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DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ

Year 2021, Volume: 24 Issue: 2, 399 - 414, 23.06.2021

E. Fatma Seyfioğlu N. Ümit Başdaş

Abstract

Sağlık bakımında en düşük maliyetle en iyi sonuçları elde etmek ve hastalar için değeri en üst seviyeye çıkarmak için yeni bir strateji geliştirilmiştir. Değer temelli sağlık hizmetlerinde ana hedef, hastalar için değer yaratmak olduğundan, bu hedefe ulaşmanın yolu hasta sonuçlarının ölçümüdür. Sonuçları anlamak değer sağlamada merkezi bir öneme sahiptir. Değişen rekabet ortamında başarılı olmak için sonuçların ölçümü ve rapor edilmesi en iyi uygulamaların iyileştirilmesini ve benimsenmesini teşvik ettiğinden bir avantaj olarak görülmektedir. Güvenilir sonuç ölçümleri sayesinde bütüncül bakım döngüsü boyunca etkinlik artacak, sonuçlar karşılaştırılabilir hale gelecek ve süreç iyileşecektir. Bu çalışmanın amacı, değer temelli sağlık hizmeti uygulamasında değerin iki bileşeninden biri olan hasta sonuçlarını ölçmenin önemini ve sonuç ölçümünde etkili olan çeşitli yöntemleri açıklamaktır. Bu literatür incelemesi sonucunda konuya ilişkin çeşitli yöntemler elde edilmiş ve incelenmiş, hangi yöntemlerin hangi çalışmalarda yapılacağına ilişkin önerilerde bulunulmuştur.

