-making in this field. Consequently, 11 studies were selected for use in the second and third phases. In the second phase, to determine information needs, a researcher-developed questionnaire including 17 classes was given to 50 people under the cover of the family medicine plan in Shiraz city. By choosing one of the two options “Yes” or “No” by them, the necessary data classes were determined. In the third phase, the second researcher-developed questionnaire was designed and administered to 100 family physicians in Shiraz city. This questionnaire included the data elements corresponding to the data classes approved in the previous phase. The family physicians were asked to rate the importance of each data element using a Likert scale with five options, ranging from “very unimportant” to “very important.” The necessary data elements were determined based on these scores. RESULTS: In the first questionnaire, 16 of the 17 data classes received approval from individuals covered by the family medicine plan. Consequently, a questionnaire comprising 16 classes and 105 data elements was administered to the family physicians. Ultimately, the MDS was determined to include 16 classes and 72 data elements. CONCLUSIONS: Determining essential data elements, especially for patient/physician interaction in family medicine, should be such that they can be managed by the person while being comprehensive and providing sufficient help to the physician during the treatment process. This MDS can be used to interact with and refer PHRs to other physicians and specialists, as well as help interoperability between the PHR and other health systems, such as hospital information systems (HIS) and electronic health records (EHRs).

THE RELATIONSHIP BETWEEN FRAILTY AND CAREGIVERS’ CLOSENESS IN ELDERLY PATIENTS IN TURKEY

Introduction:Being cared for by family members is very important in Turkish society. We aim to evaluate the relationship between the frailty index and caregivers’ closeness to patients aged 65 years and older. Materials and Method: Four hundred people aged 65 and over living in the Çumra district of Turkey’s Konya Province were included in our research. A sociodemographic data form consisting of 50 questions and the Tilburg Frailty Scale which consisted of 25 questions completed by all participants. Results:The prevalence of frailty was found to be 60.0%. A statistically significant difference was found in the Tilburg Frailty Scale among age groups (p < 0.0001).A statistically significant difference was also found in the Tilburg Frailty Scale between the group living alone and the group not living alone, between the group receiving care and the group not receiving care, and between those cared for by their children and those cared for by other relatives or neighbors. Conclusion:Frailty has been determined to be common enough to be considered a public health problem in Turkey. It has been concluded that almost all elderly people want to stay with their families and that state-sponsored arrangements are urgently needed in terms of caring for elderly people. The fastest and easiest way to educate caregivers and the elderly is possible with the family medicine system. We believe that the coordinated work of family doctors and caregivers will increase the success of home care. Keywords: Frailty; Caregivers; Aged; Family.

Birinci Basamak Sağlık Hizmetlerinde Hasta Memnuniyeti Üzerine Bir Araştırma: Bilecik İli Örneği

The aim of this study is to determine whether patient satisfaction in Bilecik province is affected by personal factors, characteristics of the health institution and the quality of the health service provided within the scope of family medicine practice. The data collection method in the study was carried out with face-to-face and web-based questionnaires. The data collection process was carried out between 1-28 February 2021. The prepared questionnaire forms were printed on paper and also transferred to the website. The address of the website was shared via the internet. As a result of data collection, 406 valid questionnaire forms were obtained. The questionnaire consists of three sections. Under the heading of demographic information; gender, marital status, educational status, occupational information, social security, total monthly income of the household, the reason for applying to the family physician and the first person to whom the health problem is applied when encountered are included. 3 questions are included in the section ''Level of knowledge about family medicine practice''. The next stage is on ''Evaluation of service places''. There are 3 questions under the heading ''Evaluation of procedures''. There are 5 questions under the title ''Evaluation of family medicine'', 2 questions under the title ''Evaluation of family health personnel'' and 5 questions under the title ''Evaluation of family medicine services''. Finally, a section has been reserved for the participants to indicate the issues that they would like to specify about the family medicine service.
 According to the results of the research; 53% of the participating patients were male and 47% were female, accordingly, it was determined that the majority of the employees participating in the research were male. It was determined that there was no statistically significant difference between the difference in the gender of the patients and their level of satisfaction with the family medicine system. In addition to these, it has been concluded that there is a statistically significant difference between the different ages of the patients and their satisfaction levels with the family medicine system, and that the satisfaction levels of the patients increase with increasing age. It has been determined that there is a statistically significant difference between the marital status of the patients and their satisfaction levels with the family medicine system and that married patients have higher satisfaction levels with family medicine than single patients.

