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Changes in Barriers to Accessing Health Care Services Over Time and Their Effects on Treatable Mortality Rates: A Panel Data Approach on European Union Countries

Yıl 2025, Cilt: 47 Sayı: 5, 784 - 795, 04.09.2025
https://doi.org/10.20515/otd.1686165

Öz

Unmet healthcare needs often degrade individuals' health status and can lead to death due to the inability to address health needs. The purpose of the current study is to reveal the impact of unmet healthcare needs on treatable deaths. This study is a longitudinal study conducted with data from 27 European Union member countries between 2011 and 2021. The data in the study were extracted from individual declaration reports on unmet healthcare needs published on the Eurostat website. Treatable deaths were included in the model as the dependent variable, while cost, waiting time, and distance were included as independent variables. Analyses were performed using Jamovi Version 2.4. The findings indicate that, in the model constructed without including the time unit, cost and waiting time statistically significantly and positively affect deaths from treatable causes, whereas distance shows no statistically significant effect. With the inclusion of the time unit, it was found that only waiting time significantly and positively affects treatable deaths, while other variables have no significant effect. Furthermore, the time variable itself was observed to positively affect treatable deaths in all other years compared to 2011. This study sheds light on critical issues in the healthcare system by examining the impact of barriers to healthcare access on treatable deaths. The analysis results show that, especially long waiting times, have a significant and consistent positive effect on treatable deaths. This is consistent with the literature suggesting that delays in accessing healthcare negatively affect the treatment of diseases requiring timely intervention and increase the risk of mortality.

Etik Beyan

Since this study was prepared from secondary data, ethics committee approval was not required. Ethical rules were followed throughout the research.