Keywords

Değer Temelli Sağlık Hizmeti Hasta Sonuçları Sonuç Ölçümü PRO QALY

References

  • Alahdab, H. (2019). Sağlık hizmet kalitesinde hastanın rolü. Sağlıkta Kalite ve Akreditasyon Dergisi, 2(1), 22-26.
  • Anderson, A. E., Baathe, F., Wikstrom, E., & Nilsson, K. (2015). Understanding value-based healthcare- an interview study with project team members at a Swedish University Hospital. Journal of Hospital Administration, 4(4), 64-72.
  • Bayın Donar, G. (2019). Diyaliz tedavisi alan hastaların sağlık hizmeti kullanımı ve yaşam kalitesini etkileyen faktörlerin belirlenmesi. (Yayımlanmamış Doktora Tezi). Hacettepe Üniversitesi, Ankara.
  • Catalyst, N. J. (2017). What is value-based healthcare? NEJM Catalyst, 3(1), 1-6.
  • David, D., Barnes, D. E., McMahan, R. D., Shi, Y., Katen, M. T., & Sudore, R. L. (2018). Patient activation: A key component of successful advance care planning. Journal of Palliative Medicine, 21(12), 1778-1782.
  • Donabedian, A. (1988). The quality of care: How can it be assessed? JAMA, 260(12), 1743-1748.
  • Devlin N. J., Shah K. K., Feng Y., Mulhern B., & Hout B. (2018). Valuing health-related quality of life: An EQ-5D-5L value set For England. Health Economics, 27(1), 7-22.
  • van Egdom, L. S. E., Lagendijk, M., van der Kemp, M. H., van Dam, J. H., Mureau, M. A. M., Hazelzet, J. A., & Koppert, L. B. (2019). Implementation of value based breast cancer care. European Journal of Surgical Oncology, 45(7), 1163-1170.
  • Elf, M., Flink, M., Nilsson, M., Tiastad, M., & Von Koch, L. (2017). The Case of Value-Based Healthcare for People Living with Complex Long-Term Conditions. BMC Health Services Research, 17(1), 17-24.
  • Elton, J., & O'Riordan, A. (2016). Healthcare disrupted: Next generation business models and strategies. John Wiley & Sons.
  • Erekson, E. A., & Iglesia, C. B. (2015). Improving patient outcomes in gynecology:The role of large data registries and big data analytics . J. Minim İnvasive Gynecol, 22(7), 1124-1129.
  • EUPATI-European Patient’s Academy on Therapeutic Innovation (2016). Measuring health-related quality of life (HRQoL), 1-10.
  • Franklin, E. F., Nichols, H. M., Charap, E., & Buzaglo, J. S. (2019). Perspectives of patients with cancer on the quality-adjusted life year as a measure of value in healthcare. ScienceDirect, 22(4), 474-481.
  • Gilboa, I., & Marinacci, M. (2016). Ambiguity and the bayesian paradigm. In H. Arlo-Costa, V. F. Hendricks, & J. V. Benthem, Reading in formal epistemology (pp. 385-439). Switzerland, Springer Cham.
  • Haas, D. A., Helmers, R. A., Rucci, M., Brady, M., & Kaplan, R. (2015). The Mayo Clinic model for running a value-improvement program. HBR, October, 1-2.
  • Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., Kind, P., Parkin, D., Bonsel, G. & Badia, X. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727-1736.
  • Hibbard, J. H., & Mahoney, E. (2010). Toward a theory of patient and consumer activation. Patient Education and Counselling, 78(3), 377-381. Hibbard, J. H., Mahoney, E., Stock, R., & Tusler, M. (2007). Do increase in patient activation result in improved self-management behaviors? Health Services Research, 42(4), 1443-1463.
  • Hibbard, J. H., & Cunningham, P. J. (2008). How engaged are consumers in their health and health care and why does it matter? Res Brief, 8, 1-9.
  • ICHOM (2021, February 25). What is value-based health care. http:// www.ichom.org/why-measure-outcomes.
  • Insignia Health (2020, May 12). Patient activation measure (PAM). http://www.insigniahealth.com/products/pam-survey.
  • Kalina, P. (2020). Ethical philanthropy in the era of patient-centric, value-based health care . Archives of Business Research, 8, 225-229.
  • Kampstra, N. A., Zipfel, N., Van der Nat, P. B., & Westert, G. P. (2018). Health outcomes measurement and organizational readiness support quality improvement:A systematic review. BMC Health Services Research, 18(1), 1005.
  • Kaplan, R. S., & Porter M. E. (2011) How to solve the cost crisis in health care. Harvard Business Review 89(9), 46-52.
  • Kolarczyk, L. M., Arora, H., Manning, M. W., Zvara, D. A., & Isaak, R. S. (2018). Defining value-based care in cardiac and vascular anesthesiology: The past, present and future of perioperative cardiovascular care. Journal of Cardiothoracic and Vascular Anesthesia, 32(1), 512-521.
