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Yaşlılık Sağlık Harcamalarının Geografik Dağılımı: Farklı Bölgelerde Yaşlı Sağlık Harcamalarında Gözlemlenen Değişiklikler

Year 2024, Volume: 27 Issue: 1, 152 - 167, 30.04.2024
https://doi.org/10.29249/selcuksbmyd.1422536

Abstract

Bu çalışma, Türkiye'deki yaşlı nüfusun sağlık hizmetleri taleplerini ve bu hizmetlere yönelik harcamaların coğrafi dağılımını incelemiştir. Türkiye İstatistik Kurumu'nun 2021 verileri üzerinden yapılan analizde, sağlık hizmeti talebi, üretimi ve kapasitesinin bölgesel farklılıkları dendrogram ve aglomeratif kümeleme yöntemleriyle ortaya konmuştur. Bulgular, özellikle Batı Karadeniz, Doğu Karadeniz ve Batı Marmara bölgelerinin benzer talep özelliklerine sahip olduğunu ortaya koymuştur. Ayrıca, sağlık hizmeti üretiminin heterojen bir yapıya sahip olduğu, Güneydoğu Anadolu ve Doğu Anadolu bölgelerinin diğer bölgelere göre daha düşük sağlık hizmeti üretimine sahip olduğu belirlenmiştir. Sağlık hizmeti kapasitesi açısından batı bölgelerinin genel olarak daha yüksek bir kapasiteye sahip olduğu gözlemlenmiş; Orta Anadolu ve Ortadoğu Anadolu'nun kapasite bakımından benzer olduğu, ancak Batı Karadeniz ile Batı Anadolu arasında sağlık hizmeti talepleri açısından önemli farkların olduğu tespit edilmiştir. Araştırmada bölgesel ihtiyaçları dikkate alan özelleştirilmiş sağlık stratejilerinin geliştirilmesi, sağlık altyapısının güçlendirilmesi ve kaynak dağılımının adil bir şekilde yapılması, yaşlı nüfusun sağlık hizmetlerine eşit erişiminin sağlanması, eğitim ve farkındalık kampanyalarına yatırım yapılması, sağlık hizmetleri veri toplama ve izleme süreçlerinin iyileştirilmesi ve çok disiplinli yaklaşımların teşvik edilmesi önerilmektedir. Bu çalışma, ayrıca yaşlanan nüfus için sağlık hizmetlerinin daha verimli ve etkin kullanımını destekleyecek politika ve stratejilerin belirlenmesine katkıda bulunmayı hedeflemektedir.

Ethical Statement

Bu çalışma, insan ve hayvanların (materyal/veriler dahil) bilimsel ya da deneysel bilimsel amaçlarla kullanılmadığı, hayvanlar üzerinde yapılan araştırma olmadığı, insanlar üzerinde yapılan klinik araştırma olmadığı, odak grup çalışması, görüşme teknikleri anket, gözlem, deney mülakat vasıtasıyla kişilerden veri toplanmasını gerektiren nicel ya da nitel yaklaşımlar kullanılmadığı için ve kişisel verilerin korunması kanunu gereğince retrospektif çalışma olmadığından etik kurul onayı gerektirmemektedir.

Supporting Institution

Yok

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Geographic Distribution of Old Age Health Expenditures: Observed Changes in Elderly Health Expenditures in Different Regions

Year 2024, Volume: 27 Issue: 1, 152 - 167, 30.04.2024
https://doi.org/10.29249/selcuksbmyd.1422536

Abstract

This Study, examined the geographical distribution of the health services demands of the elderly population in Türkiye and the expenditures on these services. In the analysis carried out on the 2021 data of the Turkish Statistical Institute, regional differences in health service demand, production and capacity were revealed through dendrogram and agglomerative clustering methods. The findings showed that the health service demand of the elderly population is heterogeneous and particularly the Western Black Sea, Eastern Black Sea and Western Marmara regions have similar demand characteristics. In addition, it was found that Southeastern Anatolia and Eastern Anatolia regions have lower health service production compared to other regions. It was observed that western regions generally have a higher capacity in terms of health services and it was determined that Central Anatolia and Central East Anatolia are similar in terms of health services capacity, but there are significant differences in healthcare service demands between Western Black Sea and Western Anatolia. The research recommends developing customized health strategies that take account of regional needs, strengthening the network infrastructure and ensuring equitable resource distribution, ensuring equal access to health services for the elderly population, investing in education and awareness campaigns, improving data collection and monitoring processes for health services, and encouraging multidisciplinary approaches. This study also intends to contribute to the determination of policies and strategies that will support more efficient and effective use of health services for the elderly population.

