TÜRKİYE SAĞLIK EKONOMİSİ İÇİN İSTATİSTİKSEL ÇOK AMAÇLI OPTİMİZASYON MODELİNİN UYGULANMASI

Yıl 2018, Cilt: 1 Sayı: 1, 34 - 51, 30.01.2018

Abdulkadir Atalan

Öz

Sağlık sistemleri ülkelerin alt yapısını oluşturmakla beraber aynı zamanda bu
ülkelerin ekonomik yapısının önemli temel taşlarındandır. Sağlık sistemlerinin ekonomik
yapısını etkileyen birçok faktör bulunmaktadır. Gelişmiş ülkelerde sağlık
ekonomisini ölçen iki etken mevcuttur; sağlık harcamaları ve kişi başına düşen
sağlık giderleridir. Bu çalışmada, 1990-2016 yılları arasında Türkiye’nin
sağlık ekonomisini etkileyen faktörler dikkate alınarak, istatistiksel çok
amaçlı optimizasyon yöntemi ile sağlık harcamalarının minimize ve kişi başına
düşen sağlık giderlerinin ise maksimize edilmesi amaçlanmıştır. Türkiye’nin sağlık
ekonomisi için ilk defa uygulanan bu yöntem ile sağlık harcamalarında %7,59 oranında bir
azalma sağlanmıştır. Ayrıca, kişi başına düşen sağlık giderlerinin maksimize edilerek
496 dolardan 595,9805 dolara çıkması ile %18,250 oranında iyileşme sağlayan
optimum değerler elde edilmiştir.  

Anahtar Kelimeler

Sağlık Ekonomisi, Sağlık Harcamaları, Kişi Başına Düşen Sağlık Giderleri, Çok Amaçlı Optimizasyon Modeli