Destekleyen Kurum

No

Proje Numarası

Yok

Teşekkür

No

Kaynakça

  • 1. World Health Assembly. Sustainable Health Financing, Universal Coverage and Social Health Insurance. https://iris.who.int/handle/10665/20383 Erişim 12.07.2025.
  • 2. World Health Organization. Universal health coverage (UHC). https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc) Erişim 12.07.2025.
  • 3. Nolte E, McKee M. Does Healthcare Save Lives? Avoidable Mortality Revisited. London: Published by The Nuffield Trust, 2004: 138.
  • 4. MacKenbach JP. Socioeconomic Inequalities in Health in the Netherlands: Impact of a Five-Year Research Programme. BMJ: British Medical Journal, (1994). 309(6967), 1487–91.
  • 5. OECD. Health at a Glance 2017: OECD Indicators. Paris: OECD Publishing.
  • 6. Bayefsky AF. Office of the United Nations High Commissioner for Human Rights. In: Bayefsky A, editor. The UN Human Rights Treaty System in the 21 Century. Brill | Nijhoff, (2000). 451–458.
  • 7. Stuart K, Soulsby E. Reducing global health inequalities. Part 1. J R Soc Med. (2011).104(8), 321–6.
  • 8. Bucciardini R, Zetterquist P, Rotko T, Putatti V, Mattioli B, De Castro P, et al. Addressing health inequalities in Europe: key messages from the Joint Action Health Equity Europe (JAHEE). Arch Public Health, (2023). 81-89.
  • 9. Dawkins B, Renwick C, Ensor T, Shinkins B, Jayne D, Meads D. What factors affect patients’ ability to access healthcare? An overview of systematic reviews. Tropical Medicine & International Health, (2021). 26(10):1177–1188.
  • 10. Forster T, Kentikelenis A, Bambra C. Health Inequalities in Europe: in Europe. https://feps-europe.eu/wp-content/uploads/downloads/publications/1845-6%20health%20inequalities%20inner-hr.pdf Erişim 12.07.2025.
  • 11. Baciu A, Negussie Y, et al. The Root Causes of Health Inequity. In: Communities in Action: Pathways to Health Equity. United State of America: National Academies Press, 2017.
  • 12. Turner AJ, Francetic I, Watkinson R, Gillibrand S, Sutton M. Socioeconomic inequality in access to timely and appropriate care in emergency departments. Journal of Health Economics, (2022). 85:102668.
  • 13. Ford J, Sowden S, Olivera J, Bambra C, Gimson A, Aldridge R, et al. Transforming health systems to reduce health inequalities. Future Healthc J, (2021). 8(2):e204–9.
  • 14. Case A, Kraftman L. Health inequalities. Oxford Open Economics, (2024). 3(Supplement_1):i499–528.
  • 15. McCartney G, Popham F, McMaster R, Cumbers A. Defining health and health inequalities. Public Health, (2019). 172:22–30.
  • 16. Gaspar A, Miranda JJ. Burden of treatment as a measure of healthcare quality: An innovative approach to addressing global inequities in multimorbidity. PLOS Glob Public Health, (2022). 2(5):e0000484.
  • 17. Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health, (2018). 6:e1196–252.
  • 18. Marmot M. Health equity in England: The Marmot review 10 years on. BMJ, (2020). 368:m693.
  • 19. Dabla-Norris E, Kochhar K, Ricka F, Tsounta E. Causes and Consequences of Income Inequality: A Global Perspective. (2015). 2 (3).
  • 20. WHO Regional Office for Europe. Environmental health inequalities in Europe. Copenhagen: WHO. https://iris.who.int/bitstream/handle/10665/325176/9789289054157-eng.pdf Erişim 12.07.2025.
  • 21. Chai KC, Zhang YB, Chang KC. Regional Disparity of Medical Resources and Its Effect on Mortality Rates in China. Front Public Health. (2020). 8:8.
  • 22. Farmer P, Kleinman A, Kim J, Basillico M. Reimagining Global Health. 1st Edition, 2013: 504.
  • 23. Kruk ME, Gage AD, Joseph NT, Danaei G, García-Saisó S, Salomon JA. Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. The Lancet, (2018). 392(10160): 2203–12.
  • 24. Ndubuisi NE. Noncommunicable Diseases Prevention in Low- and Middle-Income Countries: An Overview of Health in All Policies (HiAP). Inquiry, (2021). 58:0046958020927885.
  • 25. United Nations U. United Nations. United Nations. https://www.un.org/en/global-issues/health Erişim 12.07.2025.
  • 26. Rockville (MD): Agency for Healthcare Research and Quality. National Healthcare Quality and Disparities Report. US: Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK578537/ Erişim 12.07.2025.
  • 27. Hoel M, Saether E. Public Health Care with Waiting Time: The Role of Supplementary Private Health Care. Journal of health economics, (2003). 22, 599–616.
  • 28. Sartini M, Carbone A, Demartini A, Giribone L, Oliva M, Spagnolo AM, et al. Overcrowding in Emergency Department: Causes, Consequences, and Solutions—A Narrative Review. Healthcare (Basel), (2022). 10(9):1625.
  • 29. Yee CA, Legler A, Davies M, Prentice J, Pizer S. Priority access to health care: Evidence from an exogenous policy shock. Health Econ (2020). 29(3), 306–23.
  • 30. Coombs NC, Campbell DG, Caringi J. A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access. BMC Health Serv Res, (2022). 22: 438.