References

  • Ağar, A. (2020). Yaşlılarda ortaya çıkan fizyolojik değişiklikler. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 3(3), 347-354.
  • Asiskovitch, S. (2010). Gender and health outcomes: The impact of healthcare systems and their financing on life expectancies of women and men. Social Science & Medicine, 70(6), 886-895.
  • Bahar, G., Bahar, A., & Savaş, H. (2009). Yaşlılık ve Yaşlılara Sunulan Sosyal Hzimetler. Fırat Sağlık Hizmetleri Dergisi, 4(12), 85-98.
  • Banthin, J. S., & Bernard, D. M. (2006). Changes in financial burdens for health care: national estimates for the population younger than 65 years, 1996 to 2003. Jama, 296(22), 2712-2719.
  • Barnato, A. E., Chang, C. C. H., Farrell, M. H., Lave, J. R., Roberts, M. S., & Angus, D. C. (2010). Is survival better at hospitals with higher “end-of-life” treatment intensity?. Medical care, 48(2), 125.
  • Barnato, A., Herndon, M., Anthony, D., Gallagher, P., Skinner, J., Bynum, J., … & Fisher, E. (2007). Are regional variations in end-of-life care intensity explained by patient preferences?. Medical Care, 45(5), 386-393. DOI: 10.1097/01.mlr.0000255248.79308.41
  • Bradley, E. H., Elkins, B. R., Herrin, J., & Elbel, B. (2011). Health and social services expenditures: associations with health outcomes. BMJ quality & safety, 20(10), 826-831.
  • Byaro, M., Mayaya, H., & Pelizzo, R. (2022). Sustainable Development Goals for Sub-Saharan Africans' by 2030: A Pathway to Longer Life Expectancy via Higher Health-Care Spending and Low Disease Burdens. African Journal of Economic Review, 10(2), 73-87.
  • Calinski, T. (2014). Dendrogram. Wiley StatsRef: Statistics Reference Online.
  • Cheng, C., Chen, Y., Liu, T., & Yang, Y. (2011). Using spatial analysis to demonstrate the heterogeneity of the cardiovascular drug-prescribing pattern in Taiwan. BMC Public Health, 11(1). DOI: 10.1186/1471-2458-11-380
  • Chopra, I., Mattes, M. D., Findley, P., Tan, X., Dwibedi, N., & Sambamoorthi, U. (2019). Impact of incident cancer on short-term coronary artery disease–related healthcare expenditures among Medicare beneficiaries. Journal of the National Comprehensive Cancer Network, 17(2), 149-158.
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  • Cunningham, P. J. (2008). Trade-offs getting tougher: problems paying medical bills increase for US Families, 2003–2007. Track Rep, 21(1), 5.
  • Cutler, D., Skinner, J., Stern, A., & Wennberg, D. (2013). Physician beliefs and patient preferences: a new look at regional variation in health care spending.
  • Çam, C., Atay, E., Aygar, H., Öcal, E. E., Önsüz, M. F., Işıklı, B., & Metintaş, S. (2021). Elderly people's quality of life in rural areas of Turkey and its relationship with loneliness and sociodemographic characteristics. Psychogeriatrics, 21(5), 795-804.
  • Duan, W., Zheng, A., Mu, X., Li, M., Liu, C., Huang, W., & Wang, X. (2017). How great is the medical burden of disease on the aged? Research based on “System of Health Account 2011”. Health and Quality of Life Outcomes, 15, 1-10.
  • Dwivedi, R., & Pradhan, J. (2017). Does equity in healthcare spending exist among Indian states? explaining regional variations from national sample survey data. International Journal for Equity in Health, 16(1). DOI: 10.1186/s12939-017-0517-y
  • Fettahoğlu, R., & Erdem, R. (2020). Bireylerin Yaşlılık Algısının Sağlık Hizmeti Kullanımına Etkisi. Manisa Celal Bayar Üniversitesi Sosyal Bilimler Dergisi, 18(4), 12-32.
  • Fisher, E. S., Wennberg, D. E., Stukel, T. A., Gottlieb, D. J., Lucas, F. L., & Pinder, E. L. (2003a). The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Annals of internal medicine, 138(4), 273-287.
  • Fisher, E. S., Wennberg, D. E., Stukel, T. A., Gottlieb, D. J., Lucas, F. L., & Pinder, E. L. (2003b). The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care. Annals of internal medicine, 138(4), 288-298.