Kaynakça

• Abadi, M., Ajami, S., Ketabi, S., & Bagherian, H. (2013). Reducing Waiting Time in Emergency Department at Ayatollah-Kashani Hospital Using Simulation. Journal of Health Administration, 16(51), 84-94.
• Arah, O. A., Westert, G. P., Hurst, J., & Klazinga, N. S. (2006). A conceptual framework for the OECD Health Care Quality Indicators Project. International Journal for Quality in Health Care, 5-13.
• Atalan, A. (2014). Central Composite Design Optimization Using Computer Simulation Approach. Flexsim Quarterly Publication, 5-19.
• Baños, R., Manzano-Agugliaro, F., Montoya, F., Gil, C., Alcayde, A., & Gómez, J. (2011). Optimization methods applied to renewable and sustainable energy: A review. Renewable and Sustainable Energy Reviews, 15(4), 1753-1766.
• Batun, S., & Begen, M. A. (2013). Optimization in Healthcare Delivery Modeling: Methods and Applications. In B. T. Denton, Handbook of Healthcare Operations Management Methods and Applications (Vol. 184). Springer.
• Carides, G. W., Heyse, J. F., & Iglewicz, B. (2000). A regression-based method for estimating mean treatment cost in the presence of right-censoring. Biostatistics, 1(3), 299-313.
• Country Economy . (2015). Turkey - Life expectancy at birth. Retrieved from Expansion countryeconomy.com: https://countryeconomy.com/demography/life-expectancy/turkey
• Detwiler, D., Ekhande, S., & Kistner, M. (1996). Computer Aided Structural Optimization of Automotive Body Structure. In S. International (Ed.), SAE Technical Paper.
• Dukhanin, V., Searle, A., Zwerling, A., Dowdy, D. W., Taylor, H. A., & Merritt, M. W. (2018). Integrating social justice concerns into economic evaluation for healthcare and public health: A systematic review. Social Science and Medicine, 198, 27 - 35.
• Evans, J. H., Hwang, Y., & Nagarajan, N. J. (2001). Management control and hospital cost reduction: additional evidence. Journal of Accounting and Public Polic, 20(1), 73-88.
• 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.
• Gregori, D., Petrinco, M., Bo, S., Desideri, A., Merletti, F., & Pagano, E. (2011). Regression models for analyzing costs and their determinants in health care: an introductory review. International Journal for Quality in Health Care, 23(3), 331-341.
• Griswold, M., Parmigiani, G., Potosky, A., & Lipscom, J. (2004). Analyzing health care costs: A comparison of statistical methods motivated by Medicare colorectal cancer charges. Biostatistics, 1(1), 1-23.
• Iqbal, M., Azam, M., Naeem, M., KhwajaA.S., & Anpalagan, A. (2014). Optimization classification, algorithms and tools for renewable energy: A review. Renewable and Sustainable Energy Reviews, 39(Supplement C), 640-654.
• Jones, A. M., Lomas, J., & Rice, N. (2015). Healthcare Cost Regressions: Going Beyond the Mean to Estimate the Full Distribution. Health Economics, 24(9), 1192-1212.
• Liu, Y., Lei, H., Zhang, D., & Wu, Z. (2018). Robust optimization for relief logistics planning under uncertainties in demand and transportation time. Applied Mathematical Modelling, 55(Supplement C), 262 - 280.
• Mason, K., Duggan, J., & Howley, E. (2017). Multi-objective dynamic economic emission dispatch using particle swarm optimisation variants. Neurocomputing, 270(Supplement C), 188 - 197.
• Mihaylova, B., Briggs, A., O'Hagan, A., & Thompson, S. G. (2011). Review of statistical methods for analysing healthcare resources and costs. Health Economics, 20(8), 897-916.
• Mikolajczak, B. M., & Van, S. (2017). Increasing emotional intelligence to decrease healthcare expenditures: How profitable would it be? Personality and Individual Differences, 116, 343 - 347.
• Moscone, B. H. (2010). Health care expenditure and income in the OECD reconsidered: Evidence from panel data. Economic Modelling, 27(4), 804-811.
• Muyl, F., Dumas, L., & Herbert, V. (2004). Hybrid method for aerodynamic shape optimization in automotive industry. Computers and Fluids, 33(5), 849 - 858.
• Ngatchou, P., and Zarei, A., & El-Sharkawi, A. (2005). Pareto Multi Objective Optimization. Proceedings of the 13th International Conference on, Intelligent Systems Application to Power Systems, (pp. 84-91).
• OECD. (2016). Health spending. Retrieved from OECD Data: https://data.oecd.org/healthres/health-spending.htm
• OECD. (2017). Mission, The Organisation for Economic Co-operation and Development (OECD). (T. O.-o. Mission, Producer, & OECD) Retrieved from http://www.oecd.org/about/: http://www.oecd.org/about/
• OECD. (2018b). Health Care Resources-Hospitals. Retrieved from OECD Data: http://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_REAC
• OECD. (2018c). Health Care Resources-Physicians. Retrieved from OECD Data: http://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_REAC
• OECD. (2018d). Population and vital statistics. Retrieved from OECD Data: https://data.oecd.org/pop/population.htm
• Palasca, S., & Jaba, E. (2015). Economic Crisis’ Repercussions on European Healthcare Systems. Procedia Economics and Finance, 23, 525-533.
• Saki, M. A., Fatemeh, P., & Ahmadi, A. K. (2015). Statistical models for the analysis of skewed healthcare cost data: a simulation study. Health Economics Review, 5(11).
• Steiner, M. T., Datta, D., Neto, P. J., Scarpin, C. T., & Figueira, J. R. (2015). Multi-objective optimization in partitioning the healthcare system of Parana State in Brazil. Omega, 52(Supplement C), 53 - 64.
• Suzanne K., M., & Selden, T. M. (1998). Health care expenditures and GDP: panel data unit root test results. Journal of Health Economics, 17(3), 369-376.
• The World Bank. (2016a). World Bank national accounts data, and OECD National Accounts data files. GDP Turkey. Retrieved from https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=TR
• The World Bank. (2016b). World Bank national accounts data, and OECD National Accounts data files. Retrieved from https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?end=2016&locations=TR&start=1990
• The World Bank. (2018). Health expenditure per capita (current US$),Turkey. Retrieved from The World Bank Data: https://data.worldbank.org/indicator/SH.XPD.PCAP
• TÜİK. (2017). Türkiye İstatistik Kurumu . Retrieved from Sağlık Harcamaları İstatistikleri, 2016: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=24574
• Valerie, A., Davezies, L., & Thierry, D. (2010). Health expenditure models: A comparison using panel data. Economic Modelling, 27(4), 791-803.
• Weinstein, M. C., & Stason, W. B. (1977). Foundations of Cost-Effectiveness Analysis for Health and Medical Practices. New England Journal of Medicine, 296(13), 716-721.
• Yu, W. T., Wang, D. H., & Lun, K. (2015). Reexamining the red herring effect on healthcare expenditures. Journal of Business Research, 68(4), 783 - 787.