  • Lee, K. K. H., Austin, J. M., & Pronovost, P. J. (2016). Developing a measure of value in health care. Value in Health, 19(4), 323-325.
  • Leung, T. I., & Merode, G. G. (2019). Value-based health care supported by data science. In P. Kubben, M. Dumontier, & A. Dekker, Fundamentals of clinical data science (pp. 193-212). Cham, Springer.
  • Liu, T. C., Bozic, K. J., & Teisberg, E. O. (2017). Value-based healthcare: Person-centered measurement: Focusing on the three C's. Clinical Orthopaedics and Related Research, 475(2), 315-317.
  • Liu, Y., Andreas, B., & Aebersold, R. (2016). On the dependency of cellularprotein levels on mRNA Abundance. Cell,165(3), 535-550.
  • Moraros, J., Lemstra, M., & Nwankwo, C. (2016). Lean interventions in healthcare: Do they actually work? A systematic literature review. International Journal for Quality in Health Care, 28(2), 150-165.
  • Moriates, C., Mourad, M., & Wachter, R. M. (2014). Development of a hospital-based program focused on improving healthcare value. Journal of hospital medicine, 9(10), 671-677.
  • Nilsson, K., Baathe, F., Andersson, A., & Sandoff, M. (2018). The need to succeed-learning experiences resulting from the implementation of value-based healthcare. Leadership in Health Services, 31(1), 2-16.
  • Nordin, P., Kork, A. A., & Koskela, I. (2017). Value-based healthcare measurement as a context for organizational learning. Leadership in Health Services, 30(2), 159-170.
  • Pantaleon, L. (2019). Why measuring outcome is important in health care. Journal of Veterinary Internal Medicine, 33(2), 356-362.
  • Porter, M. E. (1991). Towards a dynamic theory of strategy: Special issue. Strategic Management Journal, 12(2), 95-117.
  • Porter, M. E. (1997). Competitive strategy. Measuring Business Excellence, 1(2), 12-17.
  • Porter, M. E., & Teisberg, E. O. (2006). Redefining healthcare-creating value-based competition. Boston: Harvard Business School Press.
  • Porter, M. E. (2009). A strategy for health care reform-toward a value-based system. The New England Journal of Medicine, 361(2), 109-112.
  • Porter, M. E. (2010). What is value in healthcare? New England Journal of Medicine, 363(26), 2477-2481.
  • Porter, M. E., & Lee, T. H. (2013). The strategy that will fix health care. Harvard Business Review, 91(12), 50-70.
  • Porter, M. E. (2014). Value-based health care delivery. Harvard Business School Partnetrs Healthcare Value Based Health Care Seminar (pp. 1-35). Harvard Business Review.
  • Porter, M. E., Jarsson, S., & Lee, T. H. (2016). Standardizing patient outcomes measurement. New England Journal of Medicine, 374(6), 504-506.
  • Raza, M., Jawaid, A., & Ikram, M. (2018). The effect of interventions on quality adjusted life years (QALY) of dialysis patients. Gomal University Journal of Research, 34(2), 73-79.
  • Roben, E., Johnson, J., & Verghese, G. R. (2018). Value-based health care in the pediatric emergency department. Clinical Pediatric Emergency Medicine, 19(4), 312-316.
  • Seyfioğlu, E. F. (2019a). Değer temelli sağlık hizmeti pazarlamasına stratejik yaklaşımlar: Bir Model Önerisi. (Yayınlanmamış Doktora Tezi). Beykent Üniversitesi, İstanbul.
  • Seyfioğlu, E. F. (2019b). Değer temelli sağlık hizmetleri modeli. Hacettepe Sağlık İdaresi Dergisi, 22(4), 799-822.
  • Stavrianopoulos, T. (2016). Impact of a nurses-led telephone intervention program on the quality of life in patients with heart failure in a district hospital of Greece. Health Science Journal, 10(4), 1-8.
  • Teisberg, E. O., & Wallace, S. (2016). Value for patients. Brain Injury, 12(2), 8-11.
  • TÜİK. (2020, 21 Haziran ). Sağlık harcamaları istatistikleri. http:// www.tuik.gov.tr.
  • Van der Nat, P. B., Van Veghel, D., Daeter, E., Crijns, H. J., Koolen, J., Houterman, S., ... & Meetbaar Beter Study Group. (2020). Insights on value-based healthcare implementation from Dutch heart care. International Journal of Healthcare Management, 13(3), 189-192.
  • Wallace, S., & Teisberg, E. O. (2016). Measuring what matters: Connecting excellence, professionalism and empathy. Brain Injury, 12(2), 12-14.
  • Walsh, A. P., Harrington, D., & Hines, P. (2020). Are hospital managers ready for value-based healthcare. International Journal of Organizational Analysis, 28(1), 49-65.
  • Zipfel, N., Van der Nat, P. B., Rensing, B. J., & Daeter, E. J. (2019). The implementation of change model adds value to value-based healthcare: A qualitative study. BMC Health Services Research, 19(1), 1-12.

