Healthcare workforce and expenditure: influences on life expectancy and infant mortality in Turkey

Year 2025, Volume: 7 Issue: 1, 77 - 83, 10.01.2025

Abdurrahman Yunus Sarıyıldız

https://doi.org/10.38053/acmj.1579199

Abstract

Aims: This study examines the impact of the number of health personnel and health expenditures on life expectancy and infant mortality rates in Turkiye. The study's primary purpose is to determine the effect of increased health personnel and health expenditures on quality of life and infant mortality rates. Therefore, the impact of health personnel and expenses on life expectancy and infant mortality rates was investigated. It was analyzed how these variables shape the effectiveness of health services and how they affect public health.
Methods: This study used multiple regression analysis to assess the effects of healthcare workforce and expenditures on health outcomes in Turkiye between 2001 and 2021. Life expectancy and infant mortality rate were dependent variables, while per capita healthcare expenditure, the number of doctors, and the number of nurses were used as independent variables. Data were obtained from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD) databases and analyzed using the SPSS software.
Results: The findings indicate that per capita healthcare expenditures positively and significantly affect life expectancy (B=0.015, p=0.016), suggesting that increases in healthcare spending contribute to longer life expectancy. Conversely, the effects of the number of doctors (B=-1.580, p=0.138) and nurses (B=0.232, p=0.400) were not statistically significant, indicating that workforce numbers alone may not directly impact life expectancy. Regarding infant mortality rate, healthcare expenditure (B=0.016, p=0.166) and doctor availability (B=-1.503, p=0.467) showed negative associations, while the number of nurses had a
positive but non-significant association (B=0.407, p=0.457). Although these variables theoretically demonstrated the potential to reduce infant mortality rates, none of these effects reached statistical significance. The model explained 82.5% (R²=0.825) of the variance in life expectancy and 88.7% (R²=0.887) in infant mortality rate, underscoring the model's robustness in explaining variations in these health outcomes.
Conclusion: The study findings suggest that while healthcare expenditures positively affect life expectancy, the number of healthcare workers alone is insufficient, and factors such as service quality and efficiency also play a role. In developing health policies, strategies should focus on systematically improving the quality of services rather than merely increasing the number of personnel. Particularly in rural and low-income areas, the scope and quality of healthcare services should be enhanced to reduce disparities in health indicators.

Keywords

Health expenditures, life expectancy, infant mortality, regression analysis

References

• Ayar D, Karaman MA, Karaman R. Work-life balance and mental health needs of health professionals during COVID-19 pandemic in Turkey. Int J Ment Health Addict. 2022;20(3):639-655. doi:10.1007/s11469-021-00717-6
• Lüleci D, Ada D, Kılıç B. Türkiye'de sağlık hizmeti göstergeleri ve sosyoekonomik faktörlerin bebek ölüm hızına etkisi: il düzeyinde ekolojik bir analiz. Halk Sağlığı Araştırma ve Uygulamaları Dergisi. 2024;2(1):44-50. doi:10.5281/zenodo.11047017
• World Health Organization. National health workforce accounts: A handbook (2nd ed.). World Health Organization; 2023. Accessed October 28, 2024. https://www.who.int/publications/i/item/9789240081291.
• Nagesh S, Chakraborty S. Healthcare workers' resilience in the face of COVID-19: a scoping review of resilience factors. J Clin Nurs. 2020; 29(11-12):1785-1795. doi:10.1111/jocn.15469
• Wani RT, Hamid S, Maqbool M, Khan SM. Impact of healthcare worker density and socioeconomic factors on infant mortality rates. J Glob Health. 2022;10(1):010345. doi:10.7189/jogh.10.010345
• Ruiz-Fernández MD, Ramos-Pichardo JD, Ibáñez-Masero O, Cabrera-Troya J, Carmona-Rega MI, Ortega-Galán ÁM. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. J Clin Nurs. 2020;29(21-22):4321-4330. doi:10.1111/jocn.15469
• Sethi BA, Sethi A, Ali S, Aamir HS. Impact of coronavirus disease (COVID-19) pandemic on health professionals. Pak J Med Sci. 2020;36(COVID19-S4):S6-S11. doi:10.12669/pjms.36.COVID19-S4.2779
• Shreffler J, Petrey J, Huecker M. The impact of COVID-19 on healthcare worker wellness: a scoping review. West J Emerg Med. 2020;21(5):1059-1066. doi:10.5811/westjem.2020.7.48684
• Titanji BK, Tegomoh B, Nematollahi S, Konomos M, Kulkarni PA. Monkeypox: a contemporary review for healthcare professionals. Open Forum Infect Dis. 2022;9(7):ofac310. doi:10.1093/ofid/ofac310
• Razu SR, Yasmin T, Arif TB, et al. Challenges faced by healthcare professionals during the COVID-19 pandemic: a qualitative inquiry from Bangladesh. BMJ Open. 2021;11(3):647315. doi:10.1136/bmjopen- 2020-048097
• Naser AY, Dahmash EZ, Al‐Rousan R, et al. Mental health status of the general population, healthcare professionals, and patients with mental illness during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav. 2020;41(8):e01730. doi:10.1002/brb3.1885
• Bozdağ F, Ergün N. Psychological resilience of healthcare professionals during COVID-19 pandemic. Psychiatry Behav Sci. 2020;10(3):280-287. doi:10.5455/jmood.20200903093013
• Serrano-Ripoll MJ, Meneses-Echavez JF, Ricci-Cabello I, et al. Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis. J Affect Disord. 2020;277:347-357. doi:10.1016/j.jad.2020.08.034
• Cullen W, Gulati G, Kelly BD. Mental health in the COVID-19 pandemic. QJM Int J Med. 2020;113(5):311-312. doi:10.1093/qjmed/hcaa110
• Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. doi:10.1016/j.psychres.2020.112934
• Joshi AU, Lewiss RE. Telehealth in the time of COVID-19. Emerg Med J. 2020;37(10):637-638. doi:10.1136/emermed-2020-209846
• Said RM, El-Shafei DA. Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt. Environ Sci Pollut Res Int. 2021;28(12):10041-10048. doi:10.1007/s11356-020-11235-8
• Gupta S, Sahoo S. Pandemic and mental health of the front-line healthcare workers: a review and implications in the Indian context amidst COVID-19. Gen Psychiatry. 2020;33(5):e100284. doi:10.1136/gpsych-2020-100284
• Chen Q, Liang M, Li Y, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry. 2020;7(4):e15-e16. doi:10.1016/S2215-0366(20)30078-X
• Nixon J, Ulmann P. The relationship between health care expenditure and health outcomes. Eur J Health Econ. 2006;7(1):7-18.
• Anand S, Bärnighausen T. Human resources and health outcomes: cross-country econometric study. Lancet. 2004;364(9445):1603-1609.
• Dussault G, Franceschini MC. Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. Hum Resour Health. 2006;4(1):12. doi:10.1186/1478-4491-4-12
• Speybroeck N, Kinfu Y, Dal Poz MR, Evans DB. Reassessing the relationship between human resources for health, intervention coverage and health outcomes. World Health Organ Bull. 2013;91:268-276.
• Chuang CH, Tseng PC, Lin CY, Lin KH, Chen YY. Burnout in the intensive care unit professionals: a systematic review. Medicine (Baltimore). 2016;95(50):e5629.
• Khamisa N, Peltzer K, Ilic D, Oldenburg B. Work related stress, burnout, job satisfaction and general health of nurses. Int J Environ Res Public Health. 2015;12(1):652-666.
• World Health Organization. The world health report 2006: Working together for health. Geneva: World Health Organization; 2006.