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ASSESSMENT OF TÜRKİYE'S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX

Yıl 2024, Cilt: 27 Sayı: 3, 363 - 384, 26.09.2024

Ahmet Bahadır Şimşek

https://doi.org/10.61859/hacettepesid.1341813

Öz

Health systems assessment is critical to ensure the sustainability of health services. The interest of researchers in analysing health systems, which intensified during the pandemic, is motivated by the opportunity to identify weaknesses and propose changes. Health systems analyses provide valuable feedback for policy makers, especially in developing countries, which struggle with obstacles such as limited resources, financial constraints and deficiencies in health infrastructure. As a developing country, Türkiye has been striving to ensure equal access to health services through its health transformation programme. In the last decade, developments such as the increase in Syrian migrants and economic contraction have negatively affected this effort. This situation motivates the need to analyse the current situation in the Turkish health system and provide suggestions for improvement. The literature on the Turkish health system mostly focuses on broad health system indicators such as health service accessibility, efficiency, quality and user satisfaction. This study focuses on assessing the accessibility of health infrastructure resources. In the study, health infrastructure indicators related to the Turkish health system are evaluated on a province basis for the period from 2012 to 2021. The evaluation is based on the descriptive statistics of the dataset and the province-based health index. The findings show changing trends and gaps in access to health services with the increase in population in the period 2012-2021. Some variables (e.g. population per hospital and population per bed) show low variances, while others (e.g. population per intensive care bed) show large differences. These differences may indicate unequal development and investment in health infrastructure. For policy makers, they emphasise the need to develop policies to address these inequalities and to distribute resources equitably. Analysing the health index values shows inequalities in access to health resources in different provinces of Türkiye as a score. In particular, while some provinces such as Isparta and Bolu stand out with consistently high index scores, lower index scores in other provinces such as Şanlıurfa, Mardin, Ağrı and Şırnak indicate that inequalities in access to health services are faced. This index identifies changes and gaps in the distribution of health resources and shows policy makers priority areas for intervention.

Anahtar Kelimeler

Health Policy Health Infrastructure Health Index Score

Kaynakça

  • Akinci, F., Mollahaliloĝlu, S., Gürsöz, H., & Öĝücü, F. (2012). Assessment of the Turkish health care system reforms: A stakeholder analysis. Health Policy, 107(1), 21–30. https://doi.org/10.1016/J.HEALTHPOL.2012.05.002
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  • Bener, A., Alayoglu, N., Çatan, F., Torun, P., & Yilmaz, E. (2019). Health services management in Turkey: Failure or success? International Journal of Preventive Medicine, 10(1), 30. https://doi.org/10.4103/2008-7802.253420
  • Büken, N. Ö. (2009). The health system, health policies and health transformation program in Turkey. Medicine and Law, 28(1), 23–45.
  • Chen, L., Chen, T., Lan, T., Chen, C., & Pan, J. (2023). The Contributions of Population Distribution, Healthcare Resourcing, and Transportation Infrastructure to Spatial Accessibility of Health Care. Inquiry (United States), 60. https://doi.org/10.1177/00469580221146041
  • Currie, W. L., & Seddon, J. J. M. (2014). A cross-national analysis of eHealth in the European Union: Some policy and research directions. Information & Management, 51(6), 783–797. https://doi.org/10.1016/J.IM.2014.04.004
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  • Fleurbaey, M., & Schokkaert, E. (2009). Unfair inequalities in health and health care. Journal of Health Economics, 28(1), 73–90. https://doi.org/10.1016/J.JHEALECO.2008.07.016
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TANIMLAYICI ANALİZ VE SAĞLIK İNDEKSİ İLE TÜRKİYE'DEKİ İLLERİN SAĞLIK ALTYAPI GÖSTERGELERİYLE DEĞERLENDİRİLMESİ