Year 2021, Volume: 24 Issue: 2, 399 - 414, 23.06.2021

E. Fatma Seyfioğlu N. Ümit Başdaş

Abstract

References

  • Alahdab, H. (2019). Sağlık hizmet kalitesinde hastanın rolü. Sağlıkta Kalite ve Akreditasyon Dergisi, 2(1), 22-26.
  • Anderson, A. E., Baathe, F., Wikstrom, E., & Nilsson, K. (2015). Understanding value-based healthcare- an interview study with project team members at a Swedish University Hospital. Journal of Hospital Administration, 4(4), 64-72.
  • Bayın Donar, G. (2019). Diyaliz tedavisi alan hastaların sağlık hizmeti kullanımı ve yaşam kalitesini etkileyen faktörlerin belirlenmesi. (Yayımlanmamış Doktora Tezi). Hacettepe Üniversitesi, Ankara.
  • Catalyst, N. J. (2017). What is value-based healthcare? NEJM Catalyst, 3(1), 1-6.
  • David, D., Barnes, D. E., McMahan, R. D., Shi, Y., Katen, M. T., & Sudore, R. L. (2018). Patient activation: A key component of successful advance care planning. Journal of Palliative Medicine, 21(12), 1778-1782.
  • Donabedian, A. (1988). The quality of care: How can it be assessed? JAMA, 260(12), 1743-1748.
  • Devlin N. J., Shah K. K., Feng Y., Mulhern B., & Hout B. (2018). Valuing health-related quality of life: An EQ-5D-5L value set For England. Health Economics, 27(1), 7-22.
  • van Egdom, L. S. E., Lagendijk, M., van der Kemp, M. H., van Dam, J. H., Mureau, M. A. M., Hazelzet, J. A., & Koppert, L. B. (2019). Implementation of value based breast cancer care. European Journal of Surgical Oncology, 45(7), 1163-1170.
  • Elf, M., Flink, M., Nilsson, M., Tiastad, M., & Von Koch, L. (2017). The Case of Value-Based Healthcare for People Living with Complex Long-Term Conditions. BMC Health Services Research, 17(1), 17-24.
  • Elton, J., & O'Riordan, A. (2016). Healthcare disrupted: Next generation business models and strategies. John Wiley & Sons.
  • Erekson, E. A., & Iglesia, C. B. (2015). Improving patient outcomes in gynecology:The role of large data registries and big data analytics . J. Minim İnvasive Gynecol, 22(7), 1124-1129.
  • EUPATI-European Patient’s Academy on Therapeutic Innovation (2016). Measuring health-related quality of life (HRQoL), 1-10.
  • Franklin, E. F., Nichols, H. M., Charap, E., & Buzaglo, J. S. (2019). Perspectives of patients with cancer on the quality-adjusted life year as a measure of value in healthcare. ScienceDirect, 22(4), 474-481.
  • Gilboa, I., & Marinacci, M. (2016). Ambiguity and the bayesian paradigm. In H. Arlo-Costa, V. F. Hendricks, & J. V. Benthem, Reading in formal epistemology (pp. 385-439). Switzerland, Springer Cham.
  • Haas, D. A., Helmers, R. A., Rucci, M., Brady, M., & Kaplan, R. (2015). The Mayo Clinic model for running a value-improvement program. HBR, October, 1-2.
  • Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., Kind, P., Parkin, D., Bonsel, G. & Badia, X. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727-1736.
  • Hibbard, J. H., & Mahoney, E. (2010). Toward a theory of patient and consumer activation. Patient Education and Counselling, 78(3), 377-381. Hibbard, J. H., Mahoney, E., Stock, R., & Tusler, M. (2007). Do increase in patient activation result in improved self-management behaviors? Health Services Research, 42(4), 1443-1463.
  • Hibbard, J. H., & Cunningham, P. J. (2008). How engaged are consumers in their health and health care and why does it matter? Res Brief, 8, 1-9.
  • ICHOM (2021, February 25). What is value-based health care. http:// www.ichom.org/why-measure-outcomes.
  • Insignia Health (2020, May 12). Patient activation measure (PAM). http://www.insigniahealth.com/products/pam-survey.
  • Kalina, P. (2020). Ethical philanthropy in the era of patient-centric, value-based health care . Archives of Business Research, 8, 225-229.
  • Kampstra, N. A., Zipfel, N., Van der Nat, P. B., & Westert, G. P. (2018). Health outcomes measurement and organizational readiness support quality improvement:A systematic review. BMC Health Services Research, 18(1), 1005.
  • Kaplan, R. S., & Porter M. E. (2011) How to solve the cost crisis in health care. Harvard Business Review 89(9), 46-52.
  • Kolarczyk, L. M., Arora, H., Manning, M. W., Zvara, D. A., & Isaak, R. S. (2018). Defining value-based care in cardiac and vascular anesthesiology: The past, present and future of perioperative cardiovascular care. Journal of Cardiothoracic and Vascular Anesthesia, 32(1), 512-521.
  • Lee, K. K. H., Austin, J. M., & Pronovost, P. J. (2016). Developing a measure of value in health care. Value in Health, 19(4), 323-325.