Relationship between Multidimensional Poverty Indicators and Health Behaviors among Turkish Children

The aim of the study is to investigate the relationship between multidimensional poverty indicators and health behaviors among Turkish children. The sample of the study was determined to include at least one school from each socioeconomic status group in the districts of Ankara, which are classified into four socioeconomic groups, and the data were collected by applying face-to-face questionnaires to a total of 4,276 children, 2145 boys and 2136 girls, between the ages of 10 and 14. The data were analyzed using descriptive statistics, chi-squared test and binary logistic regression in the PASW Statistics program. The most striking results of the analysis showed that the female children, 5th, 6th, and 7th grade students, those who rated their health as good, those with a high or medium family affluence levels, those who were not deprived according to the Child Deprivation Index, those who rated their family income level as high or medium, and those who never suffered from hunger were more likely to be in the group with healthy behaviors (p<0.05). Accordingly, some school-based interventions and policies to be implemented in the family medicine system are recommended to promote the healthy behaviors of children, especially those living in poverty.

Combining and comparing regional SARS-CoV-2 epidemic dynamics in Italy: Bayesian meta-analysis of compartmental models and global sensitivity analysis.

During autumn 2020, Italy faced a second important SARS-CoV-2 epidemic wave. We explored the time pattern of the instantaneous reproductive number, R0(t), and estimated the prevalence of infections by region from August to December calibrating SIRD models on COVID-19-related deaths, fixing at values from literature Infection Fatality Rate (IFR) and average infection duration. A Global Sensitivity Analysis (GSA) was performed on the regional SIRD models. Then, we used Bayesian meta-analysis and meta-regression to combine and compare the regional results and investigate their heterogeneity. The meta-analytic R0(t) curves were similar in the Northern and Central regions, while a less peaked curve was estimated for the South. The maximum R0(t) ranged from 2.15 (South) to 2.61 (North) with an increase following school reopening and a decline at the end of October. The predictive performance of the regional models, assessed through cross validation, was good, with a Mean Absolute Percentage Error of 7.2% and 10.9% when considering prediction horizons of 7 and 14 days, respectively. Average temperature, urbanization, characteristics of family medicine and healthcare system, economic dynamism, and use of public transport could partly explain the regional heterogeneity. The GSA indicated the robustness of the regional R0(t) curves to different assumptions on IFR. The infectious period turned out to have a key role in determining the model results, but without compromising between-region comparisons.

Huzurevlerinde Yaşayan Bireyler Aile Hekimliği Uygulaması Hakkında Ne Kadar Bilgi Sahibi?

Giriş ve Amaç: Aile hekimliği uygulaması bireylere ve ailelerine sürekli ve çok yönlü sağlık hizmeti sunmayı amaçlamaktadır. Bazı yaşlı bireyler için huzurevleri barınma ihtiyacı için bir seçenek olarak gündemdeki yerini korumaktadır. Bu araştırmada Manisa merkez ilçelerinde bulunan huzurevi sakinlerinin, ülkemizdeki aile hekimliği uygulaması hakkındaki farkındalıklarının ve bu uygulamadan ne kadar hizmet alabildiklerinin saptanması amaçlanmıştır.
 Gereç ve Yöntemler: Araştırma tanımlayıcı kesitsel tiptedir. Araştırma Manisa ili merkez ilçelerinde iki farklı huzurevinde yaşamakta olan sakinler arasında yapılmıştır. Çalışmaya 81 birey dahil edilmiştir. Demografik bilgiler ile katılımcıların aile hekimliği uygulaması ile ilgili farkındalıkları, Aile Hekimliğine kayıtlı olup olmadıkları ve aile hekimliği uygulamasından nasıl yararlandıkları gibi soruları içeren bir anket uygulanmıştır. Verilerin analizi için SPSS 15.0 programı kullanılmıştır.
 Bulgular: Katılımcıların yaş ortalaması 75,8 ± 9,20 (58 – 94)’dir. Katılımcıların %70,4’ünün aile hekimliği uygulamasından haberdar olduğu görülmüştür. Bununla birlikte katılımcılar, %64,2’sinin bir aile hekimine kayıtlı durumda olduklarını belirtmiştir. Katılımcıların %37,0’ı ilk olarak devlet hastanesine, %35,8 i üniversite hastanesine, %19,8 i aile hekimliğine ve %7,4 ü özel hastaneye başvuru yapmaktadır. 
 Sonuç:Ülke çapında yaygın örgütlenmeye sahip aile sağlığı merkezlerinin yaşlı nüfus gruplarına vereceği sağlık hizmetlerinin niteliği, yaşlı nüfus topluluğu açısından büyük önem taşımaktadır. Kolay erişilebilir ve yaygın dağılımı olan aile hekimliği uygulamasının, başta huzurevlerinde yaşayan, ileri yaş nüfus grubuna tanıtılması sağlanmalıdır. Bu yönde atılacak adımların, en azından huzurevlerinde kalan yaşlı popülasyonun birinci basamak sağlık hizmetlerine erişimi açısından olumlu bir katkısı olacağı düşünülmektedir.

