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FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION

Yıl 2023, Cilt: 26 Sayı: 3, 761 - 780, 26.09.2023

Öz

Effective management of both financial and operational performance is crucial for achieving high performance in health institutions. Effective performance management can lead to improved service delivery, patient recovery, and overall performance improvement. This study aims to assess the financial performance of a Ministry of Health hospital located in the Aegean region that was affiliated with a university hospital at the end of 2011. The study also aims to compare the financial performance data with the operational performance data of the hospital. The Ratio analysis method, which is widely accepted for measuring the financial performance of hospitals, is utilized in this study. Twelve ratio analysis methods used to measure financial performance were examined, and the financial performance of the hospital before and after the affiliation was compared and evaluated. Spearman correlation analysis was performed between the financial performance data and operational performance data of the hospital during the six-year operating period between 2009-2014. In conclusion, the healthcare institution faced challenges in meeting its short-term debt obligations and experienced cash shortages. The use of liabilities and debt was reduced after the affiliation, and the institution became profitable with successful management and health service delivery. Results from Spearman correlation analysis showed a positive correlation between the number of outpatients and return on equity and return on total assets. Similarly, the number of emergency admissions, surgeries, non-physician healthcare personnel, and childbirths were positively correlated with net profit margin, return on total assets, and return on equity. The number of radiological examinations and laboratory tests had significant correlations with the inventory turnover ratio.