  • Leung, T. I., & Merode, G. G. (2019). Value-based health care supported by data science. In P. Kubben, M. Dumontier, & A. Dekker, Fundamentals of clinical data science (pp. 193-212). Cham, Springer.
  • Liu, T. C., Bozic, K. J., & Teisberg, E. O. (2017). Value-based healthcare: Person-centered measurement: Focusing on the three C's. Clinical Orthopaedics and Related Research, 475(2), 315-317.
  • Liu, Y., Andreas, B., & Aebersold, R. (2016). On the dependency of cellularprotein levels on mRNA Abundance. Cell,165(3), 535-550.
  • Moraros, J., Lemstra, M., & Nwankwo, C. (2016). Lean interventions in healthcare: Do they actually work? A systematic literature review. International Journal for Quality in Health Care, 28(2), 150-165.
  • Moriates, C., Mourad, M., & Wachter, R. M. (2014). Development of a hospital-based program focused on improving healthcare value. Journal of hospital medicine, 9(10), 671-677.
  • Nilsson, K., Baathe, F., Andersson, A., & Sandoff, M. (2018). The need to succeed-learning experiences resulting from the implementation of value-based healthcare. Leadership in Health Services, 31(1), 2-16.
  • Nordin, P., Kork, A. A., & Koskela, I. (2017). Value-based healthcare measurement as a context for organizational learning. Leadership in Health Services, 30(2), 159-170.
  • Pantaleon, L. (2019). Why measuring outcome is important in health care. Journal of Veterinary Internal Medicine, 33(2), 356-362.
  • Porter, M. E. (1991). Towards a dynamic theory of strategy: Special issue. Strategic Management Journal, 12(2), 95-117.
  • Porter, M. E. (1997). Competitive strategy. Measuring Business Excellence, 1(2), 12-17.
  • Porter, M. E., & Teisberg, E. O. (2006). Redefining healthcare-creating value-based competition. Boston: Harvard Business School Press.
  • Porter, M. E. (2009). A strategy for health care reform-toward a value-based system. The New England Journal of Medicine, 361(2), 109-112.
  • Porter, M. E. (2010). What is value in healthcare? New England Journal of Medicine, 363(26), 2477-2481.
  • Porter, M. E., & Lee, T. H. (2013). The strategy that will fix health care. Harvard Business Review, 91(12), 50-70.
  • Porter, M. E. (2014). Value-based health care delivery. Harvard Business School Partnetrs Healthcare Value Based Health Care Seminar (pp. 1-35). Harvard Business Review.
  • Porter, M. E., Jarsson, S., & Lee, T. H. (2016). Standardizing patient outcomes measurement. New England Journal of Medicine, 374(6), 504-506.
  • Raza, M., Jawaid, A., & Ikram, M. (2018). The effect of interventions on quality adjusted life years (QALY) of dialysis patients. Gomal University Journal of Research, 34(2), 73-79.
  • Roben, E., Johnson, J., & Verghese, G. R. (2018). Value-based health care in the pediatric emergency department. Clinical Pediatric Emergency Medicine, 19(4), 312-316.
  • Seyfioğlu, E. F. (2019a). Değer temelli sağlık hizmeti pazarlamasına stratejik yaklaşımlar: Bir Model Önerisi. (Yayınlanmamış Doktora Tezi). Beykent Üniversitesi, İstanbul.
  • Seyfioğlu, E. F. (2019b). Değer temelli sağlık hizmetleri modeli. Hacettepe Sağlık İdaresi Dergisi, 22(4), 799-822.
  • Stavrianopoulos, T. (2016). Impact of a nurses-led telephone intervention program on the quality of life in patients with heart failure in a district hospital of Greece. Health Science Journal, 10(4), 1-8.
  • Teisberg, E. O., & Wallace, S. (2016). Value for patients. Brain Injury, 12(2), 8-11.
  • TÜİK. (2020, 21 Haziran ). Sağlık harcamaları istatistikleri. http:// www.tuik.gov.tr.
  • Van der Nat, P. B., Van Veghel, D., Daeter, E., Crijns, H. J., Koolen, J., Houterman, S., ... & Meetbaar Beter Study Group. (2020). Insights on value-based healthcare implementation from Dutch heart care. International Journal of Healthcare Management, 13(3), 189-192.
  • Wallace, S., & Teisberg, E. O. (2016). Measuring what matters: Connecting excellence, professionalism and empathy. Brain Injury, 12(2), 12-14.
  • Walsh, A. P., Harrington, D., & Hines, P. (2020). Are hospital managers ready for value-based healthcare. International Journal of Organizational Analysis, 28(1), 49-65.
  • Zipfel, N., Van der Nat, P. B., Rensing, B. J., & Daeter, E. J. (2019). The implementation of change model adds value to value-based healthcare: A qualitative study. BMC Health Services Research, 19(1), 1-12.
There are 52 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Makaleler
Authors