  • Gerdtham, U. G., Søgaard, J., Andersson, F., & Jönsson, B. (1992). An econometric analysis of health care expenditure: A cross-section study of the OECD countries. Journal of health economics, 11(1), 63-84.
  • Getzen, T. E. (2006). Aggregation and the measurement of health care costs. Health Services Research, 41(5), 1938-1954.
  • Göpffarth, D., Kopetsch, T., & Schmitz, H. (2015). Determinants of regional variation in health expenditures in Germany. Health Economics, 25(7), 801-815. DOI: 10.1002/hec.3183
  • Göpffarth, D., & Bauhoff, S. (2015). The Public Health Dimension of Germany’s Refugee Crisis. Health Affairs Forefront.
  • Himmelstein, D. U., Thorne, D., Warren, E., & Woolhandler, S. (2009). Medical bankruptcy in the United States, 2007: results of a national study. The American journal of medicine, 122(8), 741-746.
  • Hitiris, T., & Posnett, J. (1992). The determinants and effects of health expenditure in developed countries. Journal of health economics, 11(2), 173-181.
  • Institute of Medicine (2012). New Data on Geographic Variation.
  • Japaridze, I., & Sayour, N. (2021). Dying from envy: the role of inequality. Health Economics, 30(6), 1374-1392. DOI: 10.1002/hec.4261
  • Joumard, I., André, C., & Nicq, C. (2010). Health care systems: efficiency and institutions.
  • Joumard, I., André, C., Nicq, C., & Chatal, O. (2010). Health status determinants: lifestyle, environment, health care resources and efficiency. OECD Economics Department Working Paper, (627).
  • Kaya, G. (2019). Sağlık Harcamalarının Milli Gelire Etkisi ve Bilecik İli Özelinde Türkiye’de Sağlık Harcamaları. Bilecik Şeyh Edebali Üniversitesi, Sosyal Bilimler Enstitüsü, Yayımlanmamış Yüksek Lisans Tezi, Bilecik.
  • Kollerup, A., Kjellberg, J., & Ibsen, R. (2022). Ageing and health care expenditures: the importance of age per se, steepening of the individual-level expenditure curve, and the role of morbidity. The European Journal of Health Economics, 1-29.
  • Korwatanasakul, U., Sirivunnabood, P., & Majoe, A. (2021). Demographic transition and its impacts on fiscal sustainability in East and Southeast Asia.
  • Landrum, M. B., Meara, E. R., Chandra, A., Guadagnoli, E., & Keating, N. L. (2008). Is spending more always wasteful? The appropriateness of care and outcomes among colorectal cancer patients. Health Affairs, 27(1), 159-168.
  • Lorenz, N., Ihle, P., & Breyer, F. (2020). Aging and health care expenditures: a non-parametric approach.
  • Lubitz, J. D., & Riley, G. F. (1993). Trends in Medicare payments in the last year of life. New England journal of medicine, 328(15), 1092-1096.
  • Lyszczarz, B., & Abdi, Z. (2021, December). Factors associated with out-of-pocket health expenditure in Polish Regions. Healthcare, 9(12), 1750.
  • MacKinnon, N., Emery, V., Waller, J., Ange, B., Ambade, P., Gunja, M., … & Watson, E. (2023). Mapping health disparities in 11 high-income nations. Jama Network Open, 6(7), e2322310. DOI: 10.1001/jamanetworkopen.2023.22310
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There are 68 citations in total.

Details

Primary Language Turkish
Subjects Financial Econometrics, Hospital Management
Journal Section Original Research Articles
Authors

Necati Kocakoç 0000-0001-8884-0052

Publication Date April 30, 2024
Submission Date January 19, 2024
Acceptance Date February 22, 2024
Published in Issue Year 2024 Volume: 27 Issue: 1

Cite

APA Kocakoç, N. (2024). Yaşlılık Sağlık Harcamalarının Geografik Dağılımı: Farklı Bölgelerde Yaşlı Sağlık Harcamalarında Gözlemlenen Değişiklikler. Selçuk Üniversitesi Sosyal Bilimler Meslek Yüksekokulu Dergisi, 27(1), 152-167. https://doi.org/10.29249/selcuksbmyd.1422536

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