  • 31. Evans MV, Andréambeloson T, Randriamihaja M, Ihantamalala F, Cordier L, Cowley G, et al. Geographic barriers to care persist at the community healthcare level: Evidence from rural Madagascar. PLOS Glob Public Health, (2022). 2(12): e0001028.
  • 32. Hoffman C, Paradise J. Health Insurance and Access to Health Care in the United States. Annals of the New York Academy of Sciences, (2008). 1136(1), 149–60.
  • 33. Tavares AI. Treatable mortality and health care related factors across European countries. Front Public Health. https://www.frontiersin.orghttps://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1301825/full Erişim 12.07.2025.
  • 34. Pacáková V, Šild P, Zapletalová L. Demographics and social factors of unmet health care needs and avoidable mortality in European Union countries. https://dk.upce.cz/items/fa67022d-cd34-48b0-91aa-9b532da13adb Erişim 12.07.2025.
  • 35. Marshall EG, Miller L, Moritz LR. Challenges and impacts from wait times for specialist care identified by primary care providers: Results from the MAAP study cross-sectional survey. Healthc Manage Forum. (2023). 36(5), 340–6.
  • 36. Eurostat. Standardised Preventable and Treatable Mortality. Eurostat (hlth_cd_apr). https://ec.europa.eu/eurostat/cache/metadata/en/sdg_03_42_esmsip2.htm Erişim 12.07.2025.
  • 37. Porter DC, Gujarati DN. Basic Econometrics. McGraw-Hill Education; 2008: 944.
  • 38. Gallucci M. GAMLj: General analyses for linear models. [jamovi module] 2019. https://gamlj.github.io/ Erişim 12.07.2025.
  • 39. Ramsey JB. Tests for Specification Errors in Classical Linear Least-Squares Regression Analysis. Journal of the Royal Statistical Society Series B (Methodological), (1969). 31(2), 350–71.
  • 40. Miles J. Tolerance and Variance Inflation Factor. In: Wiley StatsRef: Statistics Reference Online. John Wiley & Sons, Ltd, 2014. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118445112.stat06593 Erişim 12.07.2025.
  • 41. Durbin-Watson Test. Durbin–Watson Test. In: The Concise Encyclopedia of Statistics. New York: Springer, 2008:173–175.
  • 42. R Core Team. R: A Language and environment for statistical computing. (2022). https://cran.r-project.org Erişim 12.07.2025.
  • 43. The jamovi project. Jamovi. (2023). https://www.jamovi.org Erişim 12.07.2025.
  • 44. Tabachnick BG, Fidell LS. Using multivariate statistics. 7th ed, Pearson, 2018.
  • 45. Frees EW. Longitudinal and Panel Data: Analysis and Applications in the Social Sciences. 2004.
  • 46. Wooldridge JM. Econometric Analysis of Cross Section and Panel Data. The MIT Press, 2010.
  • 47. Barua B, Esmail N, Jackson T. The Effect of Wait Times on Mortality in Canada. Fraser Institute, (2014). 78.
  • 48. Donabedian A. Evaluating the Quality of Medical Care. Milbank Q, (2005). 83(4),691–729.
  • 49. Guttmann A, Schull MJ, Vermeulen MJ, Stukel TA. Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada. (2011). https://www.bmj.com/content/342/bmj.d2983 Erişim 12.7.2025.
  • 50. Kirkey Ş. More than 74,000 Canadians have died on wait lists since 2018. https://nationalpost.com/news/canada/canadians-health-care-wait-list-deaths Erişim 12.7.2025.
  • 51. Moscelli G, Siciliani L, Tonei V. Do waiting times affect health outcomes? Evidence from coronary bypass. Social Science & Medicine, (2016). 161, 151–9.
  • 52. Prentice JC, Pizer SD. Delayed Access to Health Care and Mortality. Health Serv Res, (2007). 42(2), 644–62.
  • 53. Reichert A, Jacobs R. The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England. Health Econ, (2018). 27(11),1772–87.
  • 54. Ammi M, Arpin E, Dedewanou FA, Allin S. Do expenditures on public health reduce preventable mortality in the long run? Evidence from the Canadian provinces. Social Science & Medicine, (2024). 345:116696.
  • 55. Goodair B, Reeves A. Outsourcing health-care services to the private sector and treatable mortality rates in England, 2013–20: an observational study of NHS privatisation. The Lancet Public Health, (2022). 7(7), e638–46.
  • 56. Ivankova V, Gavurova B, Khouri S. Understanding the relationships between health spending, treatable mortality and economic productivity in OECD countries. Front Public Health, (2022), 10:1036058.
  • 57. Mays GP, Smith SA. Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths. Health Aff (Millwood), (2011). 30(8),1585–93.
  • 58. Karra M, Fink G, Canning D. Facility distance and child mortality: a multi-country study of health facility access, service utilization, and child health outcomes. International Journal of Epidemiology, (2017). 46(3), 817–26.
  • 59. Abubakar I, Dalglish SL, Angell B, Sanuade O, Abimbola S, Adamu AL, et al. The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet, (2022). 399(10330),1155–200.
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  • 61. Omotoso O, Teibo JO, Atiba FA, Oladimeji T, Paimo OK, Ataya FS, et al. Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions. International Journal for Equity in Health, (2023). 22(1),189.