E. Fatma Seyfioğlu This is me 0000-0002-5410-1558

N. Ümit Başdaş This is me 0000-0002-9755-0134

Publication Date June 23, 2021
Published in Issue Year 2021 Volume: 24 Issue: 2

Cite

APA Seyfioğlu, E. F., & Başdaş, N. Ü. (2021). DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ. Hacettepe Sağlık İdaresi Dergisi, 24(2), 399-414.
AMA Seyfioğlu EF, Başdaş NÜ. DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ. HSİD. June 2021;24(2):399-414.
Chicago Seyfioğlu, E. Fatma, and N. Ümit Başdaş. “DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ”. Hacettepe Sağlık İdaresi Dergisi 24, no. 2 (June 2021): 399-414.
EndNote Seyfioğlu EF, Başdaş NÜ (June 1, 2021) DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ. Hacettepe Sağlık İdaresi Dergisi 24 2 399–414.
IEEE E. F. Seyfioğlu and N. Ü. Başdaş, “DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ”, HSİD, vol. 24, no. 2, pp. 399–414, 2021.
ISNAD Seyfioğlu, E. Fatma - Başdaş, N. Ümit. “DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ”. Hacettepe Sağlık İdaresi Dergisi 24/2 (June 2021), 399-414.
JAMA Seyfioğlu EF, Başdaş NÜ. DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ. HSİD. 2021;24:399–414.
MLA Seyfioğlu, E. Fatma and N. Ümit Başdaş. “DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ”. Hacettepe Sağlık İdaresi Dergisi, vol. 24, no. 2, 2021, pp. 399-14.
Vancouver Seyfioğlu EF, Başdaş NÜ. DEĞER TEMELLİ SAĞLIK HİZMETLERİNDE BİR DEĞER BİLEŞENİ OLAN HASTA SONUÇLARININ ÖLÇÜMÜ VE ÖNEMİ. HSİD. 2021;24(2):399-414.
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