Research Article
BibTex RIS Cite

Türk Hastanelerinde Sistem Yönetimi Açısından Yoğunluk ve Hasta Bekleme Sürelerinin Analizi: Haftanın Gün Ve Saatlerine Göre Model Oluşturma

Year 2024, Volume: 13 Issue: 1, 441 - 452, 27.03.2024
https://doi.org/10.37989/gumussagbil.1225744

Abstract

Bekleme sırasında geçirilen zaman hasta memnuniyeti ve hastane verimliliği açısından önemli bir sorun oluşturmaktadır ve yönetimin çözüme yönelik karar alabilmesi için kanıta dayalı bilgiye duyduğu ihtiyacı artırmaktadır. Bu çalışma, daha iyi bir hizmet sunum sistemi tasarlamak için hastanelerdeki süreç akışlarını gerçek veriler üzerinden inceleyerek, süreçteki yoğunlukların tespit edilmesi ve gerekli iyileştirmelerin planlanması açısından bir model oluşturmayı amaçlamaktadır. Bu amaç için, Türkiye’de 2. ve 3. basamak sağlık kurumlarına ait ulusal randevu sistemi (MHRS) üzerinde depolanan 2016 yılına ait veri setleri incelenmiştir. Veriler; veri ön işleme, temizleme ve dönüştürme aşamalarından geçirilerek analiz edilmiştir. Hastanelerdeki gün ve saatlere göre yoğunluk örüntüleri tespit edilmiştir. Türkiye’deki hastanelerde pazartesi gününün, hasta yoğunluğunun en fazla olduğu ve en uzun bekleme süresine sahip olan gün olduğu görülmüştür. Bunun yanında, mesai saatlerine göre analiz edildiğinde, sabah ilk 2 saat (9.00-11.00) en fazla hastanın muayene edildiği dönem olduğu tespit edilmiştir. Öğle saati (12.00-13.00 arası) ve öğleden sonra saat 16.00-17.00 arası ise hasta frekansının en düşük, ancak ortalama bekleme süresinin en uzun olduğu zamanlardır. Çalışma sonuçlarına göre, Türkiye’deki hastanelerde hasta bekleme sürelerinin özellikle bazı gün ve saatlerde yoğun olduğu tespit edilmiştir. Böylece genel bir planlama önerisinden ziyade yoğunluk örüntülerinin tespit edildiği gün ve saatler özelinde politika önerileri geliştirilebilir. Bu çalışma, süreç verileri üzerinden Türkiye'de yapılan en kapsamlı çalışmadır. Çalışma modeli farklı ülke ve bölgelerde tekrarlanabilir niteliktedir.