Yıl 2024, Cilt: 27 Sayı: 3, 363 - 384, 26.09.2024

Ahmet Bahadır Şimşek

https://doi.org/10.61859/hacettepesid.1341813

Öz

Sağlık hizmetlerinin sürdürülebilirliğini sağlamak için sağlık sistemlerinin değerlendirilmesi kritiktir. Araştırmacıların sağlık sistemlerini analiz etmeye yönelik pandemi döneminde yoğunlaşan ilgisi zayıf noktaları belirleyerek değişiklikler önerme fırsatından motive olmaktadır. Özellikle sınırlı kaynaklar, mali kısıtlamalar ve sağlık altyapısındaki eksiklikler gibi engellerle boğuşan gelişmekte olan ülkelerde sağlık sistemlerinin analizi politika yapıcılar için değerli geri bildirim sağlamaktadır. Gelişmekte olan bir ülke olan Türkiye sağlıkta dönüşüm programı ile sağlık hizmetlerine eşit erişim sağlama çabası içerisindedir. Son on yılda Suriyeli göçmenlerin artışı ve ekonomik daralma gibi gelişmeler bu çabayı olumsuz etkilemektedir. Bu durum Türk sağlık sisteminde mevcut durumu analiz etme ve iyileştirme önerileri sunma ihtiyacını motive etmektedir. Türk sağlık sistemini ele alan literatür çoğunlukla sağlık hizmetine erişilebilirlik, verimlilik, kalite ve kullanıcı memnuniyeti gibi geniş sağlık sistemi göstergelerine odaklanmaktadır. Bu çalışma, sağlık altyapı kaynaklarının erişilebilirliğini değerlendirmeye odaklanmaktadır. Çalışmada Türkiye'nin sağlık sistemine ilişkin sağlık altyapı göstergeleri 2012'den 2021'e kadar olan dönemde il bazında değerlendirilmiştir. Değerlendirme veri setinin tanımlayıcı istatistikleri ve il bazlı hesaplanan sağlık endeksi üzerinden gerçekleştirilmiştir. Bulgular, 2012-2021 döneminde nüfusun artmasıyla birlikte sağlık hizmetlerine erişimdeki değişen eğilimleri ve boşlukları göstermektedir. Bazı değişkenlerde (örneğin, hastane başına nüfus ve yatak başına nüfus) düşük varyanslar gözlemlenirken, diğerleri (örneğin, yoğun bakım yatağı başına nüfus) büyük farklılıklar göstermektedir. Bu farklılıklar, sağlık altyapısında eşitsiz gelişimi ve yatırımı işaret eder. Politika yapıcılar için, bu eşitsizliklerin giderilmesine ve kaynakların adil bir şekilde dağıtılmasına yönelik politika geliştirme ihtiyacını vurgular. Sağlık indeksi değerlerinin incelenmesi, Türkiye'nin farklı illerinde sağlık kaynaklarına erişimdeki eşitsizlikleri skor olarak göstermektedir. Özellikle, Isparta ve Bolu gibi bazı iller sürekli yüksek indeks skorlarıyla dikkat çekerken, Şanlıurfa, Mardin, Ağrı ve Şırnak gibi diğer illerdeki daha düşük indeks puanları sağlık hizmetlerine erişimde eşitsizliklerin yaşandığını göstermektedir. Bu indeks, sağlık kaynaklarının dağılımındaki değişiklikleri ve eksiklikleri belirlemekte ve politika yapıcılarına müdahale için öncelikli bölgeleri göstermektedir.

