The Efficiency of Health Services in the Provinces of the Ottoman State: The Year 1897

Year 2025, Volume: 26 Issue: 1, 16 - 28, 31.01.2025

Şahin Yeşilyurt , Abdullah Tirgil

https://doi.org/10.26650/oba.1454701

Abstract

This study examines technical efficiency scores in producing health outcomes of hospital discharges and hospital visits for the twenty-eight Ottoman State provinces. We measure efficiency scores by implementing data envelopment analysis using the first statistical yearbook of the Ottoman State for 1897. Our findings indicate that some provinces achieve relative efficiency, including Dersaadet, Jerusalem, Adana, and Aydın with good health outcomes, Biga and Benghazi with moderate health outcomes, and Yemen with lousy health outcomes. Our results also suggest that inefficient provinces can substantially reduce their inputs without reducing hospital discharges and maintaining the same hospital visits. As a result, this study measures the efficiency of health services in the Ottoman State for 1897.

Keywords

Health, efficiency, Ottoman economy, health in Ottoman economy, health policy

Osmanlı Devleti Vilayetlerinde Sağlık Hizmetlerinin Etkinliği: 1897 Yılı

Abstract

Bu çalışma, 28 Osmanlı Devleti vilayeti için hastaneden taburcu olma ve hastane müracaat sayıları sağlık sonuçlarının üretilmesinde teknik etkinlik skorlarını incelemektedir. Etkinlik sonuçlarını, Osmanlı Devleti’nin 1897 tarihli ilk istatistik yıllığını kullanarak veri zarflama analizi uygulayarak ölçmekteyiz. Bulgularımız, iyi sağlık sonuçlarıyla Dersaadet, Kudüs, Adana ve Aydın, orta sağlık sonuçlarıyla Biga ve Bingazi ve kötü sağlık sonuçlarıyla Yemen gibi bazı vilayetlerin göreli verimlilik elde ettiğini göstermektedir. Sonuçlarımız ayrıca, etkin olmayan vilayetlerin hastane taburcu ve hastane müracaat oranlarını azaltmadan girdilerini önemli ölçüde azaltabileceğini göstermektedir. Sonuç itibariyle, bu çalışma Osmanlı’da sağlık hizmetlerinin etkinliğini 1897 yılı için ölçmektedir.

Keywords

Sağlık, etkinlilik, Osmanlı ekonomisi, Osmanlı ekonomisinde sağlık, sağlık politikası