Geographic distribution of family physicians in Japan and the USA: a cross-sectional comparative study.

Solutions for geographic maldistribution of physicians is challenging around the world, but primary care specialists are expected to resolve this issue. This study compares the geographic distribution of family physicians in Japan and the USA, both of which are developed countries without a major system for physician allocation by the public sector; however, the two countries differ greatly in the maturity of family medicine (ie length of its history as part of the healthcare system and the population of qualified family medicine experts). This cross-sectional comparative study used publicly available online databases for Japan in 2018 and 2017 in the USA. The municipalities in Japan and counties in the USA were divided into quintile groups according to population density. The number of family physicians per unit population in each group of areas was calculated, and was evaluated with a residual analysis. The geographic distribution of all physicians in Japan was simulated assuming that the proportion of family physicians among all physicians in Japan (0.16%) was increased to match that in the USA (11.8%). Of 320 084 physicians in Japan and 899 244 in the USA, 519 (77.2%) family physicians in Japan and 105 999 (100%) in the USA were included. The distribution of family physicians in Japan was noticeably shifted to areas with the lowest population density. In contrast, family physicians in the USA were distributed equally across areas. The distribution of physicians of other specialties (general internists, pediatricians, surgeons and obstetricians/gynecologists) was shifted heavily to areas with the highest population densities in both countries. The simulation analysis showed the geographic maldistribution of the total number of physicians improved substantially if the proportion of family physicians in Japan is increased to match that in the USA. The distribution of family physicians is more equitable than that of other medical specialists; however, an immature family medicine system can lead to an aggregation of family physicians in rural areas. This aggregation supports equity due to the broader scope of practice required by family physicians in rural areas. In countries where family medicine has not yet matured as a specialty, provided that the equitable aggregation of family physicians in rural areas can be maintained, increasing the number of family physicians as a proportion of the total number of physicians may improve the geographic maldistribution of the total number of physicians.

The Relationship Between COVID 19 Infection and Vitamin D Levels?

Aim: Vitamin D has many known benefits. One of them is that it is immunomodulator. It is also protective against upper respiratory tract infections. It was aimed to examine vitamin D levels in Covid 19 patients, who can cause multi-organ failure and death from asymptomatic infection. Materials and Methods: 580 patients with positive Real Time-Polymerase Chain Reaction (RT-PCR, PCR) test registered in our family medicine system were scanned from the national health data system and 91 patients whose vitamin D levels were checked recently were included in the research group. In addition, 91 people with negative PCR tests with the same characteristics were taken as the control group. Their vitamin D levels were taken from the national health data system. Results: The average age of the Covid 19 patient group was 53, while the control group was 55 years, it was observed 39.60% of the participants were male and 60.40% were female. Vitamin D levels of positive patients, 69.20% (<20 ng / mL) deficiency, 23.10% (20-30 ng / mL) insufficiency, 7.70% (30-149 ng/mL) was found to be optimal and the average vitamin D is 17.61 ng / ml. The vitamin D levels of the control group were found to be 58.20% deficiency, 24.20% insufficiency, 17.60% (30-149) optimal, and the average was 20.75 ng / ml. Conclusion: Vitamin D deficiency is more common in Covid 19 patients, and the average of vitamin D is generally lower in Covid 19 patients. Vitamin D supplementation is important in our fight against Covid 19. Keywords: Covid-19, vitamin D, immunity, level