References

  • 1. Au, J, Horwood, C, Hakendorf, P. and Thompson, C. (2019). ‘‘Similar Outcomes for General Medicine Patients Discharged on any day of the week’’. Internal Medicine Journal, 49 (3), 380–384. https://doi.org/10.1111/imj.14083
  • 2. Brandenburg, L, Gabow, P. and Steele, G. (2015). ‘‘Innovation and Best Practices in Health Care Scheduling’’. NAM Perspectives.
  • 3. British Columbia Medical Association (2006). ‘‘Waiting Too Long: Reducing And Better Managing Wait Times. By The BCMA’s Council On Health Economics & Policy’’. British Columbia Medical Association.
  • 4. Budinoski, K., and Trajkovik, V. (2012). ‘‘Incorporate Social Network Services In E-Government Solutions: The Case Of Macedonia’’. International Journal of EBusiness and EGovernment Studies, 1 (4), 23–35. https://doi.org/10.17226/20220
  • 5. Cantwell, K., Morgans, A., Smith, K., Livingston, M., Spelman, T. and Dietze, P. (2015). ‘‘Time of Day and Day of Week Trends in EMS Demand’’. Prehospital Emergency Care, 19 (3), 425–431. https://doi.org/10.3109/10903127.2014.995843
  • 6. Edgar Elías Osuna. (1985). ‘‘The Psychological Cost Of Waiting’’. Journal of Mathematical Psychology, 29 (1), 82–105. https://doi.org/https://doi.org/10.1016/0022-2496(85)90020-3
  • 7. Fieldston, E. S., Hall, M., Shah, S. S., Hain, P. D., Sills, M. R., Slonim, A. D., Myers, A. L., Cannon, C. and Pati, S. (2011). ‘‘Addressing Inpatient Crowding By Smoothing Occupancy At Children’s Hospitals.’’ Journal of Hospital Medicine, 6 (8), 462–468. https://doi.org/10.1002/jhm.904
  • 8. García, M. and Harmsen, B. (2012). ‘‘QlikView 11 for Developers’’. Packt Publishing Ltd.
  • 9. Guttmann, A., Schull, M. J., Vermeulen, M. J. and Stukel, T. A. (2011). ‘‘Association Between Waiting Times And Short Term Mortality And Hospital Admission After Departure From Emergency Department: Population Based Cohort Study From Ontario, Canada’’. BMJ, 342(7809). https://doi.org/10.1136/bmj.d2983
  • 10. Hong, T. S., Shang, P. P., Arumugam, M. and Yussuf, R. M. (2013). ‘‘Use of Simulation To Solve Outpatient Clinic Problems: a Review of the Literature.’’ South African Journal of Industrial Engineering, 24 (3), 27–42.
  • 11. Johnson, W. L. and Rosenfeld, L. S. (1968). ‘‘Factors Affecting Waiting Time in Ambulatory Care Services.’’ Health Services Research, 3 (4), 286–295.
  • 12. Kocas, C. (2015). ‘‘An Extension Of Osuna’s Model To Observable Queues’’. Journal of Mathematical Psychology, 66, 53–58.
  • 13. Kreindler, S. A. (2008). ‘‘Watching Your Wait’’. Quality Management in Health Care, 17(2), 128–135. https://doi.org/10.1097/01.QMH.0000316990.48673.9f
  • 14. Kreindler, S. A. (2010). ‘‘Policy Strategies To Reduce Waits For Elective Care: A Synthesis Of International Evidence’’. British Medical Bulletin, 95 (1), 7–32. https://doi.org/10.1093/bmb/ldq014
  • 15. Küçük, A., Demirci, M., Kerman, G. and Özsoy, V. S. (2021). ‘‘Evaluating Of Hospital Appointment Systems In Turkey: Challenges And Opportunities’’. Health Policy and Technology, 10 (1), 69–74. https://doi.org/10.1016/j.hlpt.2020.11.008
  • 16. Leddy, K. M., Kaldenberg, D. O. and Becker, B. W. (2003). ‘‘Timeliness In Ambulatory Care Treatment: An Examination Of Patient Satisfaction And Wait Times In Medical Practices And Outpatient Test And Treatment Facilities’’. The Journal of Ambulatory Care Management, 26 (2), 138–149. https://doi.org/10.1097/00004479-200304000-00006
  • 17. Leiba, A., Weiss, Y., Carroll, J. S., Benedek, P. and Bar-dayan, Y. (2002). ‘‘Waiting Time İs A Major Predictor Of Patient Satisfaction in A Primary Military Clinic’’. Military Medicine, 167 (10), 842–845. https://doi.org/10.1093/milmed/167.10.842
  • 18. Mazzocato, P., Savage, C., Brommels, M., Aronsson, H. and Thor, J. (2010). ‘‘Lean Thinking in Healthcare: A Realist Review Of The Literature’’. Quality and Safety in Health Care, 19 (5), 376-382.
  • 19. Michael, M., Schaffer, S. D., Egan, P. L., Little, B. B. and Pritchard, P. S. (2013). “Improving Wait Times And Patient Satisfaction in Primary Care". Journal For Healthcare Quality, 35 (2), 50–60. https://doi.org/10.1111/jhq.12004
  • 20. Oğuzlar, A. (2003). “Veri̇ Ön İ̇şleme”. Erciyes Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 21 (1), 67–76.
  • 21. Potezny, T., Horwood, C., Hakendorf, P. and Thompson, C. (2018). “The Effect Of The Weekend Upon Admissions To General Medicine”. Journal of Evaluation in Clinical Practice, 24 (4), 726–730. https://doi.org/10.1111/jep.12953
  • 22. Pyle, D. (1999). “Data Preparation for Data Mining” (D. D. Cerra, Ed.). Morgan Kaufmann.
  • 23. Republic of Turkey Ministry of Health. (2016). “Republic of Turkey Ministry of Health Central Physician Appointment System”. Republic of Turkey Ministry of Health. https://www.hastanerandevu.gov.tr/Vatandas/hakkimizda.xhtml
  • 24. Ryan, K., Levit, K. and Davis, P. (2006). “Characteristics of Weekday and Weekend Hospital Admissions: Statistical Brief”. In Healthcare Cost and Utilization Project (HCUP) Statistical Briefs.
  • 25. Schoen, C. and Doty, M. M. (2004). “Inequities in Access To Medical Care in Five Countries: Findings from the 2001 Commonwealth Fund International Health Policy Survey”. Health Policy, 67 (3), 309–322. https://doi.org/10.1016/j.healthpol.2003.09.006
  • 26. Şengül, Ü., Eslemian, S. and Eren, M. (2013). “Türkiye’de İstatistiki Bölge Birimleri Sınıflamasına Göre Düzey 2 Bölgelerinin Ekonomik Etkinliklerinin DEA Yöntemi ile Belirlenmesi ve Tobit Model Uygulaması”. Yönetim Bilimleri Dergisi, 11(21), 75–99.
  • 27. Siciliani, L., Moran, V. and Borowitz, M. (2014). “Measuring and Comparing Health Care Waiting Times in OECD Countries”. Health Policy, 118, Art. 67.
  • 28. Speed, D., Bornstein, S., Kean, R., Bornstein, S. and Brien, S. O. (2016). “Reducing Wait Times for Outpatient Services in Newfoundland and Labrador”. Applied Health Research.
  • 29. Sun, J., Lin, Q., Zhao, P., Zhang, Q., Xu, K., Chen, H., Hu, C. J., Stuntz, M., Li, H. and Liu, Y. (2017). “Reducing Waiting Time And Raising Outpatient Satisfaction In A Chinese Public Tertiary General Hospital-An Interrupted Time Series Study”. BMC Public Health, 17 (1), 1–11. https://doi.org/10.1186/s12889-017-4667-z
  • 30. Thompson, D. A., Yarnold, P. R., Williams, D. R., Adams, S. L., Soremekun, O. A., Takayesu, J. K., Bohan, S. J., Mardiah, F. P. and Basri, M. H. (2013). “The Analysis of Appointment System to Reduce Outpatient Waiting Time at Indonesia’s Public Hospital”. Human Resource Management Research, 3 (6), 27–33. https://doi.org/10.5923/j.hrmr.20130301.06
  • 31. TR Ministry of Health. (2010). “TR Ministry of Health Central Physician Appointment System”. Access Address: https://www.mhrs.gov.tr/Vatandas/hakkimizda.xhtml
  • 32. Tsoi, L., Ip, S. and Poon, L. (2011). “Monday Syndrome: Using Statistical and Mathematical Models to Fine-Tune Services in an Emergency Department”. Hong Kong Journal of Emergency Medicine, 18 (3), 150–154. https://doi.org/10.1177/102490791101800304
  • 33. Young, T. P and McClean, S. I. (2008). “A Critical Look at Lean Thinking in Healthcare”. Quality and Safety in Health Care, 17 (5), 382–386.

Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week

Year 2024, Volume: 13 Issue: 1, 441 - 452, 27.03.2024
https://doi.org/10.37989/gumussagbil.1225744

Abstract

The time spent waiting is an important problem regarding patient satisfaction and hospital efficiency, and increases the need for evidence-based information for management to make decisions towards a solution. This study aims to examine the process flows in hospitals based on actual data with the intent to design a better service delivery system and set a pattern in terms of determining the congestion in the process and planning the necessary improvements. For this purpose, the data sets for 2016 pertaining to secondary and tertiary level hospitals in Turkey, which are stored in the central physician appointment system (CPAS), are investigated. The data is analyzed through pre-processing, cleaning and transformation stages. Congestion patterns are determined by days and hours spent in hospitals. Monday is found to be the day with the highest patient density and the longest wait time in Turkish hospitals. Additionally, when analyzed by working hours, it is determined that the first 2 hours in the morning (9.00 a.m. to 11.00 a.m.) is the period when most patentse are examined. The lunchtime (between 12.00 p.m. - 1.00 p.m.) and the afternoon from 4.00 p.m. to 5.00 p.m. are the times when patient density is the lowest, but average wait time is the longest. Turkish hospitals are found to be particularly congested on some days and during some hours regarding patient wait times. Thus, policy recommendations can be developed specifically to the days and times when congestion patterns are identified rather than suggesting a general policy. This study is the most comprehensive study conducted in Turkey through process data. The working model is reproducible in different countries and regions.