Ethical Statement

NA

References

• İdare-i Umumiye-i TıbbiYe Nizamnamesi, Düstur, Tertip I, 2, 800-803. https://isamveri.org/pdfdrg/D02894/2007_3/2007_3_AKMANM.pdf google scholar
• Tababet-i BeLediye İcrasına Dair Nizamname, Düstur, Tertip I, 2, 814-816. https://isamveri.org/pdfdrg/D02894/2007_3/2007_3_AKMANM. pdf google scholar
• Vilayet-i İdare-i Sıhhiye Nizamnamesi, Düstur, Tertip II, 5, 362-366. https://search.trdizin.gov.tr/tr/Yayin/detay/60153/ google scholar
• ALexander, John, and Sophia Laiou. “HeaLth and PhiLanthropY Among the üttoman ürthodox PopuLation, Eighteenth to EarLY Nineteenth google scholar
• Century.” Turkish Historical Review 5 (2014): 1-15. https://www.academia.edu/14489386/_HeaLth_and_PhiLanthropY_among_the_ üttoman_ürthodox_PopuLation_Eighteenth_to_EarLY_Nineteenth_CenturY_Turkish_HistoricaL_Review_5_2014_1_15 google scholar
• AYaLon, Yaron. “ReLigion and üttoman SocietY’s Responses to Epidemics in the Seventeenth and Eighteenth Centuries.” In Plague and Contagion in the Islamic Mediterranean, edited bY Nükhet VarLık, 179-198. Arc Humanities Press, 2017. https://dokumen.pub/ qdownLoad/pLague-and-contagion-in-the-isLamic-mediterranean-1942401159-9781942401155.htmL google scholar
• AYdın, Erdem. “19. YüzYıL üsmanLı SağLık TeşkiLatLanması.” Ankara Üniversitesi Osmanlı Tarihi Araştırma ve Uygulama Merkezi Dergisi 15 (2004): 185-207. https://doi.org/10.1501/üTAM_0000000511 google scholar
• Banker, R. D., A. Charnes, and W. W. Cooper. “Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment AnaLYsis.” Management Science 30(9) (1984): 1078-1092. http://www.jstor.org/stabLe/2631725 google scholar
• Isacar A. BoLahos. “The üttomans During the Global Crises of ChoLera and PLague: The View from lraq and The Gulf.” International Journal of Mlddle East Studles 51 (2019): 603-620. https://www.academia.edu/82523790/_The_Ottomans_During_the_GLobaL_Crises_of_ ChoLera_and_PLague_The_View_from_Iraq_and_the_GuLf_?f_ri=153220, google scholar
• Boyar, Ebru. “Medicine in Practice: European Influences on the üttoman MedicaL Habitat.” Turklsh Hlstorlcal Revlew 9 (2018): 213-241. https://www.academia.edu/42283715/Medicine_in_practice_European_influences_on_the_üttoman_medicaL_habitat google scholar
• Bulmuş, Birsen. Plague, Quarantlnes And Geopolltlcs ln the Ottoman Emplre. Edinburg: Edinburg UniversitY Press, 2012. https://www. researchgate.net/pubLication/303420354_PLague_Quarantines_and_GeopoLitics_in_the_üttoman_Empire google scholar
• Charnes, A., W. W. Cooper, and E. Rhodes. “Measuring The EfficiencY of Decision Making Units.” European Journal of Operatlonal Research 2(6) (1978): 429-444. https://doi.org/10.1016/0377-2217(78)90138-8 google scholar
• Coelli, Tim. “A Guide to DEAP Version 2.1: A Data EnveLopment AnaLYsis (Computer) Program.” Centre for Efficlency and Productlvlty Analysls 96(8) (1996): 1-49. https://www.owLnet.rice.edu/~econ380/DEAP.PDF google scholar
• Coelli, TimothY J., D.S. Prasada Rao, Christopher J. ü’DonneLL, and George E. Battese. An Introductlon to Efficlency and Productlvlty Analysls. Springer Science & Business Media, 2005. https://www.researchgate.net/pubLication/37621826_An_Introduction_to_ EfficiencY_and_ProductivitY_AnaLYsis google scholar
• Güran, Tevfik. Osmanlı Devletlnln İlk İstatlstlk Yıllığı. Ankara: TürkiYe İstatistik Kurumu Matbaası, T.C. BaşbakanLık DevLet İstatistik Enstitüsü 1997. https://kutuphane.ttk.gov.tr/detaiLs?id=429690&materiaLTYpe=KT&querY=Tevfik google scholar
• Hobson, William, The Theory and Practlce of Publlc Health. Oxford: Oxford University Press 1965. google scholar
• Ianeva, SvetLa. “HYgiene In Nineteenth-CenturY üttoman BuLgaria.” Turklsh Hlstorlcal Revlews 5 (2014): 16-31. https://www.researchgate. net/pubLication/273601680_HYgiene_in_Nineteenth-CenturY_üttoman_BuLgaria google scholar
• Ji, Yong-bae, and Choonjoo Lee. “Data EnveLopment AnaLYsis.” The Stata Journal 10(2) (2010): 267-280. https://econpapers.repec.org/ articLe/tsjstataj/v_3a10_3aY_3a2010_3ai_3a2_3ap_3a267-280.htm google scholar