Sağlık Hizmetlerine Erişim Engellerinin Zaman İçindeki Değişimi ve Tedavi Edilebilir Ölüm Oranları Üzerindeki Etkisi: Avrupa Birliği Ülkeleri Üzerine Bir Panel Veri Yaklaşımı

Yıl 2025, Cilt: 47 Sayı: 5, 784 - 795, 04.09.2025
https://doi.org/10.20515/otd.1686165

Öz

Karşılanamayan sağlık hizmetleri çoğu zaman bireylerin hem sağlık statüsünü düşürmekte hem de sağlık ihtiyacının giderilmemesi sebebi ile ölümle sonuçlanabilmektedir. Mevcut çalışmanın amacı karşılanamayan sağlık hizmetlerinin tedavi edilebilir ölümler üzerindeki etkisini ortaya koymaktır. Bu çalışma Avrupa Birliği üyesi 27 ülkenin 2011-2021 yılları arasındaki verisi ile yürütülmüş bir boylamsal çalışmadır. Çalışmadaki veriler Eurostat web sitesinde yayınlanan karşılanamayan sağlık ihtiyaçlarına yönelik bireysel beyan raporundan çekilmiştir. Tedavi edilebilir ölümler, bağımlı değişken, pahalılık, bekleme süresi ve uzaklık ise bağımsız değişken olarak modele dahil edilmiştir. Analizler Jamovi Sürüm 2.4 ile gerçekleştirilmiştir. Elde edilen bulgular zaman biriminin dahil edilmeden kurulan modele göre pahalılık ve bekleme süresinin tedavi edilebilir nedenlerden kaynaklanan ölümleri istatistiksel olarak anlamlı pozitif yönde etkilemekte, buna karşın uzaklığın istatistiksel olarak anlamlı bir etki göstermediği görülmektedir. Zaman biriminin dahil edilmesi ile birlikte sadece bekleme süresinin tedavi edilebilir ölümleri anlamlı pozitif yönde etkilediği buna karşın diğer değişkenlerin anlamlı bir etkiye sahip olmadığı tespit edilmiştir. Bununla birlikte zaman değişkeninin de 2011 yılı ile kıyas edildiğinde tüm diğer yıllarda tedavi edilebilir ölümleri pozitif yönde etkilediği görülmüştür. Bu çalışma, sağlık hizmetlerine erişimde yaşanan engellerin, tedavi edilebilir ölümler üzerindeki etkisini inceleyerek, sağlık sistemindeki kritik sorunlara ışık tutmaktadır. Analiz sonuçları, özellikle uzun bekleme sürelerinin, tedavi edilebilir ölümler üzerinde anlamlı ve istikrarlı bir etkisi olduğunu göstermektedir. Bu durum, sağlık hizmetlerine erişimde yaşanan gecikmelerin, zamanında müdahale gerektiren hastalıkların tedavisini olumsuz etkilediği ve ölüm riskini artırdığı yönündeki literatürle tutarlılık göstermektedir.

Etik Beyan

Bu çalışma ikinci verilerden hazırlandığı için etik kurul onayına gerek duyulmamıştır. Araştırma süresince etik kurallara riayet edilmiştir.