Kaynakça

  • Akdoğan, N., & Tenker, N. (2007). Finansal Tablolar ve Mali Analiz Teknikleri. Gazi Kitapevi. Akgüç, Ö. (1998). Finansal Yönetim. Avcıol Basım Yayın.
  • Aksoylu, S., & Cavmak, D. (2023). Financial Analysis of Hospital Services Sector of Turkey in a Sustainability Approach Using Reports of the Central Bank of the Republic of Turkey. Journal Of Busıness Research-Turk, 15(1), 1-13.
  • Alparslan, D., Gençtürk, M., & Özgülbaş, N. (2015). Sağlık Bakanlığı Hastanelerinde İşletme Sermayesi İle Finansal Performans Göstergeleri Arasındaki İlişkinin Analizi. Suleyman Demirel University the Journal of Faculty of Economics and Administrative Sciences, 20(1), 317–338.
  • Avcı, K. (2014). Bir Eğitim ve Araştırma Hastanesinin Finansal ve Operasyonel Performans Göstergeleri Arasındaki İlişki. Hacettepe Sağlık İdaresi Dergisi, 17(1), 1–20.
  • Bernstein, J. (2009). Impact of the Economy on Health Care. Changes in Health Care Financing & Organization. http://hcfo.org/files/hcfo/findings0809_0.pdf
  • Cleverley, W. O. (1993). The 1993 Almanac of Hospital Financial & Operating Indicators. The Center for Healthcare Industry Performance Studies (CHIPS).
  • Cleverley, W. O., & Harvey, R. K. (1992). Competitive Strategy for Successful Hospital Management. Hospital & Health Services Administration, 37(1), 53–69.
  • Cleverley, W. O., Song, P. H., & Cleverley, J. O. (2011). Essentials of Healthcare Finance (7th ed.). Jones & Bartlett Learning.
  • Cleverly, W. O. (1990). Improving Financial Performance: A Study of 50 Hospitals. Hospital & Health Services Administration, 35(2), 173–187.
  • Čučković D, Ćosić I, Delić M, Miškić M, & Ranisavljev Kovačev S. (2021). Influence of Interpersonal Processes on the Performance of Primary Health Care Organizations. Sustainability, 13(21),12243. https://doi.org/10.3390/su132112243
  • Davies, H. T. O., & Lampel, J. (1998). Viewpoints Trust in Performance Indicators? Quality in Health Care, 7, 159–162.
  • Doshi, P. P., Bhosai, S. J., Goldmann, D., & Udayakumar, K. (2021). Imagining the Future of Primary Care: A Global Look at Innovative Health Care Delivery. NEJM Catalyst Innovations in Care Delivery, 2(1),1-15. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0481
  • Dubas-Jakóbczyk, K., Kocot, E., & Kozieł, A. (2020). Financial Performance of Public Hospitals: a Cross-sectional Study Among Polish Providers. International Journal of Environmental Research and Public Health, 17(7), 2188.
  • Ercan, C., Dayı, F., & Akdemir, E. (2013). Kamu Sağlık İşletmelerinde Finansal Performans Değerlemesi: Kamu Hastaneleri Birlikleri Üzerine Bir Uygulama. Asia Minor Studies-International Journal of Social Sciences, 1(2), 54–71.
  • Frenk, J. (2015, May). OECD Observer. OECD. http://oecdobserver.org/news/archivestory.php/aid/1241/Health_and_the_economy:_A_vital_relationship_.html
  • Fuchs, V. R. (2015). Major Concepts of Health Care Economics. Ann Intern Med, 162(5), 380–383. https://doi.org/10.7326/M14-1183
  • Gider, Ö. (2004). Hastanelerde İndirgenmiş Nakit Akımı Yöntemi İle Firma Değerinin Tespiti ve Ekonomik Katma Değer (EVA) Yöntemine Göre Finansal Performansın Değerlendirilmesi [Doktora Tezi]. Hacettepe Üniveristesi.
  • Gider, Ö. (2011). Ekonomik Kriz Dönemlerinin Özel Hastanelere Etkileri: Bir Özel Hastanenin Oran Analizleri Yöntemiyle Finansal Performansına Bakış. Marmara Üniversitesi Sosyal Bilimler Enstitüsü Öneri Dergisi, 9(36), 87–103.
  • Hall, R. E., & Jones, C. I. (2007). The Value of Life and The Rise in Health Spending. The Quarterly Journal of Economics, 122(1), 39–72.
  • Jin, B., & Nembhard, I. M. (2022). Effects of Affiliation Network Membership on Hospital Quality and Financial Performance. Health Services Research, 57(2), 248-258.
  • Lee, M. (2015). Financial Analysis of National University Hospitals in Korea. Osong Public Health and Research Perspectives, 6(5), 310–317. https://doi.org/10.1016/j.phrp.2015.10.007
  • Li, L. X., & Benton, W. C. (1996). Performance Measurement Criteria in Health Care Organizations: Review and Future Research Directions. European Journal of Operational Research, 93, 449–468.
  • Mulligan, J.-A., & Fox-Rushby, J. (2003). Unit Costs of Health Care Inputs in Low and Middle Income Regions. Disease Control Priorities Project Working Paper, 9, 1–56. https://www.researchgate.net/publication/228582375
  • Nerenz, D. R., & Neil, N. (2001). Performance Measures for Health Care Systems. In Commissioned Paper for the Center for Health Management Research.
  • T.R. Ministry of Health. (2011). Sağlık Bakanlığına Bağlı Sağlık Tesisleri Ve Üniversitelere Ait İlgili Birimlerin Birlikte Kullanımı Ve İşbirliği Usul ve Esasları Hakkında Yönetmelik. Accessed 09 May 2015, https://www.resmigazete.gov.tr/eskiler/2011/02/20110218-3-1.htm
  • Shortell, S. M., Gillies, R. R., Anderson, D. A., Erickson, M. K., & Mitchell, J. B. (1996). Remaking Health Care in America: Building Organized Delivery Systems. Jossey-Bass Publishers.
  • Sultz, H. A., & Young, K. M. (2014). Hospitals: Origin, Organization and Performance. In Hospitals: Origin, Organization and Performance (8th ed., pp. 69–119). Jones & Bartlett Learning.
  • Walburg, J., Bevan, H., Wilderspin, J., & Lemmens, K. (2006). Performance Management in Health Care: Improving Patient Outcomes: An Integrated Approach. Taylor & Francis Group.
  • World Health Organization. (2008). Integrated Health Services- What and Why. Technical Brief. Accessed 18 December 2014, http://www.who.int/healthsystems/service_delivery_techbrief1.pdf
  • World Health Organization. (2022). Guidance on the Analysis and Use of Routine Health İnformation Systems: Rehabilitation Module. Accessed 20 May 2023, https://www.who.int/publications/i/item/9789240050242
  • Wu, J. S. (2023). Applying Frontier Approach to Measure the Financial Efficiency of Hospitals. Digital Health, 9. https://doi.org/10.1177/20552076231162987orld