Anahtar Kelimeler

Sağlık Politikası Sağlık Altyapısı Sağlık İndeksi Puanı

Kaynakça

  • Akinci, F., Mollahaliloĝlu, S., Gürsöz, H., & Öĝücü, F. (2012). Assessment of the Turkish health care system reforms: A stakeholder analysis. Health Policy, 107(1), 21–30. https://doi.org/10.1016/J.HEALTHPOL.2012.05.002
  • Ali Jadoo, S. A., Aljunid, S. M., Sulku, S. N., & Nur, A. M. (2014). Turkish health system reform from the people’s perspective: A cross sectional study. BMC Health Services Research, 14(1), 1–9. https://doi.org/10.1186/1472-6963-14-30
  • Baker, S., Chard, D., Ketterlin-Geller, L., Apichatabutra, C., & Doabler, C. (2009). Teaching writing to at-risk students: the quality of evidence for self-regulated strategy development. Exceptional Children, 75(3), 303-318. https://doi.org/10.1177/001440290907500303
  • Bener, A., Alayoglu, N., Çatan, F., Torun, P., & Yilmaz, E. (2019). Health services management in Turkey: Failure or success? International Journal of Preventive Medicine, 10(1), 30. https://doi.org/10.4103/2008-7802.253420
  • Büken, N. Ö. (2009). The health system, health policies and health transformation program in Turkey. Medicine and Law, 28(1), 23–45.
  • Chen, L., Chen, T., Lan, T., Chen, C., & Pan, J. (2023). The Contributions of Population Distribution, Healthcare Resourcing, and Transportation Infrastructure to Spatial Accessibility of Health Care. Inquiry (United States), 60. https://doi.org/10.1177/00469580221146041
  • Currie, W. L., & Seddon, J. J. M. (2014). A cross-national analysis of eHealth in the European Union: Some policy and research directions. Information & Management, 51(6), 783–797. https://doi.org/10.1016/J.IM.2014.04.004
  • Cutler, D. M., & Summers, L. H. (2020). The COVID-19 Pandemic and the $16 Trillion Virus. JAMA, 324(15), 1495–1496. https://doi.org/10.1001/JAMA.2020.19759
  • Deurzen, I., Oorschot, W., & Ingen, E. (2014). The link between inequality and population health in low and middle income countries: policy myth or social reality?. Plos One, 9(12). https://doi.org/10.1371/journal.pone.0115109
  • Dundar, M., & Ozdemir, S. Y. (2012). Overview of the Healthcare System in Turkey. Advances in Predictive, Preventive and Personalised Medicine, 1, 167–187. https://doi.org/10.1007/978-94-007-4602-2_10
  • Elola, J., Daponte, A., & Navarro, V. (1995). Health indicators and the organization of health care systems in Western Europe. American Journal of Public Health, 85(10), 1397–1401. https://doi.org/10.2105/AJPH.85.10.1397
  • Fagnani, F., & Dumenil, G. (1976). Health indicators or health system analysis? Extracts from a French survey. Social Indicators Research, 3(1), 37–74. https://doi.org/10.1007/BF00286163
  • Fang, P., Si-ping, D., Xiao, J., Liu, G., Xiang, F., & Wang, Y. (2010). Regional inequality in health and its determinants: evidence from China. Health Policy, 94(1), 14-25. https://doi.org/10.1016/j.healthpol.2009.08.002
  • Farajzadegan, Z., Javadi, A., Asgari, G., & Manzoori, L. (2007). Indicators of Utilization as a Means for Assessment of Health Information Management Systems. Health Information Management, 4(1), 23-31.
  • Fleurbaey, M., & Schokkaert, E. (2009). Unfair inequalities in health and health care. Journal of Health Economics, 28(1), 73–90. https://doi.org/10.1016/J.JHEALECO.2008.07.016
  • Groenewegen, P. P. (2013). Analyzing European health systems: Europe as a research laboratory. European Journal of Public Health, 23(2), 185–186. https://doi.org/10.1093/EURPUB/CKT032
  • Hafeez, A., Dangel, W. J., Ostroff, S. M., Kiani, A. G., Glenn, S. D., Abbas, J., Afzal, M. S., Afzal, S., Ahmad, S., Ahmed, A., Ahmed, H., Ali, L., Ali, M., Ali, Z., Arshad, M., Ashraf, T., Bhutta, Z. A., Bibi, S., Butt, Z. A., … Mokdad, A. H. (2023). The state of health in Pakistan and its provinces and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Global Health, 11(2), 229–243. https://doi.org/10.1016/S2214-109X(22)00497-1
