The Relationship Between Economic Factors and Health Personnel Employment in Turkey: An Econometric Anaylsis

Year 2020, Issue: 56, 1 - 18, 30.08.2020

Ümit Çıraklı

https://doi.org/10.18070/erciyesiibd.659335

Abstract

This study applies the ARDL (Autoregressive Distributed Lag) bounds testing approach developed by Pesaran, Shin and Smith (2001) to reveal the relationship between economic factors and health personnel employment in Turkey between 1974-2015. While the health personnel data includes the number of physicians and other health personnel (midwives and nurses), reel GDP (Real Gross Domestic Product) and economic crises are included as economic factors in the study. In terms of long-run relationships between economic growth and health personnel number, this study shows that while the employment of the physicians is made independently of economic growth, other health personnel are employed directly proportional to the increase in income in Turkey. The findings of the study show that the 1994 economic crisis has had a significant decreasing effect on only the number of other health personnel. Both the results of long-run relationships and impacts of economic crises in this study shows that the politicians pay more attention to the physicians than other health personnel. As health care services are based on teamwork, cuts in the number of other health personnel during any economic hardship will make it difficult to meet the health services needs of population in terms of quality and quantity. Therefore, politicians need to pay more attention to the recruitment of other health personnel too.

Keywords

Economic factors, Economic crisis, Health personnel number, Turkey, ARDL bouns testing

Türkiye’de Ekonomik Faktörler ve Sağlık İşgücü İstihdamı Arasındaki İlişki: Ekonometrik Bir Analiz

Abstract

Bu çalışma, 1974-2015 arası Türkiye’de ekonomik faktörler ve sağlık personeli istihdamı arasındaki ilişkiyi ortaya koymak için Pesaran, Shin ve Smith (2001) tarafından geliştirilen ARDL (Otoregresif Dağıtılmış Gecikme Modeli) sınır testi yaklaşımını uygulamaktadır. Sağlık personeli verisi hekim, diğer sağlık personeli (ebe ve hemşire) sayısını kapsamakta iken, reel GSYH ve ekonomik krizler çalışmaya ekonomik faktörler olarak dahil edilmiştir. Ekonomik büyüme ile sağlık personeli sayısı arasındaki uzun dönemli ilişki açısından bu çalışma, Türkiye’de hekim istihdamının ekonomik büyümeden bağımsız olarak yapıldığını, ebe ve hemşire istihdamının ise doğrudan ekonomik büyüme ile orantılı yapıldığı ortaya koymaktadır. Çalışmanın bulguları, 1994 ekonomik krizinin sadece ebe ve hemşire sayısı üzerinde önemli şekilde azaltıcı etkisinin olduğunu göstermektedir. Çalışmanın hem uzun dönem ilişkilere hem de krizlerin etkilerine dair sonuçları politikacıların hekimlere ebeler ve hemşirelerden daha fazla önem verdiklerini göstermektedir. Sağık hizmetleri ekip çalışmasına dayalı olduğu için bir ekonomik zorluk döneminde ebe ve hemşire sayısında yapılacak kesintiler toplumun sağlık hizmeti ihtiyacının nicelik ve kalite açısından karşılanmasını zorlaştıracaktır. Bu yüzden politikacıların diğer sağlık personeli istihdamına da daha fazla önem vermesi gerekmektedir.

Keywords

Ekonomik faktörler, Ekonomik kriz, Sağlık Personeli Sayısı, Türkiye, ARDL sınır testi