Aile Hekimliği Sisteminde Hasta Memnuniyeti: Kesitsel Bir Çalışma

Objective: Family medicine, which has an important place in the provision of health services, provides a more equitable service delivery in health, and also ensures that health expenditures are more cost-effective. In this study, it was aimed to determine the satisfaction levels with family medicine services of individuals who have received service from family physicians in the central districts of Turkey/Kahramanmaraş during the last year and to examine them in terms of various variables.&#x0D; &#x0D; Materials and Methods: This is an observational study. It is also cross-sectional and descriptive. Accordingly, the STROBE statement was used in the reporting of the study. The "Family Medicine SatisfactionQuestionnaire” was used in the study. The validity and reliability of the questionnaire were carried out within the scope of the study. Before the factor analysis, Kaiser-Meyer Olkin (KMO) and Bartlett tests were conducted to examine the suitability of the data and the sample to the principal component analysis. Values of the exploratory and confirmatory factor analyzes of the study were included in the findings section.&#x0D; &#x0D; Results: While the general satisfaction score of the participants was above the average, it was below the average in terms of family medicine physical equipment and communication sub-dimensions. On the other hand, the dimension in which the satisfaction levels of the participants were the highest was the behavior of family physician dimension. The satisfaction level regarding the benefits of the family medicine system was also above average. No significant difference was found in the general satisfaction status of the participants by gender and whether they have a chronic illness. A significant difference was determined in the satisfaction level of the participants according to the age groups, marital status, educational status, income level, number of children owned. &#x0D; &#x0D; Conclusion: As a result of the study, it was determined that satisfaction with family medicine is generally high. In order to increase the quality of the family medicine system, which is one of the most important elements of primary health care services, patient satisfaction should be continuously evaluated and improvements should be made by detecting the disruptions in service. It is clear that the improvements to be provided in the service delivery processes will increase the satisfaction of the patients.

The primary care physicians' despair levels: Original research article.

The profession of medicine is very depressing both mentally and physically. There were studies conducted to investigate the reasons of depression and burnout. Hopelessness leads to depression and may be it is the first sign. The aim of our study is to determine the despair levels of primary care physicians. This research is a descriptive study. The study conducted with family physicians and Beck Hopelessness Scale was applied. Statistical analysis of the data was performed using IBM SPSS 23. 40.9% of those without children, 48.9% of those with chronic diseases, 47% of those who had been subjected to violence and 53.5% of those who are not satisfied with working in the primary care received severe hopelessness scores, and these score were significant (P<.05). The dissatisfied aspects of Family Medicine System should be examined in detail, and necessary measures should be taken against violence, which is a common problem in the whole healthcare sector. In this way, employee satisfaction and therefore patient satisfaction can be achieved.

Recommendations for Family Medicine System in Turkey

As the main component of primary health care services, the Family Medicine system has been introduced in most developed and developing countries, and almost all preventive health care services are provided through this system. A quality family medicine system will also reduce the burden of other healthcare institutions, as it includes ease of access to the patient and secondary protection, and will also increase their quality and efficiency. On the contrary, both the burden of other health institutions will increase and disruptions in preventive health services will occur due to unplanned density in the family medicine system.

Are family medicine centres achieving their target in Turkey: Impact on health care utilization of mothers and infants.

The family medicine (FM) system was introduced as the main source of primary care in Turkey as a component of the Health Transformation Program reforms. During a gradual implementation process, provinces switched to the FM system at different points in time between 2005 and 2010. In this paper, we use a micro-level data set to test whether the health care utilization of mothers during pregnancy, childbirth and the postnatal period is affected by the program. Using a difference-in-differences method for estimation, we find that the program is only effective for pregnant women who lived in provinces with a limited availability of specialist doctors. As a result of the FM program, women are likely to have their first prenatal consultancy earlier and their probability of seeing a doctor during their prenatal visit and receiving an ultrasound and blood and urine sample checks increases if they live in a province with a low number of specialists per 10,000 people. We find that the impact of the FM program decreases as the rate of specialists in a province increases, which negates any positive effect of the program on health care use.

Sharing experience from Chinese General Practitioners to International colleagues on how to tackle COVID-19

China was the first country where the novel coronavirus appeared. General Practitioners (GPs) in China are at the forefront of tackling the spread of the virus. While the health sector in China has been under scrutiny globally, many articles have been disseminated within the country about the response. GPs in China are keen to share their experiences with GP colleagues, as other countries go through similar experiences. The hope is that by sharing our experiences, our international colleagues can benefit from what worked well and what went less well.&#x0D; Coronavirus started spreading from Wuhan in Hubei Province in late 2019. As in many parts of China, Wuhan is a hospital-oriented health service, as the family medicine system is not yet fully implemented. The surge of patients to hospitals quickly overwhelmed the health system in Wuhan and surrounding towns and cities, as patients sought testing and treatment, and in the process helped to spread the virus more quickly. The experience has put the spotlight on the ineffectiveness of hospitals as the first port of call for this and other types of virus.

