Utilization of Primary Healthcare Services in Türkiye and Its Impact on Health Expenditures: A Study Based on Dermatology Outpatient Clinic Data

Objectives: The aim of this study was to evaluate the effect of examinations on health expenditures in patients who applied to the dermatology outpatient clinic in case of a referral to the appropriate healthcare center. Methods: Of the 29.929 patients who applied to the dermatology outpatient clinic between January and December 2023. The patients were administered a 16-question questionnaire, including complaints, sociodemographic characteristics, and treatment access habits. Expert judgment was used to determine the appropriate healthcare service for each patient, and the economic impact of misreferrals was calculated. Results: The mean age of the participants was 31.5±13.0 years, and only 20 (5.3%) patients needed tertiary healthcare services. One hundred and sixty (42.2%) of the patients could be treated in primary healthcare service and 199 (52.5%) in secondary healthcare service. A total of 154.632 TL was invoiced for all patients who were examined in the dermatology clinic. Since the patients were not treated in the appropriate health service, an overpayment of 109.502,48 TL was made in health expenses. Among the reasons for not applying to a family physician, 98 (25.8%) frequently stated that they did not trust the knowledge and capacity of the family physician and 123 (32.5%) frequently stated that they expected to receive better service at the university hospital. Conclusion: To reduce health expenditures and improve the quality of care, appropriate referral patterns of patients to health centers should be developed, which can significantly improve the cost-effectiveness and functionality of the health system.