BİREYLER SAĞLIK HİZMETLERİNİ RASYONEL KULLANIYORLAR MI? KÜRESEL COVİD-19 SALGININDAN KANITLAR

Year 2022, , 1391 - 1407, 30.09.2022

Hatice Genç Kavas

https://doi.org/10.48070/erciyesakademi.1155805

Abstract

Çalışmanın yapıldığı tarih itibariyle dünya genelinde Covid-19 kaynaklı yaklaşık 6,4 milyon ölüm meydana gelmiştir. Hastalığın hızla yayılması, ölüm oranlarının yüksek olması, hastalık hakkında net bilgiye sahip olunamama gibi nedenler bireylerin günlük yaşam rutinlerini değiştirmelerine neden olmuştur. Kısıtlamaların ya da yasakların olmadığı dönemlerde bile bireyler normal şartlarda sergiledikleri davranışlarına devam etmemişlerdir. Bu değişikliklerden biri de bireylerin sağlık hizmeti taleplerinde ortaya çıkmıştır. Covid-19'un hayatımıza girmesiyle birlikte bireylerin hastaneye gitme oranları önemli ölçüde azaldı. Bu bağlamda bu çalışma, Covid-19 Pandemisi döneminde insanların sağlık hizmeti taleplerindeki değişimi ortaya koymayı amaçlamaktadır. Araştırma için 01.09.2019 - 11.03.2021 tarihleri arasında Sivas merkezinde bulunan ikinci ve üçüncü basamak sağlık kuruluşlarından alınan hasta kabul sayılarının arşiv verileri kullanılmış ve cinsiyet, yaş, sağlık sigortası, ve sağlık hizmeti alınan departmanlara göre aynı döneme tekabül eden sağlık talebindeki değişimler dönemsel olarak değerlendirilmiştir. 2020 Eylül- 2021 Mart döneminde toplam hastane başvuruları (Covid-19 şüphesi ve onkoloji poliklinikleri gibi zorunlu tedavi gerektiren bölümler hariç tutulmuştur) 2019 Eylül - 2020 Mart dönemindeki toplam hastaneye başvuru sayısından yaklaşık olarak %46 daha düşük gerçekleşmiştir. Yine aynı dönemler için “çocuk acil” başvuruları değerlendirildiğinde %66’lık bir düşüş görülebilmektedir. Böylesine önemli bir düşüşlerin, bireylerin normal şartlar altında sağlık hizmeti taleplerindeki rasyonel davranışlarını sorgulamamıza neden olmaktadır. Eğer rasyonal bir davranış olmadığı düşünülüyorsa bireylerin sağlık hizmetleri kullanımı konusunda önemli adımlar atılmalıdır. Bireylerin bu konuda eğitilmeleri kilit rol oynamaktadır.

Keywords

Covid-19, Sağlık sektörü, Hasta davranışı, Sağlık hizmetleri talebi, Sağlık hizmetleri kullanımı, Sağlık ekonomisi, Covid-19

DO INDIVIDUALS RATIONALLY UTILIZE HEALTHCARE SERVİCES? EVIDENCE FROM THE GLOBAL COVID-19 PANDEMIC

Abstract

Up to the date of the study, approximately 6.4 million people worldwide died due to Covid-19. In this process, individuals changed their daily life routines due to reasons such as the high contagiousness of the disease, the high number of deaths and the increasing rate of the disease, and ignorance about the disease. Even in periods when there were no restrictions or prohibitions, individuals did not continue their behavior under normal conditions. One of these changes has emerged in the health service demands of individuals. After the onset of the disease, hospital admission rates decreased significantly. In this context, the study aims to analyze the change in people's health care demands during the Covid-19 Pandemic period. Archival data of the number of patient admissions from the secondary and tertiary health institutions in the center of Sivas between 01.09.2019 - 11.03.2021 was used and the changes in the health demand according to gender, age, health insurance/payment, and the departments were analyzed periodically. In the period September 2020 - March 2021, total hospital admissions (excluding suspected Covid-19 and departments requiring mandatory treatment such as oncology, etc…) were approximately 46% lower than the total number of hospital admissions between September 2019 - March 2020. When the "child emergency" applications are evaluated for the same periods, a decrease of 66% can be seen. Such a significant decrease causes us to question the rational behavior of individuals in health care demands under normal conditions. If it is thought that it is not rational behavior, important steps should be taken about the use of healthcare services by individuals. The education of individuals on this issue plays a key role.