EGE BÖLGESİNDE BİR SAĞLIK BAKANLIĞI HASTANESİNİN AFİLİASYON ÖNCESİ VE SONRASI FİNANSAL PERFORMANS ANALİZİ

Yıl 2023, Cilt: 26 Sayı: 3, 761 - 780, 26.09.2023

Öz

Sağlık kurumlarının yüksek düzeyde bir performans göstermesi genellikle finansal ve operasyonel performansların yönetimine bağlıdır. İyi performans yönetimi sonucu iyi hizmet sunumu, iyileşmiş hasta ve performans geliştirme oluşacaktır. Çalışmanın amacı, Ege bölgesinde faaliyet gösteren ve 2011 yılı sonunda, bir üniversite hastanesi ile afiliye olan bir Sağlık Bakanlığı hastanesinin afiliasyondan önceki ve sonraki dönemde finansal performansının değerlendirilmesi ve hesaplanan finansal performans verileri ile hastanenin operasyonel performans verilerinin karşılaştırılmasıdır. Çalışmada, hastanelerin finansal performans ölçümünde kullanılması genel kabul görmüş Rasyo analiz yöntemi ele alınmıştır. Finansal performans ölçülürken kullanılan, 12 rasyo analizi yöntemi incelenmiş, hastanenin, afiliye olmadan önceki ve afiliye olduktan sonraki, finansal performans durumu karşılaştırılarak değerlendirilmiştir. Hastanenin, 2009-2014 yılları arasındaki altı yıllık faaliyet dönemleri arasındaki finansal performans verileri ile operasyonel performans verileri arasında Spearman korelasyon analizi yapılmıştır. Sonuç olarak, kurumun genel olarak kısa vadeli borçlarını ödemede zorluk yaşadığı ve nakit sıkıntısı yaşadığı gözlemlenmiştir. Kurum afiliasyon öncesinde daha fazla yabancı kaynak kullanırken afiliasyondan sonra kurumda yabancı kaynak kullanımı azalmış, borç düzeyi düşmüştür. Kurum afiliasyon öncesinde zararla çalışırken afiliasyon sonrasında kâra geçmiştir, yönetimde ve sağlık hizmetinin üretilip dağıtılmasında başarı elde edilmiştir. Diğer taraftan, finansal performans verileri ile operasyonel performans verileri arasında yapılan Spearman korelasyon analizi sonuçlarına göre, poliklinik hasta sayısı açısından bu sayı ile öz sermaye getiri oranı ve toplam aktiflerin getiri oranı arasında anlamlı ve pozitif bir ilişki bulunmuştur. Acil müracaat sayısı, ameliyat sayısı, hekim dışı sağlık personeli sayısı ve doğum sayısı açısından, bu sayılarla, net kâr marjı, toplam aktiflerin getiri oranı ve öz sermaye getiri oranı arasında anlamlı ve pozitif bir ilişki, ayrıca, radyolojik tetkik sayısı ve laboratuvar tetkik sayısı açısından bu sayılar ile stok devir hızı arasında anlamlı ilişkiler bulunmaktadır.