References

  • 1. Au, J, Horwood, C, Hakendorf, P. and Thompson, C. (2019). ‘‘Similar Outcomes for General Medicine Patients Discharged on any day of the week’’. Internal Medicine Journal, 49 (3), 380–384. https://doi.org/10.1111/imj.14083
  • 2. Brandenburg, L, Gabow, P. and Steele, G. (2015). ‘‘Innovation and Best Practices in Health Care Scheduling’’. NAM Perspectives.
  • 3. British Columbia Medical Association (2006). ‘‘Waiting Too Long: Reducing And Better Managing Wait Times. By The BCMA’s Council On Health Economics & Policy’’. British Columbia Medical Association.
  • 4. Budinoski, K., and Trajkovik, V. (2012). ‘‘Incorporate Social Network Services In E-Government Solutions: The Case Of Macedonia’’. International Journal of EBusiness and EGovernment Studies, 1 (4), 23–35. https://doi.org/10.17226/20220
  • 5. Cantwell, K., Morgans, A., Smith, K., Livingston, M., Spelman, T. and Dietze, P. (2015). ‘‘Time of Day and Day of Week Trends in EMS Demand’’. Prehospital Emergency Care, 19 (3), 425–431. https://doi.org/10.3109/10903127.2014.995843
  • 6. Edgar Elías Osuna. (1985). ‘‘The Psychological Cost Of Waiting’’. Journal of Mathematical Psychology, 29 (1), 82–105. https://doi.org/https://doi.org/10.1016/0022-2496(85)90020-3
  • 7. Fieldston, E. S., Hall, M., Shah, S. S., Hain, P. D., Sills, M. R., Slonim, A. D., Myers, A. L., Cannon, C. and Pati, S. (2011). ‘‘Addressing Inpatient Crowding By Smoothing Occupancy At Children’s Hospitals.’’ Journal of Hospital Medicine, 6 (8), 462–468. https://doi.org/10.1002/jhm.904
  • 8. García, M. and Harmsen, B. (2012). ‘‘QlikView 11 for Developers’’. Packt Publishing Ltd.
  • 9. Guttmann, A., Schull, M. J., Vermeulen, M. J. and Stukel, T. A. (2011). ‘‘Association Between Waiting Times And Short Term Mortality And Hospital Admission After Departure From Emergency Department: Population Based Cohort Study From Ontario, Canada’’. BMJ, 342(7809). https://doi.org/10.1136/bmj.d2983
  • 10. Hong, T. S., Shang, P. P., Arumugam, M. and Yussuf, R. M. (2013). ‘‘Use of Simulation To Solve Outpatient Clinic Problems: a Review of the Literature.’’ South African Journal of Industrial Engineering, 24 (3), 27–42.
  • 11. Johnson, W. L. and Rosenfeld, L. S. (1968). ‘‘Factors Affecting Waiting Time in Ambulatory Care Services.’’ Health Services Research, 3 (4), 286–295.
  • 12. Kocas, C. (2015). ‘‘An Extension Of Osuna’s Model To Observable Queues’’. Journal of Mathematical Psychology, 66, 53–58.
  • 13. Kreindler, S. A. (2008). ‘‘Watching Your Wait’’. Quality Management in Health Care, 17(2), 128–135. https://doi.org/10.1097/01.QMH.0000316990.48673.9f
  • 14. Kreindler, S. A. (2010). ‘‘Policy Strategies To Reduce Waits For Elective Care: A Synthesis Of International Evidence’’. British Medical Bulletin, 95 (1), 7–32. https://doi.org/10.1093/bmb/ldq014
  • 15. Küçük, A., Demirci, M., Kerman, G. and Özsoy, V. S. (2021). ‘‘Evaluating Of Hospital Appointment Systems In Turkey: Challenges And Opportunities’’. Health Policy and Technology, 10 (1), 69–74. https://doi.org/10.1016/j.hlpt.2020.11.008
  • 16. Leddy, K. M., Kaldenberg, D. O. and Becker, B. W. (2003). ‘‘Timeliness In Ambulatory Care Treatment: An Examination Of Patient Satisfaction And Wait Times In Medical Practices And Outpatient Test And Treatment Facilities’’. The Journal of Ambulatory Care Management, 26 (2), 138–149. https://doi.org/10.1097/00004479-200304000-00006
  • 17. Leiba, A., Weiss, Y., Carroll, J. S., Benedek, P. and Bar-dayan, Y. (2002). ‘‘Waiting Time İs A Major Predictor Of Patient Satisfaction in A Primary Military Clinic’’. Military Medicine, 167 (10), 842–845. https://doi.org/10.1093/milmed/167.10.842
