SAĞLIK HİZMET HATASI ALGISININ İNCELENMESİ: AZERBAYCAN ÖRNEĞİ

Year 2024, Volume: 5 Issue: 1, 66 - 82, 30.07.2024

Nijat Guliyev , Furkan Bilbay

https://doi.org/10.54439/gupayad.1456355

Abstract

Amaç: Bu çalışmanın amacı Azerbaycan’da sağlık hizmet hatalarının neler olduğunu incelemektir. Gereç ve Yöntem: Bu çalışmada nicel araştırma yöntemlerinden tarama araştırma yöntemi kullanılmıştır. Çalışmanın evrenini Azerbaycan’da sağlık hizmeti almış 18 yaş üstü bireyler oluşturmaktadır. Veriler anket tekniği ile kolayda örneklem yöntemi kullanılarak toplanmıştır. Toplanan verilere SPSS paket programı kullanılarak frekans analizi uygulanmış ortalamalara bakılmıştır. Bulgular: Katılımcıların %49,8’i erkek, %50,2’si kadın olup, yaş ortalaması 26,87±7,65 yıldır. Katılımcıların %54,7’si sağlık hizmet hataları ile karşılaştığını bildirmiştir. Sağlık hizmet hatalarının en önemli nedenlerinin sırasıyla hizmet sunum hataları, fiziksel alt yapı ile ilgili hatalar, fiyat konusunda yapılan hatalar, hasta şikâyetlerinin üst merciler tarafından ciddiye alınmaması ile ilgili hatalar, mevzuat dışında ücret talep edilmesi ve acil hizmetlerinden ücret talep edilmesi ile ilgili olduğu görülmüştür. Sonuç: Çalışma sonuçları değerlendirildiğinde iş deneyimi, hasta sayısı, vardiyalı çalışma ve sağlık çalışanlarının haklarının devlet tarafından yeterince ödenmemesi, oturmuş bir sağlık sigorta sisteminin olmaması sağlık hizmet hatalarına neden olan önemli konular olduğu söylenebilir. Sağlık çalışanlarının tıbbi bilgilerini geliştirmek için eğitim kursları ve eğitim-öğretim sürecinin değiştirilmesi, bakım verdikleri hasta sayısının azaltılması, çalışma saatlerinin düzenlenmesi ve devlet tarafından sağlık sisteminde çalışanların gelir düzeyinin iyileştirilmesi önerilir.

Keywords

Sağlık Hizmet Hatası, Azerbaycan Sağlık Sistemi, Sağlık Hizmet Algısı.

INVESTIGATION OF THE PERCEPTION OF HEALTH CARE FAILURE: AZERBAIJAN CASE

Abstract

Purpose: The aim of this study is to evaluate what healthcare errors are in Azerbaijan. Material and Method: In this study, survey research method, one of the quantitative research methods, was used. The population of the study consists of individual sover the age of 18 who received health care services in Azerbaijan. Data were collected using the survey technique and convenience sampling method. Frequency analysis was app lied to the collected data using the SPSS package program and the averages were examined. Findings: 49.8% of the participants are male and 50.2% are female, and the average age is 26.87±7.65 years. 54.7% of the participants reported that they encountered health care errors. It has been observed that the most important reasons for health care errors are service delivery errors, errors related to physicalin frastructure, errors regarding prices, errors related to patient complaints not being taken seriously by higher authorities, requesting fees outside the legislation and charging fees for emergency services. Results: When the study results are evaluated, it can be said that work experience, number of patients, shift work, inadequate payment of the rights of health care workers by the state, and the lack of an established health insurance system are important issues that cause health care errors. In order to improve the medical knowledge of health care professionals, it is recommended to change the training courses and education-training process, reduce the number of patients they care for, regulate working hours, and improve the income level of employees in the health care system by the state.

