AIM: To identify the patients’ demographic characteristics and reasons for preferring to receive treatment in a tertiary health facility instead of first level of health care.
METHOD: A descriptive study of patients reporting for treatment at General Out-Patient Department of University of Nigeria Teaching Hospital, Itukku-Ozalla, Enugu State was carried out between July and September, 2008.
RESULTS: Three hundred and seventy people were studied; males were 158 (42.7%) while females were 212 (57.3%). Many have the opinion that illnesses like uncomplicated headache and malaria should be managed in the tertiary hospital. Severity of ailment, presence of equipment and duration of ailment are the most compelling factors to making a patient decide where to receive care.
Significantly more females (x2=85.64, P<0.001), more educated persons (x2=106.78, P < 0.001) and skilled workers (x2=61.48, P<0.001) access tertiary health care. Of all the patients who were interviewed, 231 (62.4%) were not referred. Presence of doctor and diagnostic equipments are some of the suggestions that could improve utilization of primary health care.
CONCLUSION: Tertiary health facilities manage many cases that can be managed at the primary health centers. To improve utilization of primary health centers improved manpower and diagnostic equipments should be in place at these centers.