• LowrY, Heath W. “Pushing The Stone UphiLL: The Impact of Bubonic PLague on üttoman Urban SocietY in the Fifteenth and Sixteenth Centuries.” Osmanlı Araştırmaları 23 (2003): 93-132. https://dergipark.org.tr/tr/pub/oa/issue/10955/130953 google scholar
• Mossensohn, Miri Shefer. “HeaLth as a SociaL Agent in üttoman Patronage and AuthoritY.” New Perspectlves on Turkey 37 (2007): 147-175. google scholar
• https://www.researchgate.net/pubLication/295263709_HeaLth_as_a_SociaL_Agent_in_üttoman_Patronage_and_AuthoritY google scholar
• Mossensohn, Miri Shefer. “The ManY Masters of üttoman HospitaLs: Between The ImperiaL PaLace, The Harem, BureaucracY, and the MusLim Law Courts.” Turklsh Hlstorlcal Revlew 5 (2014): 94-114. https://www.researchgate.net/pubLication/270721110_The_ManY_ Masters_of_üttoman_HospitaLs_Between_the_ImperiaL_PaLace_the_Harem_BureaucracY_and_the_MusLim_Law_Courts google scholar
• MurpheY, Rhoads. “üttoman Medicine and TranscuLturaLism from the Sixteenth Through the Eighteenth CenturY.” Bulletln of the Hlstory of Medlclne 66(3) (1992): 376-403. https://www.jstor.org/stabLe/44442674 google scholar
• Panzac, DanieL. “PLague” İn Encyclopedla of the Ottoman Emplre, edited bY Gâbor Âgoston and Bruce Masters, Facts on File, İne., An imprint of Infobase PubLishing, 2009. google scholar
• Rafeq, AbduL-Karim. “TraditionaL and İnstitutionaL Medicine in üttoman Damascus.” Turklsh Hlstorlcal Revlew 6 (2015): 76-102.https:// schoLarworks.aub.edu.Lb/bitstream/handLe/10938/23593/NabuLsiDana.pdf?sequence=3 google scholar
• RetzLaff-Roberts, Donna, CYriL F. Chang, and Rose M. Rubin. 2004. “TechnicaL EfficiencY in the Use of HeaLth Care Resources: A Comparison of üECD Countries.” Health Pollcy 69 (2004): 55-72. https://doi.org/10.1016/j.heaLthpoL.2003.12.002 google scholar
• Robarts, Andrew. “Nowhere to Run to, Nowhere to Hide? Society, State, and Epidemic Diseases in the Early Nineteenth-Century Ottoman Balkans.” in Plague and Contaglon ln The Islamlc Medlterranean, edited bY Nükhet VarLık, 221-242. Arc Humani-ties Press, 2017. https://www.academia.edu/33263821/PLague_and_Contagion_in_the_İsLamic_Mediterranean_New_Histories_of_ Disease_in_üttoman_SocietY_KaLamazoo_Mİ_ARC_Humanities_Press_2017_ google scholar
• Samut, Pınar Kaya and Reyhan Cafrı. “Analysis of the Efficiency Determinants of HeaLth SYstems in OECD Countries BY DEA and Panel Tobit.” Social Indlcators Research 129(1) (2016): 113-132. https://www.jstor.org/stabLe/48715278 google scholar
• Sarı, NiL. “Mekteb-i Tıbbiyye” DiYanet İslam Ansiklopedisi, 29 (2004): 2-5. https://isLamansikLopedisi.org.tr/mekteb-i-tibbiYYe google scholar
• SarıYıLdız, GüLden. “OsmanLıLar’da Hıfzısıhha” DiYanet İsLam AnsikLopedisi, 17 (2004) 319-321. https://isLamansikLopedisi.org.tr/ hifzissihha google scholar
• Sayılı, AYdın. “The Emergence of the Prototype of the Modern HospitaL in Medieval İslam.” Belleten 44(174) (1980): 279-286. https:// dergipark.org.tr/tr/pub/ttkbeLLeten/issue/72101/1160658 google scholar
• Şehsuvaroğlu, Bedi N. İstanbulda 500 Yıllık Sağlık Hayatımız. İstanbul: İstanbul Fethi Neşriyatı, 1953. google scholar
• Uludağ, Osman Şevki. 1991. Beşbuçuk Asırlık Türk Tababeti Tarihi. Ankara: Kültür Bakanlığı Yayınları, 1991. google scholar
• Varlık, Nükhet. Plague and Empire in the EariyModern Mediterranean World The üttoman Experience. 1347-1600. Cambridge: Cambridge UniversitY Press, 2015. https://www.academia.edu/15327877/PLague_and_Empire_in_the_EarLY_Modern_Mediterranean_WorLd_ The_üttoman_Experience_1347_1600_Cambridge_Cambridge_UniversitY_Press_2015_ISBN_9781107013384 google scholar
• Yılmaz, Coşkun and Yılmaz, Cevdet. Osmanlılarda Sağlık I, II. İstanbul: Biofarma 2006. google scholar
• White, Sam. “A Model Disaster: From the Great üttoman Panzootic to the CattLe PLagues of Early Modern Europe.” In Plague and Contagion In The Islamic Mediterranean. Edited by Nükhet Varlık. 91-116. Arc Humanities Press, 2017. google scholar