Kaynakça

  • Akdoğan, N., & Tenker, N. (2007). Finansal Tablolar ve Mali Analiz Teknikleri. Gazi Kitapevi. Akgüç, Ö. (1998). Finansal Yönetim. Avcıol Basım Yayın.
  • Aksoylu, S., & Cavmak, D. (2023). Financial Analysis of Hospital Services Sector of Turkey in a Sustainability Approach Using Reports of the Central Bank of the Republic of Turkey. Journal Of Busıness Research-Turk, 15(1), 1-13.
  • Alparslan, D., Gençtürk, M., & Özgülbaş, N. (2015). Sağlık Bakanlığı Hastanelerinde İşletme Sermayesi İle Finansal Performans Göstergeleri Arasındaki İlişkinin Analizi. Suleyman Demirel University the Journal of Faculty of Economics and Administrative Sciences, 20(1), 317–338.
  • Avcı, K. (2014). Bir Eğitim ve Araştırma Hastanesinin Finansal ve Operasyonel Performans Göstergeleri Arasındaki İlişki. Hacettepe Sağlık İdaresi Dergisi, 17(1), 1–20.
  • Bernstein, J. (2009). Impact of the Economy on Health Care. Changes in Health Care Financing & Organization. http://hcfo.org/files/hcfo/findings0809_0.pdf
  • Cleverley, W. O. (1993). The 1993 Almanac of Hospital Financial & Operating Indicators. The Center for Healthcare Industry Performance Studies (CHIPS).
  • Cleverley, W. O., & Harvey, R. K. (1992). Competitive Strategy for Successful Hospital Management. Hospital & Health Services Administration, 37(1), 53–69.
  • Cleverley, W. O., Song, P. H., & Cleverley, J. O. (2011). Essentials of Healthcare Finance (7th ed.). Jones & Bartlett Learning.
  • Cleverly, W. O. (1990). Improving Financial Performance: A Study of 50 Hospitals. Hospital & Health Services Administration, 35(2), 173–187.
  • Čučković D, Ćosić I, Delić M, Miškić M, & Ranisavljev Kovačev S. (2021). Influence of Interpersonal Processes on the Performance of Primary Health Care Organizations. Sustainability, 13(21),12243. https://doi.org/10.3390/su132112243
  • Davies, H. T. O., & Lampel, J. (1998). Viewpoints Trust in Performance Indicators? Quality in Health Care, 7, 159–162.
  • Doshi, P. P., Bhosai, S. J., Goldmann, D., & Udayakumar, K. (2021). Imagining the Future of Primary Care: A Global Look at Innovative Health Care Delivery. NEJM Catalyst Innovations in Care Delivery, 2(1),1-15. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0481
  • Dubas-Jakóbczyk, K., Kocot, E., & Kozieł, A. (2020). Financial Performance of Public Hospitals: a Cross-sectional Study Among Polish Providers. International Journal of Environmental Research and Public Health, 17(7), 2188.
  • Ercan, C., Dayı, F., & Akdemir, E. (2013). Kamu Sağlık İşletmelerinde Finansal Performans Değerlemesi: Kamu Hastaneleri Birlikleri Üzerine Bir Uygulama. Asia Minor Studies-International Journal of Social Sciences, 1(2), 54–71.
  • Frenk, J. (2015, May). OECD Observer. OECD. http://oecdobserver.org/news/archivestory.php/aid/1241/Health_and_the_economy:_A_vital_relationship_.html
  • Fuchs, V. R. (2015). Major Concepts of Health Care Economics. Ann Intern Med, 162(5), 380–383. https://doi.org/10.7326/M14-1183
  • Gider, Ö. (2004). Hastanelerde İndirgenmiş Nakit Akımı Yöntemi İle Firma Değerinin Tespiti ve Ekonomik Katma Değer (EVA) Yöntemine Göre Finansal Performansın Değerlendirilmesi [Doktora Tezi]. Hacettepe Üniveristesi.
  • Gider, Ö. (2011). Ekonomik Kriz Dönemlerinin Özel Hastanelere Etkileri: Bir Özel Hastanenin Oran Analizleri Yöntemiyle Finansal Performansına Bakış. Marmara Üniversitesi Sosyal Bilimler Enstitüsü Öneri Dergisi, 9(36), 87–103.
  • Hall, R. E., & Jones, C. I. (2007). The Value of Life and The Rise in Health Spending. The Quarterly Journal of Economics, 122(1), 39–72.
  • Jin, B., & Nembhard, I. M. (2022). Effects of Affiliation Network Membership on Hospital Quality and Financial Performance. Health Services Research, 57(2), 248-258.
  • Lee, M. (2015). Financial Analysis of National University Hospitals in Korea. Osong Public Health and Research Perspectives, 6(5), 310–317. https://doi.org/10.1016/j.phrp.2015.10.007
  • Li, L. X., & Benton, W. C. (1996). Performance Measurement Criteria in Health Care Organizations: Review and Future Research Directions. European Journal of Operational Research, 93, 449–468.
  • Mulligan, J.-A., & Fox-Rushby, J. (2003). Unit Costs of Health Care Inputs in Low and Middle Income Regions. Disease Control Priorities Project Working Paper, 9, 1–56. https://www.researchgate.net/publication/228582375
  • Nerenz, D. R., & Neil, N. (2001). Performance Measures for Health Care Systems. In Commissioned Paper for the Center for Health Management Research.
  • T.R. Ministry of Health. (2011). Sağlık Bakanlığına Bağlı Sağlık Tesisleri Ve Üniversitelere Ait İlgili Birimlerin Birlikte Kullanımı Ve İşbirliği Usul ve Esasları Hakkında Yönetmelik. Accessed 09 May 2015, https://www.resmigazete.gov.tr/eskiler/2011/02/20110218-3-1.htm
  • Shortell, S. M., Gillies, R. R., Anderson, D. A., Erickson, M. K., & Mitchell, J. B. (1996). Remaking Health Care in America: Building Organized Delivery Systems. Jossey-Bass Publishers.
  • Sultz, H. A., & Young, K. M. (2014). Hospitals: Origin, Organization and Performance. In Hospitals: Origin, Organization and Performance (8th ed., pp. 69–119). Jones & Bartlett Learning.
  • Walburg, J., Bevan, H., Wilderspin, J., & Lemmens, K. (2006). Performance Management in Health Care: Improving Patient Outcomes: An Integrated Approach. Taylor & Francis Group.
  • World Health Organization. (2008). Integrated Health Services- What and Why. Technical Brief. Accessed 18 December 2014, http://www.who.int/healthsystems/service_delivery_techbrief1.pdf
  • World Health Organization. (2022). Guidance on the Analysis and Use of Routine Health İnformation Systems: Rehabilitation Module. Accessed 20 May 2023, https://www.who.int/publications/i/item/9789240050242
  • Wu, J. S. (2023). Applying Frontier Approach to Measure the Financial Efficiency of Hospitals. Digital Health, 9. https://doi.org/10.1177/20552076231162987orld
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Meryem Demirtaş 0000-0002-0790-8471

