Analysis of the Relationships between Compulsory Health Spending, Doctors, Hospital Beds and Hospital Stays for Turkiye

Year 2023, , 101 - 111, 27.12.2023

Esra N. Kılcı

https://doi.org/10.26650/ekoist.2023.39.1334140

Abstract

A significant part of health expenditures is allocated to hospitals, but whether the funds invested in resources are used successfully or not is determined by assessing factors such as the number of hospital beds and the number of doctors. Additionally, the length of hospital stay is a critical performance indicator. The objective of this paper is to investigate the mutual relationships between compulsory health spending, the number of doctors, the number of hospital beds, and hospital stays in the case of a developing country. We focus on Turkiye using the annual data on compulsory health spending (U.S dollars/capita), the number of doctors (per 1.000 inhabitants), the number of hospital beds (per 1.000 inhabitants), and the length of hospital stay (days) for the period of 1994-2020. In our analysis, following testing the stationary properties of the variables, we employ the Fourier causality tests proposed by Enders and Jones (2016) and Nazlioglu et al. (2016) to analyze the causality links between compulsory health spending, the number of doctors, the number of hospital beds and the length of hospital stay. Our findings confirm the evidence of causal runs from compulsory health spending to the number of hospital beds and from the number of doctors to compulsory health spending in the relevant period.