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Kaynakça

  • 1. World Health Assembly. Sustainable Health Financing, Universal Coverage and Social Health Insurance. https://iris.who.int/handle/10665/20383 Erişim 12.07.2025.
  • 2. World Health Organization. Universal health coverage (UHC). https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc) Erişim 12.07.2025.
  • 3. Nolte E, McKee M. Does Healthcare Save Lives? Avoidable Mortality Revisited. London: Published by The Nuffield Trust, 2004: 138.
  • 4. MacKenbach JP. Socioeconomic Inequalities in Health in the Netherlands: Impact of a Five-Year Research Programme. BMJ: British Medical Journal, (1994). 309(6967), 1487–91.
  • 5. OECD. Health at a Glance 2017: OECD Indicators. Paris: OECD Publishing.
  • 6. Bayefsky AF. Office of the United Nations High Commissioner for Human Rights. In: Bayefsky A, editor. The UN Human Rights Treaty System in the 21 Century. Brill | Nijhoff, (2000). 451–458.
  • 7. Stuart K, Soulsby E. Reducing global health inequalities. Part 1. J R Soc Med. (2011).104(8), 321–6.
  • 8. Bucciardini R, Zetterquist P, Rotko T, Putatti V, Mattioli B, De Castro P, et al. Addressing health inequalities in Europe: key messages from the Joint Action Health Equity Europe (JAHEE). Arch Public Health, (2023). 81-89.
  • 9. Dawkins B, Renwick C, Ensor T, Shinkins B, Jayne D, Meads D. What factors affect patients’ ability to access healthcare? An overview of systematic reviews. Tropical Medicine & International Health, (2021). 26(10):1177–1188.
  • 10. Forster T, Kentikelenis A, Bambra C. Health Inequalities in Europe: in Europe. https://feps-europe.eu/wp-content/uploads/downloads/publications/1845-6%20health%20inequalities%20inner-hr.pdf Erişim 12.07.2025.
  • 11. Baciu A, Negussie Y, et al. The Root Causes of Health Inequity. In: Communities in Action: Pathways to Health Equity. United State of America: National Academies Press, 2017.
  • 12. Turner AJ, Francetic I, Watkinson R, Gillibrand S, Sutton M. Socioeconomic inequality in access to timely and appropriate care in emergency departments. Journal of Health Economics, (2022). 85:102668.
  • 13. Ford J, Sowden S, Olivera J, Bambra C, Gimson A, Aldridge R, et al. Transforming health systems to reduce health inequalities. Future Healthc J, (2021). 8(2):e204–9.
  • 14. Case A, Kraftman L. Health inequalities. Oxford Open Economics, (2024). 3(Supplement_1):i499–528.
  • 15. McCartney G, Popham F, McMaster R, Cumbers A. Defining health and health inequalities. Public Health, (2019). 172:22–30.
  • 16. Gaspar A, Miranda JJ. Burden of treatment as a measure of healthcare quality: An innovative approach to addressing global inequities in multimorbidity. PLOS Glob Public Health, (2022). 2(5):e0000484.
  • 17. Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health, (2018). 6:e1196–252.
  • 18. Marmot M. Health equity in England: The Marmot review 10 years on. BMJ, (2020). 368:m693.
  • 19. Dabla-Norris E, Kochhar K, Ricka F, Tsounta E. Causes and Consequences of Income Inequality: A Global Perspective. (2015). 2 (3).
  • 20. WHO Regional Office for Europe. Environmental health inequalities in Europe. Copenhagen: WHO. https://iris.who.int/bitstream/handle/10665/325176/9789289054157-eng.pdf Erişim 12.07.2025.
  • 21. Chai KC, Zhang YB, Chang KC. Regional Disparity of Medical Resources and Its Effect on Mortality Rates in China. Front Public Health. (2020). 8:8.
  • 22. Farmer P, Kleinman A, Kim J, Basillico M. Reimagining Global Health. 1st Edition, 2013: 504.