Ömer Gider 0000-0002-0838-8754

Yayımlanma Tarihi 26 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 26 Sayı: 3

Kaynak Göster

APA Demirtaş, M., & Gider, Ö. (2023). FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION. Hacettepe Sağlık İdaresi Dergisi, 26(3), 761-780.
AMA Demirtaş M, Gider Ö. FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION. HSİD. Eylül 2023;26(3):761-780.
Chicago Demirtaş, Meryem, ve Ömer Gider. “FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION”. Hacettepe Sağlık İdaresi Dergisi 26, sy. 3 (Eylül 2023): 761-80.
EndNote Demirtaş M, Gider Ö (01 Eylül 2023) FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION. Hacettepe Sağlık İdaresi Dergisi 26 3 761–780.
IEEE M. Demirtaş ve Ö. Gider, “FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION”, HSİD, c. 26, sy. 3, ss. 761–780, 2023.
ISNAD Demirtaş, Meryem - Gider, Ömer. “FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION”. Hacettepe Sağlık İdaresi Dergisi 26/3 (Eylül 2023), 761-780.
JAMA Demirtaş M, Gider Ö. FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION. HSİD. 2023;26:761–780.
MLA Demirtaş, Meryem ve Ömer Gider. “FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION”. Hacettepe Sağlık İdaresi Dergisi, c. 26, sy. 3, 2023, ss. 761-80.
Vancouver Demirtaş M, Gider Ö. FINANCIAL PERFORMANCE ANALYSIS OF A MINISTRY OF HEALTH HOSPITAL IN THE AEGEAN REGION BEFORE AND AFTER AFFILIATION. HSİD. 2023;26(3):761-80.