Tariq Zaman, Muhammad Jahangir, Huma Ali Asghar, Nadia Shafique.
Utilization of Tertiary Care Centres - The Actual Picture - A Study of 1500 Patients Presenting to Dermatology Department, AIMC / Jinnah Hospital Lahore.
J Pak Assoc Derma Jan ;11(4):13-8.

Introduction: In our country, a three-tiered health care delivery system is in place in the public sector, with primary, secondary and tertiary level health care facilities. Teaching hospitals by definition are tertiary care centres. Aims & Objectives: To document the extent to which a designated tertiary care unit (Dermatology Department Allama Iqbal Medical College / Jinnah Hospital, Lahore) is actually being utilized as a primary, secondary or tertiary care Centre. Patients & Methods: A total of 1500 new patients presenting to the Dermatology Outpatients Department were interviewed regarding their source of previous treatments used. A pre-designed proforma was filled out. The patients were divided into three groups according to sources of previous treatment: Group I comprised of patients who had not been treated by a qualified doctor at any point in time, and were considered to have used the unit as primary care unit. Group II comprised of patients who had consulted a qualified doctor at some point, but not a dermatologist. They used the unit as a secondary care unit. Group III included patients who had previously received treatment from a dermatologist, and were considered to have used the unit as a tertiary care unit. The results were tabulated and analyzed in a database. Results: Forty two percent (n = 623) patients used the department as a primary care centre, while 39% (n = 590) had seen a non-dermatologist doctor at some point, thereby utilizing it as a secondary care facility. Only 19% of the patients (n = 287) utilized this unit as tertiary health care facility. As many as 80% of patients had previously utilized the private sector, and only 20% had utilized state-run medical care facilities. Conclusion: The Dermatology Department at Allama Iqbal Medical College / Jinnah Hospital, Lahore, is mainly being utilized as a primary and secondary care facility. Only 19% of patients are using the unit as a tertiary care centre. Only 1/5th of the patients had previously utilized the government sector for treatment prior to presenting here.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com