  • 23. Kruk ME, Gage AD, Joseph NT, Danaei G, García-Saisó S, Salomon JA. Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. The Lancet, (2018). 392(10160): 2203–12.
  • 24. Ndubuisi NE. Noncommunicable Diseases Prevention in Low- and Middle-Income Countries: An Overview of Health in All Policies (HiAP). Inquiry, (2021). 58:0046958020927885.
  • 25. United Nations U. United Nations. United Nations. https://www.un.org/en/global-issues/health Erişim 12.07.2025.
  • 26. Rockville (MD): Agency for Healthcare Research and Quality. National Healthcare Quality and Disparities Report. US: Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK578537/ Erişim 12.07.2025.
  • 27. Hoel M, Saether E. Public Health Care with Waiting Time: The Role of Supplementary Private Health Care. Journal of health economics, (2003). 22, 599–616.
  • 28. Sartini M, Carbone A, Demartini A, Giribone L, Oliva M, Spagnolo AM, et al. Overcrowding in Emergency Department: Causes, Consequences, and Solutions—A Narrative Review. Healthcare (Basel), (2022). 10(9):1625.
  • 29. Yee CA, Legler A, Davies M, Prentice J, Pizer S. Priority access to health care: Evidence from an exogenous policy shock. Health Econ (2020). 29(3), 306–23.
  • 30. Coombs NC, Campbell DG, Caringi J. A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access. BMC Health Serv Res, (2022). 22: 438.
  • 31. Evans MV, Andréambeloson T, Randriamihaja M, Ihantamalala F, Cordier L, Cowley G, et al. Geographic barriers to care persist at the community healthcare level: Evidence from rural Madagascar. PLOS Glob Public Health, (2022). 2(12): e0001028.
  • 32. Hoffman C, Paradise J. Health Insurance and Access to Health Care in the United States. Annals of the New York Academy of Sciences, (2008). 1136(1), 149–60.
  • 33. Tavares AI. Treatable mortality and health care related factors across European countries. Front Public Health. https://www.frontiersin.orghttps://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1301825/full Erişim 12.07.2025.
  • 34. Pacáková V, Šild P, Zapletalová L. Demographics and social factors of unmet health care needs and avoidable mortality in European Union countries. https://dk.upce.cz/items/fa67022d-cd34-48b0-91aa-9b532da13adb Erişim 12.07.2025.
  • 35. Marshall EG, Miller L, Moritz LR. Challenges and impacts from wait times for specialist care identified by primary care providers: Results from the MAAP study cross-sectional survey. Healthc Manage Forum. (2023). 36(5), 340–6.
  • 36. Eurostat. Standardised Preventable and Treatable Mortality. Eurostat (hlth_cd_apr). https://ec.europa.eu/eurostat/cache/metadata/en/sdg_03_42_esmsip2.htm Erişim 12.07.2025.
  • 37. Porter DC, Gujarati DN. Basic Econometrics. McGraw-Hill Education; 2008: 944.
  • 38. Gallucci M. GAMLj: General analyses for linear models. [jamovi module] 2019. https://gamlj.github.io/ Erişim 12.07.2025.
  • 39. Ramsey JB. Tests for Specification Errors in Classical Linear Least-Squares Regression Analysis. Journal of the Royal Statistical Society Series B (Methodological), (1969). 31(2), 350–71.
  • 40. Miles J. Tolerance and Variance Inflation Factor. In: Wiley StatsRef: Statistics Reference Online. John Wiley & Sons, Ltd, 2014. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118445112.stat06593 Erişim 12.07.2025.
  • 41. Durbin-Watson Test. Durbin–Watson Test. In: The Concise Encyclopedia of Statistics. New York: Springer, 2008:173–175.
  • 42. R Core Team. R: A Language and environment for statistical computing. (2022). https://cran.r-project.org Erişim 12.07.2025.
  • 43. The jamovi project. Jamovi. (2023). https://www.jamovi.org Erişim 12.07.2025.
