Changes in primary care provision in Turkey: A comparison of 1993 and 2012

- This study compared service profiles of Turkish primary care doctors using data from 1993 European GP Task Profile and 2012 QUALICOPC studies.
- This study looks at indicators such as coordination, comprehensiveness, access and continuity of the process dimension defined by PHAMEU framework.
- The breadth of the service profile of Turkish doctors has expanded in terms of involvement in treatment of chronic diseases and first contact care.
- The negative performance criteria as applied in Turkish primary care may have created discrepancies in favour of tasks targeted by these criteria.
- For the future, room for improvement remains in the integration of health services and the number of FDs with postgraduate vocational training.

Since the early 1990s, the primary care system in Turkey has undergone fundamental changes. In the first decade of the millennium family doctor scheme was introduced to the Turkish primary care sector and the name of the primary care doctors (PCDs) changed from “general practitioner” (GP) to “family doctor” (FD). This study aims to give an insight into those changes and to compare the service profiles of PCDs in 1993 and 2012. Data, based on cross sectional surveys among Turkish doctors working in primary care are derived from the 1993 European GP Task Profile study (n = 199) and the 2012 Quality and Costs of Primary Care in Europe (QUALICOPC) study (n = 299). The study focuses on the changes in the primary care service provision based on selected aspects such as the first contact of care, preventive care, and the knowledge exchange and collaboration with other health professionals. Compared to GPs in 1993, FDs in 2012 reported that their involvement in treatment of chronic diseases, first contact care, antenatal and child health care have increased. FDs have more contact with other primary healthcare workers but their contact with hospital consultants have decreased. Overall, the services provided by PCDs seem to be expanded. However, the quality of care given by FDs and its effects on health indicators are needed to be explored by further studies.