Keywords

Healthcare sector, Patient behavior, Healthcare demand, Healthcare utilization, Health economics, Covid-19

References

• Altındağ, Ö., & Yıldız, A. (2020). Transformation of health policy in Turkey. Birey ve Toplum Sosyal Bilimler Dergisi, 10(1), 157-184. https://doi.org/10.20493/birtop.742637
• Atasever, M. (2018). Türkiye'de sağlık hizmetlerinin finansmanı ve sağlık harcamalarının gelişimi. https://www.researchgate.net/publication/331131946.
• Chen, T., Fu, X., Hensher, D.A., Li, Z.C. & Sze, N.N. (2022). The effect of online meeting and health screening on business travel: A stated preference case study in Hong Kong. Transportation Research Part E, 164, 1-18. https://doi.org/10.1016/j.tre.2022.102823
• Christian Dopfer, M. W. (2020). Covid-19 related reduction in pediatric emergency healthcare utilization - a concerning trend. BMC Pediatrics, 20(427), 2-10. https://doi.org/10.1186/s12887-020-02303-6
• Chudasama, Y., Gillies, C., Zaccardi, F., Coles, B., Davies, M., Seidu, S., & Khunti, K. (2020). Impact of Covid-19 on routine care for chronic diseases: A global survey of views from healthcare professionals. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14, 965-967. https://doi.org/10.1016/j.dsx.2020.06.042
• Çelikay, F., & Gümüş, E. (2010). Türkiye’de sağlık hizmetleri ve finansmanı. Eskişehir Osmangazi Üniversitesi Sosyal Bilimler Dergisi, 11(1), 177-216.
• Domingo, L., Comas, M., Jansana, A., Louro, J., Tizon-Marcos, H., Cos, M., ... Castells, X. (2022). Impact of covid-19 on hospital admissions and healthcare quality ındicators in non-covid patients: A retrospective study of the first covıd-19 year in a university hospital in Spain. Journal of Clinical Medicine, 11(1752), 1-15. https://doi.org/10.3390/jcm11071752
• Dopfer, C., Wetzke, M., Scharff, A. Z., Mueller, F., Dressler, F., Baumann, U., … Happle, C. (2020). COVID-19 related reduction in pediatric emergency healthcare utilization – a concerning trend. BMC Pediatrics, 20(427), 2-10 https://doi.org/10.1186/s12887-020-02303-6
• Durgun, Ö. (2021). A study in the children’s health-oriented health policies after covid-19 pandemic period in Turkey. Düzce Medical Journal, 23(1), 94-105. doi:10.18678/dtfd.861559
• General Directorate of Health Information Systems. (2019). Health statistics yearbook. The Ministry of Health of Turkey.
• Geng-Ramos, G., Taneja, R., Challa, C., Vazquez-Colon, C., Cronin, J., Campos, A., ... Melwani, A. (2022). Telemedicine for the pediatric preoperative assessment during the covid-19 pandemic: Evaluating patient and provider satisfaction. Perioperative Care and Operating Room Management, 27, 100252. https://doi.org/10.1016/j.pcorm.2022.100252
• Ghita, S.I., Saseanu, A.S., Gogonea, R.M. & Grosu R.M. (2022), Online shopping profiles within European countries during the covid-19 pandemic. Transformations in Business & Economics, 21(56), 21-40.
• Gündoğdu, H., Tanrıkulu, F., Erol, F., Koç, F., Yılmaz, D., & Dikmen, Y. (2022, March). Nursing care satisfaction among patients infected with covid-19: A Turkish perspective. Galician Medıcal Journal, 29(1), E202213. https://doi.org/10.21802/gmj.2022.1.3
• Leblebicioğlu, B., & Türkyılmaz, C. A. (2022). Understanding the moderator role of covid-19 pandemic anxiety on the relationship between internet addiction and online shopping addiction. Marmara Üniversitesi İktisadi ve İdari Bilimler Dergisi 44(1), 104-118. doi:10.14780/muiibd.1135532
• Liguora, I., Pilotto, C., Verine, M., Pusiol, A., Vidal, E. & Cogo, P. (2021). The impact of COVID-19 on a tertiary care pediatric emergency department. European Journal of Pediatric 180, 1447-1504. https://doi.org/10.1007/s00431-020-03909-9
