مقایسه شاخصهای مدیریت خدمات بهداشتی روستایی قبل و بعد از اجرای پزشک خانواده درمراکزبهداشتی درمانی روستایی استان یزد در سال92

Abstract Introduction:  A common method of managing Health Care and proper instruction and referral of patients through health system is implementing family physician planning. In order to improve health indices and referral system, family physician has been employed in the rural areas in the last 8 years. It seems quite essential to re-evaluate this system after these years. Methods: This is a descriptive study. Data were gathered by census in 1383 and the first half of 1384 as pre- implementation of family physician program and in 1389 and 1390 after utilization of it in the 38 Rural Health- Treatment Centers in the province of Yazd. It included family physicians, midwives, and clinical and para-clinical units. A validated check list including 15 questions in 5 areas (proportion of population to physician, proportion of midwives to the centers, percentage of availability of laboratories, average of number of drugs in the pharmacies of rural centers, and average of staying of physicians in the cities of the province of Yazd) was used. SPSS 19 was applied, using Mann-Whitney and t-tests to do statistical analysis. Results:  Comparing indices of health care management before and after implementation of family physician program revealed that the proportion of midwives to the centers has increased significantly. However, it did not have a positive effect on other indices, even though they improved relatively. (P-value <0.05). Conclusion: By reinforcing health care management indices in accordance with the relevant standards, and promoting welfare facilities and proper financial motivations in order to inspire physicians to stay longer in the deprived areas, we hopefully can see strengthening of referral system. This will eventually lead to the improvement of health indices.