Lack of a family medicine system in Kurdistan Region: Challenges and solutions

Lack of a family medicine system in Kurdistan Region: Challenges and solutions

Out of pocket health expenditures in Turkey following introduction of co-payments along with improved primary care services.

In 2002, Turkey started to implement reforms in health care aiming to improve access and increase efficiency. Reforms increased health insurance coverage and resulted in higher number of outpatient and inpatient treatments at both public and private hospitals. Later, to change preference towards the use of secondary and tertiary care over primary care and rein in increasing health expenditures, a series of co-payments were instituted along with an extension of primary care services through a family-medicine system that provided free access to all. This work aims to measure the impact of these two simultaneous policy measures on out-of-pocket expenditures. We find that while contributory payments resulted in higher OOP health expenditures, especially for lower income households, the impact was small. We also observe that inability to consult a physician and to visit a hospital, especially for monetary reasons, was reduced after the policy change.

Burnout among family physicians in Turkey: A comparison of two different primary care systems.

The objective of this study was to determine the prevalence of burnout syndrome and associated factors among family physicians before and after family medicine system (FMS). The first part of the study was conducted in 2008 (pre-FMS) and the second part in 2012 (post-FMS). Physician's burnout was investigated by using the Maslach Burnout Inventory (MBI). In total, 139 physicians had been participating pre-FMS and 246 physician's post-FMS. The mean pre-FMS emotional exhaustion score was 15.7 ± 5.8, increasing significantly to 17.14 ± 7.5 post-FMS (P = 0.045). Mean pre-FMS and post-FMS depersonalization and reduced personal accomplishment scores were similar (P > 0.05). Age was negatively correlated with depersonalization in this study (P = 0.012) and positively correlated with personal accomplishment (P = 0.001). The primary care physicians in the post-FMS period were older, female physicians had a greater preference for primary care, and the levels of married doctors were higher. In addition, a higher level of physicians also owned their own home and cars compared to the pre-FMS period. A negative correlation has been reported between physicians' burnout levels and home or car ownership in the present study. Our findings suggest that physicians working under the family medicine system, a new primary care model, are at greater risk of emotional exhaustion, but that no change has occurred in terms of personal accomplishment or depersonalization, despite this new system.

Health Care Services and the Elderly: Utilization and Satisfaction in the Aftermath of the Turkish Health Transformation Program.

With the implementation of the health transformation program, Turkey has gone through substantial changes in its health system in the last decade. This study relies on two nationally representative data sets to investigate health service utilization and satisfaction of the elderly. In particular, it examines the share of elderly who have an unmet need for medical care and who could not afford a medical examination or treatment over the years 2006 to 2015, using data from the Turkish Survey of Income and Living Conditions. It also examines the utilization of health services and satisfaction from these services by the elderly in years 2004 to 2015 using data from the Turkish Life Satisfaction Survey. This study finds that utilization has increased and, coinciding with the introduction of the family medicine system, the percentage of patients choosing primary care facilities has increased. The share of the elderly with unmet need and those who could not afford health care have declined. Notwithstanding, overall satisfaction increased only until 2011-2012. Understanding the utilization and satisfaction of the elderly is important, because along with many other countries, the population is aging in Turkey. In the near future, health care needs of the elderly will have a higher priority on the agenda of policy makers.