  • 18. Mazzocato, P., Savage, C., Brommels, M., Aronsson, H. and Thor, J. (2010). ‘‘Lean Thinking in Healthcare: A Realist Review Of The Literature’’. Quality and Safety in Health Care, 19 (5), 376-382.
  • 19. Michael, M., Schaffer, S. D., Egan, P. L., Little, B. B. and Pritchard, P. S. (2013). “Improving Wait Times And Patient Satisfaction in Primary Care". Journal For Healthcare Quality, 35 (2), 50–60. https://doi.org/10.1111/jhq.12004
  • 20. Oğuzlar, A. (2003). “Veri̇ Ön İ̇şleme”. Erciyes Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 21 (1), 67–76.
  • 21. Potezny, T., Horwood, C., Hakendorf, P. and Thompson, C. (2018). “The Effect Of The Weekend Upon Admissions To General Medicine”. Journal of Evaluation in Clinical Practice, 24 (4), 726–730. https://doi.org/10.1111/jep.12953
  • 22. Pyle, D. (1999). “Data Preparation for Data Mining” (D. D. Cerra, Ed.). Morgan Kaufmann.
  • 23. Republic of Turkey Ministry of Health. (2016). “Republic of Turkey Ministry of Health Central Physician Appointment System”. Republic of Turkey Ministry of Health. https://www.hastanerandevu.gov.tr/Vatandas/hakkimizda.xhtml
  • 24. Ryan, K., Levit, K. and Davis, P. (2006). “Characteristics of Weekday and Weekend Hospital Admissions: Statistical Brief”. In Healthcare Cost and Utilization Project (HCUP) Statistical Briefs.
  • 25. Schoen, C. and Doty, M. M. (2004). “Inequities in Access To Medical Care in Five Countries: Findings from the 2001 Commonwealth Fund International Health Policy Survey”. Health Policy, 67 (3), 309–322. https://doi.org/10.1016/j.healthpol.2003.09.006
  • 26. Şengül, Ü., Eslemian, S. and Eren, M. (2013). “Türkiye’de İstatistiki Bölge Birimleri Sınıflamasına Göre Düzey 2 Bölgelerinin Ekonomik Etkinliklerinin DEA Yöntemi ile Belirlenmesi ve Tobit Model Uygulaması”. Yönetim Bilimleri Dergisi, 11(21), 75–99.
  • 27. Siciliani, L., Moran, V. and Borowitz, M. (2014). “Measuring and Comparing Health Care Waiting Times in OECD Countries”. Health Policy, 118, Art. 67.
  • 28. Speed, D., Bornstein, S., Kean, R., Bornstein, S. and Brien, S. O. (2016). “Reducing Wait Times for Outpatient Services in Newfoundland and Labrador”. Applied Health Research.
  • 29. Sun, J., Lin, Q., Zhao, P., Zhang, Q., Xu, K., Chen, H., Hu, C. J., Stuntz, M., Li, H. and Liu, Y. (2017). “Reducing Waiting Time And Raising Outpatient Satisfaction In A Chinese Public Tertiary General Hospital-An Interrupted Time Series Study”. BMC Public Health, 17 (1), 1–11. https://doi.org/10.1186/s12889-017-4667-z
  • 30. Thompson, D. A., Yarnold, P. R., Williams, D. R., Adams, S. L., Soremekun, O. A., Takayesu, J. K., Bohan, S. J., Mardiah, F. P. and Basri, M. H. (2013). “The Analysis of Appointment System to Reduce Outpatient Waiting Time at Indonesia’s Public Hospital”. Human Resource Management Research, 3 (6), 27–33. https://doi.org/10.5923/j.hrmr.20130301.06
  • 31. TR Ministry of Health. (2010). “TR Ministry of Health Central Physician Appointment System”. Access Address: https://www.mhrs.gov.tr/Vatandas/hakkimizda.xhtml
  • 32. Tsoi, L., Ip, S. and Poon, L. (2011). “Monday Syndrome: Using Statistical and Mathematical Models to Fine-Tune Services in an Emergency Department”. Hong Kong Journal of Emergency Medicine, 18 (3), 150–154. https://doi.org/10.1177/102490791101800304
  • 33. Young, T. P and McClean, S. I. (2008). “A Critical Look at Lean Thinking in Healthcare”. Quality and Safety in Health Care, 17 (5), 382–386.
There are 33 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Olcay Özen 0000-0001-6562-8286

