SAĞLIK KAYNAKLARININ KULLANILABİLİRLİĞİ: TÜRKİYE VE SEÇİLİ OECD ÜLKELERİNİN KARŞILAŞTIRILMASI

Yıl 2021, Cilt: 24 Sayı: 3, 603 - 618, 29.09.2021

Şafak Kıran , Mahmut Akbolat

Öz

Bir ülkenin sağlık sistemindeki kaynakların göstergeleri, sağlığa erişimin önemli belirleyicileri olarak kabul edilebilir. Bu çalışma, sağlık hizmetlerine erişimin fiziksel boyutlarından biri olan “kullanılabilirlik” boyutu açısından Türkiye ile seçili OECD ülkeleri arasında bir karşılaştırma yapmaktadır. Bu amaçla on sağlık kaynağı göstergesi (her bin kişiye düşen hekim, hemşire, ebe, eczacı, diş hekimi, fizyoterapist, hastane ve hastane yatak sayısı, bir milyon kişiye düşen Bilgisayarlı Tomografi (BT) ve Manyetik Rezonans Görüntüleme (MRG) cihazı sayıları ve kişi başı cari sağlık harcaması (SGP, $)) ölçüm kriteri olarak kullanılmıştır. Çalışma, 2018 yılı için veri paylaşan 29 OECD ülkesini içermektedir. 2018 yılı için veri paylaşmayan ülkeler için son bildirimde bulunduğu yıla ait veriler kullanılmıştır. Veri elde etmek için OECD ve Dünya Sağlık Örgütü (WHO) sağlık istatistikleri veri tabanları kullanılmıştır. Verilerin analizinde çok kriterli bir karar verme yöntemi olan TOPSIS yöntemi kullanılmıştır. Araştırma bulgularına göre 29 ülke arasında ilk sırada Japonya (0,712), son sırada ise Türkiye (0,084) yer alıyor. Japonya'yı Almanya (0,519) ve ABD (0,467) gibi gelişmiş ülkeler takip etmektedir. Benzer sosyo-ekonomik statüye sahip diğer ülkelerle karşılaştırıldığında, Türkiye kişi başına daha az kaynağa sahiptir. Sonuç olarak, sağlıkla ilgili kaynak planlama sürecinde farklı ülkelerle yapılan karşılaştırmalar önemli görülmektedir..

Anahtar Kelimeler

Sağlık Hizmetlerine Erişim, Sağlık Kaynakları, Kullanılabilirlik, Türkiye, OECD

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

AVAILABILITY OF HEALTH RESOURCES: A COMPARISON OF TURKEY AND SELECTED OECD COUNTRIES

Öz

Indicators of resources in a country’s healthcare system can be considered as important determinants of access to health. This study makes a comparison between Turkey and selected OECD countries in terms of the “availability” dimension, which is one of the physical dimensions of access to healthcare. For this purpose, ten indicators of health resources (number of physicians, nurses, midwives, pharmacists, dentists, physiotherapists, hospitals and hospital beds per one thousand people, the number of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) devices per one million people, and current health expenditures per capita (PPP,$) were used as measurement criteria. The study includes 29 OECD countries that shared data for 2018. For the countries that did not share data for 2018, data for the year of the last shared was used. The health statistics databases of OECD and the World Health Organization (WHO) were used to obtain data. The TOPSIS method, which is a multi-criteria decision-making method was used to analyze the data. According to the research findings, Japan (0.712) ranks first, and Turkey (0.084) ranks last among the 29 countries. Japan is followed by developed countries such as Germany (0.519) and United States (0.467). Compared to other countries of similar socio-economic status, Turkey has fewer resources per capita. As a result, comparisons with different countries are important in the health-related resource planning process