Erciyes Üniversitesi Hastanesi polikliniklerine başvuran hastaların Aile Hekimliği uygulamasından memnuniyet durumu

Abstract Introduction: The aim of this study is to evaluate the satisfaction of the people about family medicine process which adopted 5 years ago in Turkey. Methods: This descriptive study is conducted via a structured face to face interview on 854 people who admitted to outpatient departments of Erciyes University Hospitals in the January-February 2015. Sample size was calculated 864 person with count if dissatisfaction rate was 40%. Satisfaction answers was self-reported with likert type questionnaire. Results: The mean age of the study group is 41.54± 5.33 and the vast majority of them were 25-49 years of age. Of the entire group 11.9% of them stated that they never consult the family physician before. The main reason for admission to family physician is to print prescription (58.4%). The rate of recommend their family physicians to others is 59.0%. The most frequently cited reasons for recommendation are interest of family physicians. The rate of those that previously applied to family physicians for the same complaint is low with 24.6%. 87.8% of people stated that they do not choose their family physicians. Of the research group 71.5% of the participants stated that they are satisfied with the services received from the family physician. When we examined satisfaction of family physicians by gender, there is no statistical relationship. Although there is no statistically significant difference between age groups, satisfaction rate is increasing with age. The highest satisfaction level is over 65 age group with 83.7%. Satisfaction rate of individuals from family physicians is decreasing as education level increases. Satisfaction of family physicians was significantly high in Individuals with chronic disease than those without chronic diseases. The mean number of application to the family physician in the past year is 4.32 ± 3.86. This application number is significantly high in women (4.59±4.11) than in men (4.01±3.51). The mean number of application increases with age, inversely decreases with the level of education. Conclusion: In our study we concluded that the satisfaction rate from the family medicine system has increased over time, but the applicant rate is still not at the desired level. The most reason that people use family medicine practice is repeat receipt which is we think need to intervention for this. Key Words: Family medicine practice, family practitioner, patient satisfaction

Evaluation of Family Medicine Specialty Theses Between the Years 2005-2015

Objectives: As the transition to family medicine system in 2005 was a milestone of the health system in Turkey, we tried to evaluate the theses of family medicine dissertation which could be reached on internet websites between 2005 and 2015. Materials and Methods: In our observational, analytical and retrospective study, the theses were evaluated with a Thesis Data Sheet that we prepared. Results: 492 theses in total were evaluated. The number of theses was the highest in 2008 with a rate of 23.58% and 50.80% of them were from the 10 training and research hospitals in Istanbul. 49.20% of the theses were from medical faculties of 33 universities. 50.80% of the authors were women and 49.20% were men. Advisors were stated in 87.80% of the theses. Most of the advisors of the theses were family medicine specialists with a rate of 40.93%. Frequency of supervision of family medicine specialists increased over the years. Subjects of the theses were mostly endocrine system, nutrition, and metabolism with a rate of 21.91%. Diabetes Mellitus and glucose metabolism disorders were the most (12.07%) studied subjects. Respectively, 21.75% and 76.63% of the theses were performed in the field and in hospitals. Sample groups were mostly between 101-200 people (24.80%). Conclusion: As the use of surveys increased significantly over the years, significant decreases were observed in the use of laboratory tests. The denotation of the theses’ advisor & study type and project support increased significantly. This shows that the theses were generated more attentively. Although number of field studies increased significantly within years, they were still not sufficient. Also, we thought that primary subjects such as preventive medicine were not studied frequently enough.

The Variation of Seasonal Diseases in Family Medicine Depends on Infectious Diseases and these are Mainly Respiratory Diseases

Family medicine is a major source of information about health problems and their variation. For most illnesses the general practitioner is the first point of contact in the health care system and he looks after a population whose age and sex composition is known. He is therefore in an ideal position to conduct inquiries about seasonal variations of diseases. There are diseases where possible patterns of seasonal variation have been established: psychiatric disorders, allergies, heart disease, etc. It has long been accepted that morbidity patterns in general practice vary seasonally, which mainly depends on the acute pathology of infectious origin. In addition, it can be affirmed that respiratory infections represent the most important percentage of infections. So, seasonal variability of diseases in family medicine can be attributed to the variability of respiratory infections. Infectious disease dynamics offer a wide variety of intriguing and unexplained phenomena. There is a gap in how diverse studies encompassing immunology, mathematics, epidemiology, and virology combine to form a complete picture of seasonality. This may be due to the daunting complexity of seasonality itself, which is likely to reflect the actions of a vast multitude of variables. An understanding of what drives seasonal trends may allow: 1) better understanding of transmission dynamics, leading to better methods of prevention, health education, triage, diagnosis and management; 2) generate causal and risk factor hypotheses; 3) awareness of risks and surveillance systems; 4) monitoring the effects of intervention studies such as immunization programs; 5) identifying the specific environmental and socioeconomic factors underlying seasonal transmission; 6) better Interpretation of prevalence or incidence studies; And 7) redistribution of resources for the care of the demand in family medicine and health care system.