Keywords

Health Service Errors, Azerbaijan Health System, Health Service Perception

References

• Abry, S., Mehrabian, F., Omidi, S., Karimy, M., Kasmaei, P., & Haryalchi, K. (2022). Investigation of factors related to the behavior of reporting clinical errors in nurses working in educational and medical centers in Rashtcity, Iran. BMC Nursing, 21(1), 348. https://doi.org/10.1186/s12912-022-01134-3
• Ahmed, Z., Saada, M., Jones, A. M., & Al-Hamid, A. M. (2019). Medicalerrors: Healthcare professionals’ perspective at a tertiary hospital in Kuwait. PloS One, 14(5), e0217023. https://doi.org/10.1371/journal.pone.0217023
• Al-Worafi, Y. M. (2024). Medicalerrors: Overview. In: Al-Worafi, Y.M. (eds) Handbook of medical and health sciences in developing countries. Springer, Cham. https://doi.org/10.1007/978-3-030-74786-2_276-1 Allegranzi, B., Bagheri, Nejad, S., Combescure, C., Graafmans, W., Attar, H., Donaldson, L., & Pittet, D. (2011). Burden of endemic health-care-associated infection in developing countries: Systematic review and meta-analysis. The Lancet, 377(9761), 228-241.https://doi.org/10.1016/S0140-6736(10)61458-4
• Altun, G., & Yorulmaz, A. C. (2010). Yasal değişiklikler sonrası hekim sorumluluğu ve malpraktis. Balkan Medical Journal, 2010(1), 7-12. Aştı, T., & Acaroğlu, R. (2000). Hemşirelikte sık karşılaşılan hatalı uygulamalar. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi, 4(2), 22-27.
• Australian Commission on Safety and Quality in Health Care. (2023). National Safety and Quality Health Service Standards (second edition). Erişim adresi: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/national-safety-and-quality-health-service-standards-second-edition Erişim tarihi: 27.06.2024.
• Azerbaijan-Healthcare, (2023, 30 Ocak). International Trade Administration.Erişim adresi: https://www.trade.gov/country-commercial-guides/azerbaijan-healthcare Erişim tarihi: 01.06.2024
• Banda, S., Nkungula, N., Chiumia, I. K., Rylance, J., & Limbani, F. (2023). Tools for measuring client experiences and satisfaction with health care in low-and middle-income countries: A systematic review of measurement properties. BMC Health Services Research, 23(1), 133. https://doi.org/10.1186/s12913-023-09129-9
• Bayazidi, S., Zarezadeh, Y., Zamanzadeh, V., & Parvan, K. (2012). Medication error reporting rate and its barriers and facilitat or samong nurses. Journal of Caring Sciences, 1(4), 231. https://doi.org/10.5681/jcs.2012.032
• Bernstein, M., Hebert, P. C., & Etchells, E. (2003). Patient safety in neurosurgery: Detection of errors, prevention of errors, and disclosure of errors. Neurosurgery Quarterly, 13(2), 125-137. https://www.doi.org/10.1097/00013414-200306000-00008
• Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180-189. https://doi.org/10.1016/j.outlook.2017.10.004
• Buljac-Samardzic, M., Doekhie, K. D., & vanWijngaarden, J. D. (2020). Interventions to improve team effectiveness with in health care: A systematic review of the past decade. Human Resources for Health, 18, 1-42. https://doi.org/10.1186/s12960-019-0411-3
• Büyüköztürk, Ş., Kılıç-Çakmak, E., Akgün, Ö., Karadeniz, Ş., & Demirel, F. (2018). Bilimsel araştırma yöntemleri (24. baskı). Ankara: Pegem Yayınları.
• Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, M. L. (2016). The impact of electronic health records on health care quality: A systematic review and meta-analysis. The European Journal of Public Health, 26(1), 60-64. https://doi.org/10.1093/eurpub/ckv122