Anahtar Kelimeler

Access to Healthcare, Health Resources, Availability, Turkey, OECD

Proje Numarası

Yok

Kaynakça

• Abedini, Z., Sari, A. A., Foroushani, A. R., & Jaafaripooyan, E. (2019). Diffusion of advanced medical imaging technology, CT, and MRI scanners, in Iran: A qualitative study of determinants. The International journal of health planning and management, 34(1), 397-410.
• Aday, L. A. & Andersen, R. A. (1974). Framework for the study of access to medical care. Health Services Research, 9(3), 208-220.
• Ahmadi, H., Rad, M. S., Nilashi, M., Ibrahim, O., & Almaee, A. (2013). Ranking the micro level critical factors of electronic medical records adoption using TOPSIS Method. Health Informatics, 4(2), 19-32.
• Akbolat, M. & Işık, O. (2008). Sağlık çalışanlarının tükenmişlik düzeyi: Bir kamu hastanesi örneği. Hacettepe Sağlık İdaresi Dergisi, 11(2), 229-254.
• Akdag, H., Kalaycı, T., Karagöz, S., Zülfikar, H., & Giz, D. (2014). The evaluation of hospital service quality by fuzzy MCDM. Applied Soft Computing Journal, 23, 239-248.
• Akdağ, R. (2007). Nereden nereye: Türkiye Sağlıkta Dönüşüm Programı Kasım 2002-Haziran 2007. T.C. Sağlık Bakanlığı Yayınları, Yayın No: 713.
• Amiri, M., Ayazi, S. A., Olfat, L., & Moradi, J. S. (2011). Group decision making process for supplier selection with VIKOR under fuzzy circumstance case study: An Iranian car parts supplier. International Bulletin of Business Administration, 10(6), 66-75.
• Andersen, R. M., McCutcheon, A., Aday, L. A., Chiu, G. Y., & Bell, R. (1983). Exploring dimensions of access to medical care. Health Services Research, 18(1), 49-74.
• Asadi, R. & Daryaei, M. (2011). Strategies for development of Iran health tourism. European Journal of Social Sciences, 23(3), 329-344.
• Balçık, P. Y. & Nangır, Ö. F. (2016). Avrupa ve Türkiye’de sağlık insan gücü ve sağlık teknolojileri. Ankara Medical Journal, 16(1), 90-97.
• Behera, D. K., & Dash, U. (2020). Healthcare financing in South-East Asia: Does fiscal capacity matter? International Journal of Healthcare Management, 13(sup1), 375-384.
• Black, M., Ebener, S., Aguilar, P. N., Vidaurre, M., & El Morjani, Z. (2004). Using GIS to measure physical accessibility to health care. World Health Organization.
• Bulut, T. & Durur, G. (2017). Türkiye’nin sağlık turizm performansının TOPSIS yöntemiyle değerlendirilmesi. Sağlık ve Sosyal Politikalara Bakış Dergisi, 1, 82-99.
• Büyüközkan, G., Çifçi, G. & Güleryüz, S. (2011). Strategic analysis of healthcare service quality using Fuzzy AHP Methodology. Expert Systems with Applications, 38(8), 9407-9424.
• Çakır, S. & Perçin, S. (2013). Çok kriterli karar verme teknikleriyle lojistik firmalarında performans ölçümü. Ege Akademik Bakış, 13(4), 449-459.
• Cristóbal, J. R. S. (2012). Contractor selection using multicriteria decision-making methods. Journal of Construction Engineering and Management, 138(6), 751-758.
• Docteur, E. & Oxley, H. (2003). Health-Care Systems: Lessons from the Reform Experience. OECD Health Working Papers, No. 9, OECD Publishing, Paris.
• Dursun, M., Karsak, E. & Karadayı, M. (2011). A fuzzy MCDM approach for healthcare waste management. International Journal of Industrial and Manufacturing Engineering, 5(1), 176-182.
• Eleren, A. & Karagül, M. (2008). 1986-2006 Türkiye ekonomisinin performans değerlendirmesi. Celal Bayar Üniversitesi İİBF Yönetim ve Ekonomi Dergisi, 15(1), 1-14.
• Ersöz, F. (2008). Türkiye ile OECD ülkelerinin sağlık düzeyleri ve sağlık harcamalarının analizi. İstatistikçiler Dergisi: İstatistik ve Aktüerya, 1(2), 95-104.
• Frenk, J. (1992). The concept and measurement of accessibility. In: White, K. L., editor. Health services research: An anthology (p. 842-855). Pan American Health Organization, Washington.
• Gavurová, B., Kováč, V., & Fedačko, J. (2017). Regional disparities in medical equipment distribution in the Slovak Republic–a platform for a health policy regulatory mechanism. Health Economics Review, 7(1), 1-13.
• Goddard, M. & Smith, P. (2001). Equity of access to health care services: Theory and evidence from the UK. Social Science & Medicine, 53(9), 1149-1162.