Keywords

compulsory health spending, hospital beds, number of doctors, hospital stay

References

• Behera, D. K. & Dash, U. (2020). Is Health Expenditure Effective for Achieving Healthcare Goals? Empirical Evidence from South-East Asia Region. Asia-Pacific Journal of Regional Science, 4(2), 593-618. google scholar
• Boz, C., Yilmaz, F. & Senel, İ. K. (2018). Türkiye Kamu Hastane Birliklerinin Yatak Kullanım Performansı Üzerinde Etkili Olan Faktörler. Ombudsman Akademik, 5(9), 203-221. google scholar
• Carnegie Europe (2020). The Ripple Effects of the Coronavirus in Turkey. https://carnegieeurope.eu/strategiceurope/81574(Cited 04.05.2020). google scholar
• Chernew, M. E., Sabik, L., Chandra, A. & Newhouse, J. P. (2009). Would Having More Primary Care Doctors Cut Health Spending Growth? Health Affairs, 28(5), https://doi.org/10.1377/hlthaff.28.5.1327 google scholar
• Enders W. & Lee, J. (2012), The Flexible Fourier Form and Dickey-Fuller Type Unit Root Tests. Economics Letters, 117(1), 196-199. google scholar
• Enders, W & Jones, P. (2016) Grain Prices, Oil Prices, and Multiple Smooth Breaks in a VAR. Studies in Nonlinear Dynamics & Econometrics, 20(4), 399-419. google scholar
• European Centre for Disease Prevention and Control (2020) Publication and Data. https://www.ecdc.europa.eu/en/publications- data/ download- todays- data- geographic- distribution- covid- 19- cases- worldwide (Cited 30.04.2020). google scholar
• Fitch Solutions (2020), Emerging Market Healthcare Systems Poorly Positioned to Tackle Covid-19 Pandemic. https://store. fitchsolutions.com/all-products?type=Special%20Reports (cited 24.04.2020). google scholar
• Jaba, E., Balan, C. B. & Robu, I-B. (2014). The Relationship between Life Expectancy at Birth and Health Expenditures Estimated by a Cross-Country and Time-Series Analysis, Procedia Economics and Finance, 15, 108-114. google scholar
• Kilci, E. N. (2021). A Study on Financial Sustainability of Healthcare Indicators for Turkey under the Health Transformation Program. The International Journal of Health Planning and Management, 36 (4), 1287-1307. google scholar
• Kilci, E. N. (2022). Can We Increase Health Expenditure Per Capita Through Higher Economic Growth? Empirical Evidence from Turkey. Ekoist: Journal of Econometrics and Statistics, 36, 137-152. google scholar
• Madsen, J. B. (2018). Health-Led Growth Since 1800. Macroeconomic Dynamics, 22(4), 961-1000. google scholar
• Ministry of Health of the Republic of Turkey (2003). Health Transformation Program. https://www.mindbank.info/item/3885 (Cited 11.01.2020). google scholar
• Ministry of Health - MoH (2022). Health Statistics Yearbooks. https://sbsgm.saglik.gov.tr/TR-93445/ saglik-istatistikleri-yilligi.html (Cited 01.11.2022). google scholar
• Nazlioglu, S., Gormus, N. A. & Soytas, U. (2016). Oil Prices and Real Estate Investment Trusts (REITs): Gradual-Shift Causality and Volatility Transmission Analysis. Energy Economics, 60, 168-175. google scholar
• Nixon, J. & Ulmann, P. (2006). The Relationship between Health Care Expenditure and Health Outcomes, The European Journal of Health Economics, 7, 7-18. google scholar
• OECD (2005). Health At a Glance, OECD Indicators. https://www.oecd-ilibrary.org/social-issues-migration-health/ health-at-a-glance-2005_9789264012639-en (Cited 24.12.2019). google scholar
• OECD (2014). OECD Reviews of Health Care Quality: Turkey Raising Standards, 25 November 2014. http://www.oecd.org/els/ health-systems/Review-of-Health-Care-Quality-Turkey_ExecutiveSummary.pdf (Cited 07.01.2020). google scholar
• OECD (2017). Health at a Glance 2017, OECD Indicators. https://www.oecd.org/els/health-systems/ Health- at- a- Glance- 2017- Chartset.pdf (Cited 15.01.2020). google scholar
• OECD (2019). Health at a Glance 2019, OECD Indicators. https://www.oecd.org/health/health-systems/ health- at- a- glance- 19991312.htm (Cited 25.12.2019). google scholar
• OECD Statistics (2022). Health Spending and Health Equipment Statistics. https://data.oecd.org (Cited 07.11.2022). google scholar
• OECD (2020). Beyond Containment: Health Systems Responses to COVID-19 in the OECD Countries, Updated 20 March, OECD. https://read.oecd-ilibrary.org/view/?ref=119_119689-ud5comtf84&title=Beyond_Containment:Health_systems_ responses_to_COVID-19_in_the_OECD (cited 25.03.2020). google scholar
• Okem, Z. G. & Cakar, M. (2015). What Have Health Care Reforms Achieved in Turkey? An Appraisal of the “Health Transformation Programme”, Health Policy, 119(9), 1153-63. google scholar
• Oxford Business Group (2015). Turkey’s Health Sector Indicators Improving Under the Gov-ernment’s Health Transformation Programme. https://oxfordbusinessgroup.com/overview/ google scholar
• smooth- operators- indicators- are- improving- under- far- reaching- government- programme (Cited 14.11.2019). google scholar
• Othman-Abdullah, Y. (2022). Analysis of the Causal Relationship between Government Health Spending and Health Services in Kurdistan Region-Iraq during the Period (2005-2020). AL-Anbar University Journal of Economic and Administration Sciences, 14 (2), 1-19. google scholar
• Ray, D. & Linden, M. (2020). Health Expenditure, Longevity, and Child Mortality: Dynamic Panel Data Approach with Global Data, International Journal of Health Economics and Management, 20, 99-119. google scholar
• Statista (2020). Number of New Cases of Coronavirus (COVID-19) Worldwide from January 23 to March 8, 2021, by day. https://www.statista.com/statistics/1103046/new-coronavirus-covid19-cases-number-worldwide-by-day/ (Cited 08.03.2021). google scholar
• Tiehi, T. N. & Coulibaly, F. N. (2022). Determinants of Public Health Spending in WAEMU Area: An Empirical Investigation. Bulletin of Applied Economics, 2022, 9(1), 39-49. google scholar
• TOBB (2017). Turkey Healthcare Landscape Report, December, 2017. https://www.tobb.org.tr/saglik/ 20171229- tss- genel- bakis- en.pdf (Cited 14.01.2020). google scholar
• TRT World (2020). Why Turkey Stands Out in Its Fight against the Coronavirus Pandemic. https://www.trtworld.com/turkey/ why- turkey- stands- out- in- its- fight- against- the- coronavirus- pandemic- 35625 (Cited 04.05.2020) google scholar
• Walsh, B., Smith, S., Wren, M.-A., Eighan, J.& Lyons, S. (2022). The Impact of Inpatient Bed Capacity on Length of Stay. The European Journal of Health Economics, 23(3), 499-510. google scholar
• World Bank (2018). Result Briefs: Turkish Health Transformation Program and Beyond, April 2, 2018. https://www.worldbank.org/en/ results/2018/04/02/turkish- health- transformation- program- and- beyond. (Cited 11.11.2019). google scholar
• World Bank (2019). The World Bank in Turkey Country Snapshot. https://www.worldbank.org/en/country/turkey/overview (Cited 20.01.2020). google scholar
• World Bank (2022). Data Catalog. https://datacatalog.worldbank.org/ (Cited 07.11.2022). google scholar
• World Health Organization (2012). Turkey Health System Performance Assessment 2011, May 2012. http://www.euro.who.int/__data/ assets/pdf_file/0004/165109/e95429.pdf (Cited 15.11.2019) google scholar
• World Health Organization (2020). Coronavirus Disease (COVID-19): European Region Focusing on Readiness. http://www.euro.who.int/ en/countries/turkey/news/news/2020/2/coronavirus-disease-covid-19-european-region-focusing-on-readiness (Cited 25.04.2020) google scholar
• Yasar, G. Y. (2010). Health Transformation Programme in Turkey: An Assessment. The International Journal of Health Planning and Management, 26 (2), 110-133. google scholar