• Chegini, Z., Kakemam, E., Asghari Jafarabadi, M., & Janati, A. (2020). The impact of patient safety culture and the leader coaching behaviour of nurses on the intention to report errors: A cross-sectional survey. BMC Nursing, 19, 1-9. https://doi.org/10.1186/s12912-020-00472-4
• Çırpı, F., Merih, Y. D., & Kocabey, M. Y. (2009). Hasta güvenliğine yönelik hemşirelik uygulamalarının ve hemşirelerin bu konudaki görüşlerinin belirlenmesi. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi, 2(3), 26-34.
• Donaldson, M. S., Corrigan, J. M., &Kohn, L. T. (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press. https://doi.org/10.17226/9728
• Gandhi, T. K., Weingart, S. N., Borus, J., Seger, A. C., Peterson, J., Burdick, E., ... & Bates, D. W. (2010). Adverse drug events in ambulatory care. The New England Journal of Medicine, 363(21), 2061-2065. https://doi.org/10.1056/NEJMsa020703
• Gandhi, T. K., Kachalia, A., Thomas, E. J., Puopolo, A. L., Yoon, C., Brennan, T. A., & Studdert, D. M. (2006). Missed and delayed diagnoses in the ambulatory setting: A study of closed malpractice claims. Annals of Internal medicine, 145(7), 488-496. https://doi.org/10.7326/0003-4819-145-7-200610030-00006
• Gökdoğan, F., & Yorgun, S. (2010). Sağlık hizmetlerinde hasta güvenliği ve hemşireler. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 13(2), 53-59.
• Güleç, D., & Seren-İntepeler, Ş. (2013). Tıbbi hatalarda tutum ölçeğinin geliştirilmesi. Hemşirelikte Araştırma Geliştirme Dergisi, 15(3), 26-41.
• Hawryluck, L., & Styra, R. (2021). Coping with the psychological impact of medical errors: Some practical strategies. Health Management.org. Erişim adresi: https://healthmanagement.org/c/icu/IssueArticle/coping-with-the-psychological-impact-of-medical-errors-some-practical-strategies Erişim tarihi: 25.06.2024.
• Health and Youth Care Inspectorate. (2023). Monitoring the quality of healthcare. Erişim adresi: https://www.government.nl/topics/quality-of-healthcare/monitoring-and-quality-requirements/monitoring-the-quality-of-healthcare Erişim tarihi: 27.06.2024.
• Hunter, D., & Bains, N., (1999). Rates of adverse events among hospitalad missions and day surgeries in Ontariofrom1992 To 1997. Canadian Medical Association Journal. 160(11), 1585-1596.
• Ibrahimov, F., Ibrahimova, A., Kehler, J., Richardson, E., & World HealthOrganization. (2010). Azerbaijan: Health system review. European Observatory on Health Systems and Policies. Erişim adresi: https://eurohealthobservatory.who.int/publications/i/azerbaijan-health-system-review-2010 Erişim tarihi: 03.06.2024
• İntepeler, Ş. S., & Dursun, M. (2012). Tıbbi hatalar ve tıbbi hata bildirim sistemleri. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 15(2), 129-135.
• Jaam, M., Naseralallah, L. M., Hussain, T. A., & Pawluk, S. A. (2023). Correction: Pharmacist-led educational interventions provided to health care providers to reduce medication errors: A systematic review and meta-analysis. Plos One, 18(11), e0294195. https://doi.org/10.1371/journal.pone.0294195
• Karataş, M., & Yakıncı, C. (2010). Tıbbi hata nedenleri ve çözüm yolları. Journal of Turgut Ozal Medical Center, 17(3), 233-236.
• Kassabry, M. F. (2023). Theeffect of simulation-based advanced cardiac life support training on nursing students’ self-efficacy, attitudes, and anxiety in Palestine: Aquasi-experimental study. BMC Nursing, 22(1), 420. https://doi.org/10.1186/s12912-023-01588-z
• Kaya, E., & Gündüz, S. (2022). Sağlık kurumlarında merhamet yorgunluğu ve hasta güvenliğinin önemi. Uygulamalı Sosyal Bilimler ve Güzel Sanatlar Dergisi, 4(8), 46-61.
• Keleş, B., & Aloğlu, E. (2022). Hastanelerde olay bildirimi. Ankara: İksad Yayınevi.