  • 44. Tabachnick BG, Fidell LS. Using multivariate statistics. 7th ed, Pearson, 2018.
  • 45. Frees EW. Longitudinal and Panel Data: Analysis and Applications in the Social Sciences. 2004.
  • 46. Wooldridge JM. Econometric Analysis of Cross Section and Panel Data. The MIT Press, 2010.
  • 47. Barua B, Esmail N, Jackson T. The Effect of Wait Times on Mortality in Canada. Fraser Institute, (2014). 78.
  • 48. Donabedian A. Evaluating the Quality of Medical Care. Milbank Q, (2005). 83(4),691–729.
  • 49. Guttmann A, Schull MJ, Vermeulen MJ, Stukel TA. Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada. (2011). https://www.bmj.com/content/342/bmj.d2983 Erişim 12.7.2025.
  • 50. Kirkey Ş. More than 74,000 Canadians have died on wait lists since 2018. https://nationalpost.com/news/canada/canadians-health-care-wait-list-deaths Erişim 12.7.2025.
  • 51. Moscelli G, Siciliani L, Tonei V. Do waiting times affect health outcomes? Evidence from coronary bypass. Social Science & Medicine, (2016). 161, 151–9.
  • 52. Prentice JC, Pizer SD. Delayed Access to Health Care and Mortality. Health Serv Res, (2007). 42(2), 644–62.
  • 53. Reichert A, Jacobs R. The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England. Health Econ, (2018). 27(11),1772–87.
  • 54. Ammi M, Arpin E, Dedewanou FA, Allin S. Do expenditures on public health reduce preventable mortality in the long run? Evidence from the Canadian provinces. Social Science & Medicine, (2024). 345:116696.
  • 55. Goodair B, Reeves A. Outsourcing health-care services to the private sector and treatable mortality rates in England, 2013–20: an observational study of NHS privatisation. The Lancet Public Health, (2022). 7(7), e638–46.
  • 56. Ivankova V, Gavurova B, Khouri S. Understanding the relationships between health spending, treatable mortality and economic productivity in OECD countries. Front Public Health, (2022), 10:1036058.
  • 57. Mays GP, Smith SA. Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths. Health Aff (Millwood), (2011). 30(8),1585–93.
  • 58. Karra M, Fink G, Canning D. Facility distance and child mortality: a multi-country study of health facility access, service utilization, and child health outcomes. International Journal of Epidemiology, (2017). 46(3), 817–26.
  • 59. Abubakar I, Dalglish SL, Angell B, Sanuade O, Abimbola S, Adamu AL, et al. The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet, (2022). 399(10330),1155–200.
  • 60. Mills A, Rasheed F, Tollman S. Strengthening Health Systems. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al., editors. Disease Control Priorities in Developing Countries. 2nd ed, Washington (DC), The International Bank for Reconstruction and Development / The World Bank, 2006.
  • 61. Omotoso O, Teibo JO, Atiba FA, Oladimeji T, Paimo OK, Ataya FS, et al. Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions. International Journal for Equity in Health, (2023). 22(1),189.
Toplam 61 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlığın Sosyal Belirleyicileri, Sağlıkta Hakkaniyet
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Haşim Çapar 0000-0001-7056-7879

Proje Numarası Yok
Yayımlanma Tarihi 4 Eylül 2025
Gönderilme Tarihi 28 Nisan 2025
Kabul Tarihi 21 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 5

Kaynak Göster

Vancouver Çapar H. Sağlık Hizmetlerine Erişim Engellerinin Zaman İçindeki Değişimi ve Tedavi Edilebilir Ölüm Oranları Üzerindeki Etkisi: Avrupa Birliği Ülkeleri Üzerine Bir Panel Veri Yaklaşımı. Osmangazi Tıp Dergisi. 2025;47(5):784-95.


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