Caregiver reasons for tertiary health-care seeking for children aged ≤12 years.

BACKGROUND: In Turkey, a mandatory referral system is not used. Caregivers, for their children, present directly to health-care providers at all levels. This allows patients to present directly to university hospitals. In this study, reasons for university hospital-treatment seeking by caregivers for child health problems is discussed. METHODS: This was a cross-sectional descriptive study at Dokuz Eylul University Faculty of Medicine, Izmir, Turkey, of 235 caregivers whose children were admitted to the outpatient clinic of the General Pediatrics Department between 4 and 11 April 2013. They completed a questionnaire on demographic data and reasons for presentation to the university hospital. Mann-Whitney U-test was used to compare group means, and Pearson chi-squared test for ratios between groups. P <0.05 was considered to be statistically significant. RESULTS: A total of 54.5% of participants lived far from the hospital. The most frequent complaints involved the respiratory tract, among which the most frequent complaint was cough. Time from symptom onset to presentation was ≥7 days in 58.3% of patients, and 48.9% had never presented to another institution. The most common reason for choosing the university hospital was the availability of the necessary tests (88.1%). CONCLUSIONS: Despite common use of primary health-care systems, with regard to tertiary hospital presentation, the most important factors for preferring tertiary hospital presentation were caregiver trust in tertiary hospital resources for diagnosis and treatment.