• Kim, Y. S., Kim, H. S., Kim, H. A., Chun, J., Kwak, M. J., Kim, M. S., ... & Kim, H. (2020). Can patient and family education prevent medical errors? A descriptive study. BMC Health Services Research, 20, 1-7. https://doi.org/10.1186/s12913-020-05083-y
• Lewandowski, R., Goncharuk, A. G., & Cirella, G. T. (2021). Restoring patient trust in health care: medical information impact case study in Poland. BMC Health Services Research, 21(1), 865. https://doi.org/10.1186/s12913-021-06879-2
• Lingard, L., Espin, S., Whyte, S., Regehr, G., Baker, G. R., Reznick, R., … & Grober, E. (2004). Communication failures in the operating room: An observational classification of recurrent types and effects. Quality and Safety in Health Care, 14(4), 240-246. https://doi.org/10.1136/qshc.2003.008425
• Lingard, L., Regehr, G., Orser, B., Reznick, R., Baker, G. R., Doran, D., ... & Whyte, S. (2008). Evaluation of a preoperative check list and team briefing among surgeons, nurses, and anes the siologists to reduce failures in communication. Archives of Surgery, 143(1), 12-17. https://doi.org/10.1001/archsurg.2007.21
• Lingard, L., Reznick, R., Espin, S., Regehr, G., & DeVito, I. (2002). Team communications in theoperatingroom: Talk patterns, sites of tension, and implications for novices. Academic Medicine, 77(3), 232–237. https://doi.org/10.1097/00001888-200203000-00013
• Lippi, G., Blanckaert, N., Bonini, P., Green, S., Kitchen, S., Palicka, V., ... & Plebani, M. (2009). Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. Clinical Chemistry & Laboratory Medicine, 47(2), 143-153. https://doi.org/10.1515/CCLM.2009.045
• Norman, R. M., & Sjetne, I. S. (2017). Measuring nurses’ perception of work environment: A scoping review of questionnaires. BMC Nursing, 16, 1-15. https://doi.org/10.1186/s12912-017-0256-9
• NHS England, (2023). The NHS Patient Safety Strategy. Erişim adresi: https://www.england.nhs.uk/patient-safety/ Erişim Tarihi: 27.06. 2024
• Oktay, C. (2000). Acil serviste hasta memnuniyeti. Aktüel Tıp Dergisi, 5(9), 54.
• Oxford UniversityPress, USA. (2000). American National Biography Online. Oxford University Press. Erişim adresi: https://www.anb.org Erişim tarihi: 03.06.2024
• Öcel, Y. (2020). Evaluation of complaints in health services in Turkey. Hacettepe Sağlık İdaresi Dergisi, 23(1), 55-80.
• Öcel, Y., Çatı, K., Yorgun, S., & Bayraktar, M.F. (2022). Health-service-failure scale: developing a scale to determine health service faiures. Hacettepe Sağlık İdaresi Dergisi, 25(2), 389-408.
• Özata, M., Altunkan H., (2010). Hastanelerde tıbbi hata görülme sıklıkları, tıbbi hata türleri ve tıbbi hata nedenlerinin belirlenmesi: Konya örneği. Tıp Araştırmaları Dergisi, 8(2), 100-111.
• Prentice, J. C., Bell, S. K., Thomas, E. J., Schneider, E. C., Weingart, S. N., Weissman, J. S., & Schlesinger, M. J. (2020). Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey. BMJ Quality & Safety, 29(11), 883-894. https://doi.org/10.1136/bmjqs-2019-010367
• Reader, T. W., Gillespie, A., & Roberts, J. (2014). Patient complaints in health care systems: A systematic review and coding taxonomy. BMJ Quality & Safety, 23(8), 678-689. https://doi.org/10.1136/bmjqs-2013-002437
• Renkema, E., Broekhuis, M., &Ahaus, K. (2014). Conditions that influence the impact of malpractice litigation risk on physicians’ behavior regarding patient safety. BMC Health Services Research, 14, 1-6. https://doi.org/10.1186/1472-6963-14-38
• Rong, R., Lin, L., Yang, Y., Zhao, S., Guo, R., Ye, J., ... & Liu, D. (2023). Trending prevalence of healthcare-associated infections in a tertiary hospital in China during the COVID-19 pandemic. BMC Infectious Diseases, 23(1), 41. https://doi.org/10.1186/s12879-022-07952-9
