Background: Vaccination is the administration of a vaccine to help the immune system develop protection from a disease. It is the most cost-effective mechanism for disease prevention that allows people to have better protection from specific bacteria and viruses. Objective: The goal of the research is to determine mothers’ knowledge, attitudes and practices towards child immunization. Methods: In the framework of a cross-sectional study, 188 mothers with children from three to five years of age, were surveyed in 7 kindergartens of Tbilisi (capital city of Georgia). The semi-structured questionnaire was administered in a face-to-face manner. Results: The majority of interviewed mothers (97%) showed a positive attitude towards immunization and believe that vaccination plays an important role in disease prevention. 32% do not have sufficient information about the routine vaccination schedule and subsequently, 36% of children have incomplete vaccination. The reasons for incomplete vaccination are: a lack of knowledge about a routine vaccination schedule (25.5%), limited information about the necessity of the second or the third dose of vaccination (18.6%), fear of post-vaccination side effects (16%) and fear of a child illness (9.6%). A significant association was found between mothers’ education, practice and attitude regarding immunization. Health institutions (49.5%) and internet sources (21.3%) were the most popular sources of information about immunization. Conclusion: Incomplete immunization is related to mother’s lack of information about the immunization schedules, limited awareness about the second and the third dose of vaccination, and it is also related to fear of child getting sick after the vaccination. Some respondents believe that vaccination is not safe and can cause serious side effects. But the majority of mothers have a positive attitude towards child immunization, but their levels of awareness are very low and they do not have comprehensive information about a routine vaccination schedule. It is necessary to raise public awareness of the importance of immunization by implementing educational programs and by traditional and social media.

Background: Patient satisfaction is widely used as an important component in evaluating quality of health care. The current study aimed to evaluate patient satisfaction with the quality of healthcare. Methods: The study was carried out by a cross-sectional method for evaluation of hospitalized patient satisfaction with provided services. Participants of this research include patients who have been hospitalized during the last 5 years (2012-2016). Research tools were prepared on the basis of specially developed “Medical Outcomes Study, Patient Satisfaction Questionnaire” (MOS PSQ-III). Results: Most of the patients positively evaluated financial accessibility and quality of health services, even though some aspects of health care need improvement. This may be related to the introduction of the Universal Health Care Program in 2013, which increased population coverage. The international quality accreditation of the Emergency Cardiology Center has also played an important role in raising patient's satisfaction levels and in achieving higher standards in the sectors of patient safety and quality management. However, the study indicated, that there was a moderate level of satisfaction with the accessibility of healthcare services. So the further revisions and actions are needed to expand and refine the Universal Health Care Program. We also found an evidence that gender, age and education act as the socioeconomic determinants of satisfaction with healthcare quality. Conclusion: The patient satisfaction study, as one of the most important quality indicators, should be developed throughout the country. It will promote the development of healthy competitive environment among medical organizations and will improve the quality of medical services.

No abstract

Pensioners in Republic of Georgia are covered by the Universal Healthcare Program. In addition, socially vulnerable chronic patients additionally benefit from the Program for Providing Medicine for the Chronic Diseases (PPMCD). The research aims to assess the financial accessibility to outpatient medicines for the elderly in Georgia. Totally, 700 pensioners were surveyed within the quantitative research. The study showed that PPMCD (launched in 2017) has facilitated the affordability of medicines for elderly, especially the socially vulnerable chronic patients. However, the out-of-pocket spending on medicine is still high for most respondents. The main problem for the family is the high unaffordable price (26%). Nearly a third of respondents (31%) could not fully purchase all the outpatient medicine prescribed by the doctor, and 15% could not purchase them at all due to the high costs. Most of the respondents (57%) buy outpatient medicine without visiting family doctor and 37% self-medicate. This shows the irrational choice of elderly people during their health problems. In this regard, the pharmacy and self-treatment play an important role in the informal network of medical service. A significant part of the respondents (36%) does not know about PPMDC. The low level of awareness of the PPMCD among pensioners increases the risk of impoverishment. It is necessary to increase pensioners' awareness about PPMCD. It is recommended to include not only socially vulnerable people in the PPMDC, but also chronic patients of pension age, because the expenses may often be catastrophic for them. Keywords the elderly, personal income, spending on medicines, affordability of medicines 806316H HCXXX10.

Background. Adequate utilization of primary care directly reflects the health status of the population. In Georgia (Republic), many patients seek care without a referral by a primary-care provider, and as a result, patient referral rates to family physicians are low. A tendency of patient self-referral behavior may reduce the effectiveness of the healthcare system. Objectives. The purpose of the research is to study the problem of the low rate of patient referrals to family physicians in Georgia. Material and methods. Within the quantitative survey, 20 family physicians and 300 patients were interviewed through a semi-structured questionnaire in different regions of Georgia. Results. Patient referral rates to family physicians are low. 15% (n = 3) of family physicians recognize that patients often address them only for a referral to specialists. Only 5% (n = 3) of family physicians provide preventive consultations on occasion and 50% (n = 10)-in the case of need only. 70% (n = 14) of family physicians think that their remuneration is not adequate for their work and that they work more than they are paid. 35% (n = 105) of respondents in the case of a health problem address both a family physician and a specialist-physician. 42% (n = 126) of patients visit a family physician once a year or do not visit at all, and 47% (n = 141) of patients believe that the family physician institute needs some changes. Conclusion. The result suggests that the low rate of patient referrals to family physicians is due to distrust towards family physicians, which is related to a lack of qualification of physicians and low public awareness of the competence of the family physicians. Due to inadequate reimbursement, family physicians do not have enough motivation to provide adequate service, and the lack of continuous professional education negatively affects their professional development. It is recommended to raise public awareness about primary care, to introduce effective methods for payment of family physicians and to increase the role and affordability of continuous professional education.