References

• Cirakli, U. (2019). Investigation of the relationship between macroeconomic factors and health expenditures and ministry of health budget in Turkey through ARDL bounds testing approach. Afyon Kocatepe University Journal of Social Sciences, 21(2), 581-596. https://doi.org/10.32709/akusosbil.449527.
• Cirakli, U., and Yildirim, H. H. (2018). Health policy choices and countermeaures taken in times of economic crisis from 1994 to 2014 in the world: A theoretical review. Health Care Academician Journal, 5(4), 43-51.
• Cirakli, U., and Yildirim, H. H. (2019). The impacts of economic crisis on the public health in Turkey: An ARDL bounds testing approach. Hacettepe Sağlık İdaresi Dergisi, 22(2), 259-280.
• Cirakli, U., Celik, Y. and Beylik, U. (2015). The importance and benefits of effective teamwork in health care: A literature survey. Health Care Academician Journal, 2(3), 140-146. https://doi.org/10.5455/sad.2015131452108477.
• Duffin, C. (2014). Increase in nurse numbers linked to better patient survival rates in ICU. Nursing Standart, 28(33), 10-10. https://doi.org/10.7748/ns2014.04.28.33.10.s8.
• Engle, R. F. and Granger, C. W. J. (1987). Co-integration and error correction: representation, estimation and testing. Econometrica, 55(2), 251-276. http://dx.doi.org/10.2307/1913236.
• Erdem, E., İlgün, M. F. ve Dumrul, C. (2011). Finansal İstikrarın Bankacılık Sisteminin Borç Verme Politikaları Üzerindeki Etkisi: 2008 Küresel Krizi Çerçevesinde Türkiye Üzerine Bir İnceleme. BDDK Bankacılık ve Finansal Piyasalar, 5(1), 9-34.
• Erdogan, S. and Bozkurt, H. (2008). The relation between life expectancy and economic growth: an analysis with ARDL model. The Journal of Knowledge Economy and Knowledge Management, 3(1), 25-38.
• Eurofound (European Foundation for the Improvement of Living and Working Conditions). (2014). Access to healthcare in times of crisis. Luxembourg: Publications Office of the European Union.
• Greene, W. H. (2008). Econometric analysis (6th ed.). Prentice Hall.
• Gujarati, D. N. (2004). Basic econometric (4th ed.). The McGraw-Hill Companies.
• Gujarati, D. N. (2011). Econometrics by example. Palgrave Macmillian.
• HOPE (European Hospital and Healthcare Federation). (2011). The Crisis, Hospitals and Health Care. European Hospital and Healthcare Federation.
• Imirlioglu, I. (2009). The Sources of Stress for the Medical Doctors and the Nurses That Work for the State Hospitals and Their Views on the Affects of Stress on Their Performances (An Example of the Province of Ankara). Verimlilik Dergisi, 4, 53-101.
• Islek, N. (2005). Evaluation of nursing service performance and manpower planning based on a workload analysis of nursing services (Unpublished Master Thesis). Hacettepe University.
• Johansen, S. (1988). Statistical analysis of cointegration vectors. Journal of Economic Dynamics and Control, 12, 231-254. https://doi.org/10.1016/0165-1889(88)90041-3.
• Johansen, S. and Juselius, K. (1990). Maximum likelihood estimation and inferences on cointegration-with applications to the demand for money. Oxford Bulletin of Economics and Statistics, 52, 169-210. https://doi.org/10.1111/j.1468-0084.1990.mp52002003.x.
• Kilic, B. (2007). Health manpower planning and employment policies for Turkey. TAF Preventive Medicine Bulletin, 6(6), 501-514.
• Narayan, P. K. and Smyth, R. (2006). What determines migration flows from low-income to high-income countries? an empirical investigation of Fiji-US migration 1972–2001. Contemporary Economic Policy, 24(2), 332–342. https://doi.org/10.1093/cep/byj019.
• Narayan, S. and Narayan, P. K. (2004). Determinats of demand of Fiji’s exports: an empirical investigation. The Developing Economics, 42(1), 95-112. https://doi.org/10.1111/j.1746-1049.2004.tb01017.x.
• Newhouse, J. P. (2002). Pricing the priceless: a health care conundrum. MA: MIT Press, Cambridge.
• Palese, A. and Watson, R. (2014). Nurse staffing and education in Europe: if not now, when? The Lancet, 383, 1789-1790. https://doi.org/10.1016/S0140-6736(14)60188-4.
• Pesaran, M. H., Shin, Y. and Smith, R. J. (2001). Bounds testing approaches to the analysis of level relationships. Journal of Applied Econometrics, 16(3), 289-326. https://doi.org/10.1002/jae.616.
• Phillips, P. C. B. and Hansen, B. E. (1990). Statistical inference in instrumental variables regression with I(1) processes. Review of Economic Studies, 57, 99-125. https://doi.org/10.2307/2297545.
• Tuncsiper, B. and Bicen, O. F. (2013). The effects of European debt crisis on Turkey's exports. In: S. Sarı, A. H. Gencer, I. Sozen (Eds.), Proceedings of international conference on Eurasian economies (pp. 486-495). St. Petersburg, Russia.
• TurkStat. (2016, 4 August). Health statistics. Accessed http://www.tuik.gov.tr/PreIstatistikTablo.do?istab_id=254.
• World Bank. (2016, 4 August). World development indicators. Accessed http://databank.worldbank.org/data/reports.aspx?source=2&country=TUR#.
• Yakisik, H. and Cetin, A. (2014). The impacts of education, health and level of technology on economic growth: ARDL bound test approach. Socio-economics, 21(21), 169-186 .
• Yildirim, H. H. (2015). Health and politics articles. Ankara: ABSAM Publications.