Usual source of care of 0-5 years old children asociated factors and evaluation of health care in Burhaniye Balikesir

Objective: The aim of this study was to determine the usual source of care (USC) of 0-5 year old children and assess sociodemographic factors associated with having a usual  source of care. To evaluate the health care by using primary health care’s main characteristics (fist-contact/continuity/comprehensiveness/coordination).

 Method: Cross sectional study was conducted in January 2008 Burhaniye Balıkesir. The sample size was calculated from 756 children by 50% prevalance, with confidence interval of 95%, sample error 5% which led sample of 306 children. The data were collected from mothers with a questionnary by direct home visits by the researchers. Response rate was 83.7%. Primary care score was evaluated by Starfield’s conceptual framework. The main socioeconomical variables were poverty, social class,  migration status. Poverty was evaluated by using a poverty threshold. Chi-square test, Student’s t-test and ANOVA were used.
Results: Rate of children having a USC was 58.6%. 53.7% of them were public health centers, 23.4% were hospitals, 13.3% were private primary care facilities. Children whose parents have low education, blue-collar worker or unemployed, living below poverty household, low income perception, lack of insurance, migrants found significantly associated with not having USC. Poors, migrants, children who have chronical disease, low educated mothers children use significantly public health facilities as USC(p<0,05). Public primary care establishments as USC had significantly higher mean primary care scores (3.79±0.69) rather than the private ones(3.19±0.66) and the hospitals(3.05±0.83). The public health care centers mean primary care scores were significantly higher(3,77±0,71) than the others(3,28±0,79)(p<0,05).
Conclusions: The disadvantaged people do not have adequate USC and use public health facilities as USC.  The health care provided by the public health care centers has the best respond to primary health care’s main characteristics. This may depends on the holostic approach both preventive and curative care on primary care of the public health care centers.