• Sağlık Hizmetleri Temel Kanunu. (1983, 29 Haziran). 3359 sayılı Kanun. Erişim adresi: https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=3359&MevzuatTur=1&MevzuatTertip=5 Erişim tarihi: 3.06.2024
• Scott L. D., Rogers A. E., Hwang W. T., & Zhang Y. (2006). Effects of critical care nurses' work hours on vigilance and patients' safety. American Journal of Critical Care, 15(1), 30-37. https://doi.org/10.4037/ajcc2006.15.1.30
• Singh, H., Giardina, T. D., Meyer, A. N., Forjuoh, S. N., Reis, M. D., & Thomas, E. J. (2013). Types and origins of diagnostic errors in primary care settings. JAMA Internal medicine, 175(2), 286-295. hptts://doi.org/10.1001/jamainternmed.2013.2777
• Sorra, J. S., & Dyer, N. (2010). Multi level psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Services Research, 10, 199. https://doi.org/10.1186/1472-6963-10-199
• State Statistical Committee of the Republic of Azerbaijan, Ministry of Health, & MEASURE DHS, ICF International, (2011). Azerbaijan Demographic and Health Survey 2011. Erişim adresi: https://ghdx.healthdata.org/record/azerbaijan-demographic-and-health-survey-2011 Erişim tarihi: 27.06.2024
• Temel, M. (2005). Sağlık personelini ilgilendiren önemli bir konu: Malpraktis. Hemşirelik Forum Dergisi, 3(1), 84-90.
• The Joint Commission, (2002). National patient safety goals fact sheet. Erişim adresi: https://www.jointcommission.org/resources/news-and-multimedia/fact-sheets/facts-about-national-patient-safety-goals/Erişim tarihi: 03.06.2024
• The Joint Commission, (2023). National Patient Safety Goals. Erişim adresi: https://www.jointcommission.org/standards/national-patient-safety-goals/ Erişim tarihi: 27.06.2024
• Top, M., Gider, Ö., Taş, Y., & Çimen, S. (2008). Hekimlerin tıbbi hatalara neden olan faktörlere ilişkin değerlendirmeleri: Kocaeli ilinden bir alan çalışması. Hacettepe Sağlık İdaresi Dergisi, 11(2), 161-200.
• Vural, F., Çiftçi, S., Şükran, F. İ. L., AYDIN, A., & Vural, B. (2014). Sağlık çalışanlarının hasta güvenliği iklimi algıları ve tıbbi hataların raporlanmasını. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, (2), 152-157.
• Wawersik, D., & Palaganas, J. (2022). Organizational factors that promote error reporting in healthcare: A scoping review. Journal of Healthcare Management, 67(4), 283-301. https://doi.org/10.1097/jhm-d-21-00166
• WHO, (2011). Constitution of the World HealthOrganization. Geneva, Switzerland: World HealthOrganization. Erişim adresi: https://apps.who.int/gb/bd/PDF/bd48/basic-documents-48th-edition-en.pdf Erişim tarihi: 03.06.2024
• WHO, (2021, 12 Ekim). Azerbaijan strengthens its health work force to boost primary health care. Retrieved from: https://www.who.int/news-room/feature-stories/detail/azerbaijan-strengthens-its-health-workforce-to-boost-primary-health-careWHO, (2023). Patient safety. Erişim adresi: https://www.who.int/news-room/fact-sheets/detail/patient-safety Erişim tarihi: 01.06.2024
• Wong, E., Mavondo, F., & Fisher, J. (2020). Patient feed back to improve quality of patient-centred care in public hospitals: a systematic review of the evidence. BMC Health Services Research, 20, 1-17. https://doi.org/10.1186/s12913-020-05383-3
• World Bank, (2005). Azerbaijan: Health sector review note, Volume 2, Background papers. Washington, DC: World Bank Group. Erişim adresi: https://hdl.handle.net/10986/8691 Erişim tarihi: 03.06.2024
• WHO, (2004). World Alliance for Patient Safety: Forward Programme 2005. World Health Organization. Erişim adresi: https://iris.who.int/handle/10665/43072 Erişim tarihi: 03.06.2024