• Gözlü, M. & Tatlıdil, H. (2015). Türkiye’deki 81 ilin kamu tarafından sunulan sağlık hizmetlerine erişim durumları. Sosyal Güvenlik Dergisi, 5(2), 145-165.
• Hentschker, C., & Mennicken, R. (2015). The volume‐outcome relationship and minimum volume standards–empirical evidence for Germany. Health Economics, 24(6), 644-658.
• Hossein, T. M. M., Hamid, B. M. & Ali, M. S. (2012). Investigation and ranking of Iranian provinces in terms of access to health sector indicators. Health Information Management, 9(3), 356-369.
• Jin, Y., Zhu, W., Yuan, B., & Meng, Q. (2017). Impact of health workforce availability on health care seeking behavior of patients with diabetes mellitus in China. International Journal for Equity in Health, 16(1), 1-10.
• Jin, Y., Yuan, B., Zhu, W., Zhang, Y., Xu, L., & Meng, Q. (2019). The interaction effect of health insurance reimbursement and health workforce on health care‐seeking behaviour in China. The International Journal of Health Planning and Management, 34(3), 900-911.
• Kanuganti, S., Sarkar, A. K., & Singh, A. P. (2016). Quantifying accessibility to health care using two-step floating catchment area method (2SFCA): A case study in Rajasthan. Transportation Research Procedia, 17, 391-399.
• Kanuganti, S., Sarkar, A. K., Singh, A. P., & Arkatkar, S. S. (2015). Quantification of accessibility to health facilities in rural areas. Case Studies on Transport Policy, 3(3), 311-320.
• Khaing, M., Saw, Y. M., Than, T. M., Mon, A. M., Cho, S. M., Saw, T. N., ... & Hamajima, N. (2020). Geographic distribution and utilisation of CT and MRI services at public hospitals in Myanmar. BMC health services research, 20(1), 1-14.
• Kumar, A. and M. Schoenstein (2013). Managing hospital volumes: Germany and experiences from OECD countries. OECD Health Working Papers, No. 64, OECD Publishing, Paris.
• Kuo, R., Wu, Y. & Hsu, T. (2012). Integration of Fuzzy Set Theory and TOPSIS into HFMEA to improve outpatient service for elderly patients in Taiwan. Journal of the Chinese Medical Association, 75(7), 341-348.
• Kurt, Ö. (2007). Ülkemizde sağlik hizmetlerine erişim sorunlu mudur? Aile hekimliği bu sorunu çözebilir mi? In M Eskiocak (ed.). Kentsel bölgede sağlik örgütlenmesi: Çok sektörlü yaklaşım “Aile hekimliği ülkemiz için uygun bir model midir?” (s.69-78). Türk Tabipleri Birliği Yayınları, Ankara.
• Lai, G. (2018). An initial investigation and analysis of healthcare expenditures in Hong Kong. International Journal of Healthcare Management, 11(4), 363-370.
• Levesque, J. F., Harris, M. F. & Russell, G. (2013). Patient-centered access to health care: conceptualising access at the ınterface of health systems and populations. International Journal for Equity in Health, 12(18), 1-9.
• Liao, H., Chen, Y. & Chang, H. (2011). The APP strategies selected in SCM of the hospital. International Journal of Services, Technology and Management, 15(3-4), 298-313.
• Lin, C. & Tsai, M. (2010). Evaluating the optimal city in south china for new medical facilities: The application modified Porter's diamond framework. Journal of Testing and Evaluation, 38(4), 1-11.
• Matsumoto, M., Koike, S., Kashima, S., & Awai, K. (2015). Geographic distribution of CT, MRI and PET devices in Japan: A longitudinal analysis based on national census data. PLoS One, 10(5), e0126036.
• McGrail, M. R. (2012). Spatial accessibility of primary health care utilising the two-step floating catchment area method: an assessment of recent improvements. International Journal of Health Geographics, 11(1), 1-12.
• Mcintyre, D., Meheus, F., & Røttingen, J. A. (2017). What level of domestic government health expenditure should we aspire to for universal health coverage? Health Economics, Policy and Law, 12(2), 125-137.
• Moreno-Serra, R., & Smith, P. C. (2015). Broader health coverage is good for the nation's health: Evidence from country level panel data. Journal of the Royal Statistical Society. Series A,(Statistics in Society), 178(1), 101.
• OECD health statistics database. (cited 2020 April 10). Available from: http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT.