İlker Köse 0000-0002-5549-5579

Pakize Yıgıt 0000-0002-5919-1986

Şeyma Güner 0000-0002-9591-9276

Sabahattin Aydın 0000-0001-6374-817X

Publication Date March 27, 2024
Published in Issue Year 2024 Volume: 13 Issue: 1

Cite

APA Özen, O., Köse, İ., Yıgıt, P., Güner, Ş., et al. (2024). Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 13(1), 441-452. https://doi.org/10.37989/gumussagbil.1225744
AMA Özen O, Köse İ, Yıgıt P, Güner Ş, Aydın S. Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. March 2024;13(1):441-452. doi:10.37989/gumussagbil.1225744
Chicago Özen, Olcay, İlker Köse, Pakize Yıgıt, Şeyma Güner, and Sabahattin Aydın. “Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 13, no. 1 (March 2024): 441-52. https://doi.org/10.37989/gumussagbil.1225744.
EndNote Özen O, Köse İ, Yıgıt P, Güner Ş, Aydın S (March 1, 2024) Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 13 1 441–452.
IEEE O. Özen, İ. Köse, P. Yıgıt, Ş. Güner, and S. Aydın, “Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week”, Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, vol. 13, no. 1, pp. 441–452, 2024, doi: 10.37989/gumussagbil.1225744.
ISNAD Özen, Olcay et al. “Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 13/1 (March 2024), 441-452. https://doi.org/10.37989/gumussagbil.1225744.
JAMA Özen O, Köse İ, Yıgıt P, Güner Ş, Aydın S. Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2024;13:441–452.
MLA Özen, Olcay et al. “Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, vol. 13, no. 1, 2024, pp. 441-52, doi:10.37989/gumussagbil.1225744.
Vancouver Özen O, Köse İ, Yıgıt P, Güner Ş, Aydın S. Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2024;13(1):441-52.