Reasons for and perceptions of patients with minor ailments bypassing local primary health care facilities

Introduction: Despite having access to several clinics and health centres in their local communities, numerous patients opt to go directly to hospitals for non-emergencies and minor ailments. Reasons for this include their perceptions of the quality of primary health care services, the attitudes and perceptions of health workers, opening hours of clinics, community involvement and participation, and drug and equipment availability as well as the quality of infrastructure. Perceptions of size, a lack of specialty care and limited services were most frequently mentioned as reasons why patients bypassed their local primary health care facilities. Aim: This study aimed to identify the reasons given by patients presenting with minor ailments, for bypassing their local primary health care facilities in the Greater Tzaneen municipal area to Letaba Hospital. Methods: A cross-sectional descriptive study was performed at Letaba Hospital over a three-month period, from 23 June 2008 to 15 August 2008, in which non-referred patients presenting with minor ailments were randomised and entered into the study on a voluntary basis. A preset questionnaire was utilised for data-collection purposes. A total of 293 participants were included in the study. The questionnaire aimed to determine the demographic profile of patients who present with minor ailments at hospital, to explore the reasons why these patients bypass their local clinics and to evaluate their knowledge, perceptions and attitudes regarding their local clinics. Results: Most patients indicated that they came to the hospital because they wanted to be seen by a doctor, followed by the request to see a dentist. The study identified that patients expressed both positive and negative opinions concerning their local clinics. Conclusion: Numerous factors influence the service-seeking behaviour of rural patients. Patients bypass their local clinics due to perceptions regarding the quality of health care services at the hospital. Improving the quality aspects of clinics and enhancing the services rendered will not only increase the utilisation of clinic services, but also reduce hospital overcrowding.