• Linden, K., & Gonzalez, P. (2021). Zoom invigilated exams: A protocol for rapid adoption to remote examinations. British Journal of Educational Technology, 52(4), 1323–1337. https://doi.org/10.1111/ bjet.13109
• Liu, S.-A., Wu, C.-L., Chou, I.-J., Wang, P.-C., Hsu, C.-L., & Chen, C.-P. (2022). The impacts of covid-19 on healthcare quality in tertiary medical centers-a retrospective study on data from Taiwan clinical performance ındicators system. International Journal of Environmental Research and Public Health, 19(2278), 1-10. https://doi.org/10.3390/ijerph19042278
• Luzet, J., Anzola, A., Gilibert, M., & Gire, C. (2021). General practitioners' experiences during the covid-19 epidemic in the Bouches-du-Rhone: Anxiety, impact on practice and doctor-patient relationship. La Presse Médicale Open, 2, 100016. https://doi.org/10.1016/j.lpmope.2021.100016
• Mahoney, S., Steyn, E., & Lategan, H. (2021). Informing future policy for trauma prevention: The effect of the covid-19 "National State of disaster lockdown" on the trauma burden of a tertiary trauma center in the Western Cape of South Africa. African Journal of Emergency Medicine, 11, 361-365. https://doi.org/10.1016/j.afjem.2021.06.002
• Markham, J. L., Richardson, T., DePorre, A., Teufel, R. J., Hersh, A. L., Fleegler, E. W., … Shah, S. S. (2021) Inpatient utilization and outcomes at children’s hospitals during the early covıd-19 pandemic. Pediatrics, 147(6), e2020044735 doi:10.1542/peds.2020-044735
• Moynihan, R., Sanders, S., Michaleff, Z., Scott, A., Clark, J., To, E., ... Albarqouni, L. (2021). Impact of covid-19 pandemic on utilization of health care services: a systematic review. BMJ Open, 11(e045343), 1- 10. doi:10.1136/bmjopen-2020-045343
• Organization for Economic Co-operation and Development. (2021). Health at a glance 2021 OECD indicators. OECD.
• Ramgopal, S., Pelletier, J. H., Rakkar, J., Horvat, C. M. (2021). Forecast modeling to identify changes in pediatric emergency department utilization during the COVID-19 pandemic. American Journal of Emergency Medicine 49, 142-147. https://doi.org/10.1016/j.ajem.2021.05.047
• Sağlık Bakanlığı (2021, January 13). İlk koronavirüs aşısı sağlık bakanı Fahrettin Koca'ya yapıldı. https://www.saglik.gov.tr/TR,78148/ilk-koronavirus-asisi-saglik-bakani-fahrettin-kocaya- yapildi.html#:~:text=Sa%C4%9Fl%C4%B1k%20Bakan%C4%B1%20Dr.,Sa%C4%9Fl%C4%B1k%20Bakan%C4%B1%20Koca'ya%20yap%C4%B1ld%C4%B1.
• Seidu, S., Hambling, C., Holmes, P., Fernando, K., Campbell, N., Davies, S., & Khunti, K. (2021). The impact of the covid pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care. Primary Care Diabetes, Article in Press, 1-7. https://doi.org/10.1016/j.pcd.2021.12.015
• Sosyal Güvenlik Kurumu. (2022). https://veri.sgk.gov.tr/
• Special Provincial Administration of Sivas. (2022). http://www.sivasilozelidaresi.gov.tr/nufus-bilgileri
• Tossou, Y. (2021). Effect of COVID-19 on demand for healthcare in Togo. Health Economics Review, 1-12. https://doi.org/10.1186/s13561-021-00335-x
• Türkiye İstatistik Kurumu. (2021). Health Expenditure. https://data.tuik.gov.tr/Bulten/Index?p=Health-Expenditure-Statistics-2020-37192
• Wang , H., Wu, J., Muhedaner, M. & Maihemuti, S. (2022). College students online education evaluation through SWOT analysis during covid-19. IEEE Education Society Section, 10, 88371-88385. doi:10.1109/ACCESS.2022.3198082
• Wenger, N., Stanton, A., Baxter-King, R., Sepucha, K., Vavreck, L., & Naeim, A. (2022, May). The Impact of covid-19 on routine medical care and cancer screening. J Gen Intern Med., 37(6), 1450-1456. doi:10.1007/s11606-021-07254-x
• Wollast, R., Schmitz, M., Bigot, A. & Luminet, O. (2021). The Theory of Planned Behavior during the COVID-19 pandemic: A comparison of health behaviors between Belgian and French residents. PLoS ONE 16(11): e0258320. https://doi.org/ 10.1371/journal.pone.0258320.