• Ogbole, G. I., Adeyomoye, A. O., Badu-Peprah, A., Mensah, Y., & Nzeh, D. A. (2018). Survey of magnetic resonance imaging availability in West Africa. Pan African Medical Journal, 30(1), 1-9.
• Onega, T., Duell, E. J., Shi, X., Wang, D., Demidenko, E., & Goodman, D. (2008). Geographic access to cancer care in the U.S. American Cancer Society, 112(4), 909-918.
• Özdemir, M. (2015). TOPSIS, İçinde B. F. Yıldırım, E. Önder (ed.). İşletmeciler, mühendisler ve yöneticiler için operasyonel, yönetsel ve stratejik problemlerin çözümünde çok kriterli karar verme yöntemleri (s133-153). Dora Basım-Yayın Dağıtım, Bursa.
• Paris, V., M. Devaux, & L. Wei (2010). Health systems institutional characteristics: A survey of 29 OECD countries. OECD Health Working Papers, No. 50, OECD Publishing, Paris.
• Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Hafizur Rahman, M. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136(1), 161-171.
• Reeves, A., Gourtsoyannis, Y., Basu, S., McCoy, D., McKee, M., & Stuckler, D. (2015). Financing universal health coverage—effects of alternative tax structures on public health systems: Cross-national modelling in 89 low-income and middle-income countries. The Lancet, 386(9990), 274-280.
• Russell, D. J., Humphreys, J. S., Ward, B., Chisholm, M., Buykx, P., McGrail, M., & Wakerman, J. (2013). Helping policymakers address rural health access problems. Australian Journal of Rural Health, 21(2), 61-71.
• Sağlık Bakanlığı (2011). Sağlıkta İnsan Kaynakları 2023 Vizyonu. Sağlık Bakanlığı Yayınları, Yayın No:851.
• Shengelia, B., Murray, C. J. & Adams, O. B. (2003). Beyond access and utilization: Defining and measuring health system coverage. Health Systems Performance Assessment: Debates, Methods and Empiricism (p.221-234) .World Health Organization, Geneva.
• Sığırlı, D., Ediz, B., Cangür, Ş., Ercan, İ., & Kan, İ. (2006). Türkiye ve Avrupa Birliği’ne üye ülkelerin sağlık düzeyi ölçütlerinin çok boyutlu ölçekleme analizi ile incelenmesi. İnönü Üniversitesi Tıp Fakültesi Dergisi, 13(2), 81-85.
• Sungur, C. (2016). Sağlık göstergelerine göre Ekonomik Kalkınma ve İşbirliği Örgütü ülkelerinin kümeleme analizi. Sosyal Güvenlik Dergisi, 6(1), 197-224.
• Tadić, D., Stefanović, M. & Aleksić, A. (2014). The evaluation and ranking of medical device suppliers by using Fuzzy Topsis methodology. Journal of Intelligent &Fuzzy Systems, 27(4), 2091-2101.
• Ursilica, T. E. (2016). The relationship between health care needs and accessibility to health care services in Botosani County-Romania. Procedia Environmental Sciences, 32, 300-310.
• Uzun, S. & Kazan, H. (2016). Çok kriterli karar verme yöntemlerinden AHP TOPSIS ve PROMETHEE karşılaştırılması: Gemi inşada ana makine seçimi uygulaması. Journal of Transportation and Logistics, 1(1), 99-113.
• Wang, F. & Luo, W. (2005). Assessing spatial and nonspatial factors for healthcare access: Towards an integrated approach to defining health professional shortage areas. Health & Place, 11(2), 131-146.
• Wang, X. & Pan, J. (2016). Assessing the disparity in spatial access to hospital care in ethnic minority region in Sichuan province, China. BMC Health Services Research, 16(1), 1-11.
• Waters, H. R. (2000). Measuring equity in access to health care. Social Science & Medicine, 51(4), 599-612.
• World Health Organization (1999). The health for all policy framework for the WHO European Region. World Health Organization, Geneva.
• World Health Organization (WHO) health statistics data repository. (cited 2020 April 10). Available from: http://apps.who.int/gho/data/node.main.HWF
• Yao, J., Wang, H., Yin, J., Shao, D., Guo, X., Sun, Q., & Yin, X. (2020). Factors associated with the utilization of community-based diabetes management care: A cross-sectional study in Shandong Province, China. BMC Health Services Research, 20, 1-10.
• Yetim, B., İlgün, G., Çilhoroz, Y., Demirci, Ş., & Konca, M. (2020). The socioeconomic determinants of health expenditure in OECD: An examination on panel data. International Journal of Healthcare Management, 1-5.