  • Javad, S., Sheykholeslami, S., Rahmani, S., & Yousefi, A. A. (2015). Assessment of the access of the cities of Alborz province to healthcare infrastructure using TOPSIS and MORIS models. Management Issues in Healthcare System, 1(1), 38–48. https://doi.org/10.33844/MIHS.2015.60347
  • Ismail, M. (2020). Regional disparities in the distribution of Sudan’s health resources. Eastern Mediterranean Health Journal, 26(9), 1105-1114. https://doi.org/10.26719/emhj.20.056
  • Jiménez-Rubio, D., Smith, P., & Doorslaer, E. (2007). Equity in health and health care in a decentralised context: evidence from Canada. Health Economics, 17(3), 377-392. https://doi.org/10.1002/hec.1272
  • Kaltenthaler, E., Maheswaran, R., & Beverley, C. (2004). Population-based health indexes: a systematic review. Health Policy, 68(2), 245–255. https://doi.org/10.1016/J.HEALTHPOL.2003.10.005
  • Kruk, M. E., & Freedman, L. P. (2008). Assessing health system performance in developing countries: a review of the literature. Health Policy, 85(3), 263–276.
  • Lee, S. M., & Lee, D. (2020). Lessons Learned from Battling COVID-19: The Korean Experience. International Journal of Environmental Research and Public Health 2020, Vol. 17, Page 7548, 17(20), 7548. https://doi.org/10.3390/IJERPH17207548
  • Lee, S. Y., Kim, C. W., Seo, N. K., & Lee, S. E. (2017). Analyzing the Historical Development and Transition of the Korean Health Care System. Osong Public Health and Research Perspectives, 8(4), 247. https://doi.org/10.24171/J.PHRP.2017.8.4.03
  • Levin-Zamir, D., Sorensen, K., Su, T. T., Sentell, T., Rowlands, G., Messer, M., Pleasant, A., Saboga Nunes, L., Lev-Ari, S., & Okan, O. (2021). Health promotion preparedness for health crises – a ‘must’ or ‘nice to have’? Case studies and global lessons learned from the COVID-19 pandemic. Global Health Promotion, 28(2), 27–37. https://doi.org/10.1177/1757975921998639
  • Li, O. Y., Wang, X., Yang, K., Liu, D., & Shi, H. (2023). The approaching pilot for One Health governance index. Infectious Diseases of Poverty, 12(1), 1–10. https://doi.org/10.1186/S40249-023-01067-2
  • Liu, T., Li, J., Chen, J., & Yang, S. (2020). Regional Differences and Influencing Factors of Allocation Efficiency of Rural Public Health Resources in China. Healthcare, 8(3), 270. https://doi.org/10.3390/HEALTHCARE8030270
  • Mangano, A. (2010). An analysis of the regional differences in health care utilization in Italy. Health & Place, 16(2), 301–308. https://doi.org/10.1016/J.HEALTHPLACE.2009.10.013
  • Marcassoli, A., Leonardi, M., Passavanti, M., De Angelis, V., Bentivegna, E., Martelletti, P., & Raggi, A. (2023). Lessons Learned from the Lessons Learned in Public Health during the First Years of COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 20(3), 1785. https://doi.org/10.3390/IJERPH20031785/S1
  • Mollahaliloglu, S., Kavuncubasi, S., Yilmaz, F., Younis, M. Z., Simsek, F., Kostak, M., Yildirim, S., & Nwagwu, E. (2018). Impact of health sector reforms on hospital productivity in Turkey: Malmquist index approach. International Journal of Organization Theory and Behavior, 21(2), 72–84. https://doi.org/10.1108/IJOTB-03-2018-0025
  • Nguyen, N. H., Subhan, F. B., Williams, K., & Chan, C. B. (2020). Barriers and Mitigating Strategies to Healthcare Access in Indigenous Communities of Canada: A Narrative Review. Healthcare, 8(2), 112. https://doi.org/10.3390/HEALTHCARE8020112
  • Oguz, A. B. (2020). Turkish Health Policies: Past, Present, and Future. Social Work in Public Health, 35(6), 456–472. https://doi.org/10.1080/19371918.2020.1806167
  • Orkin, F. G. K. and A. M. (2020). Improving Health and Healthcare Access for People who Experience Imprisonment in Ontario. Healthcare Quarterly, 23(1), 6–9.
  • Presidency of Migration Management. (2023). Temporary Protection. https://en.goc.gov.tr/temporary-protection27
  • Puspitasari, D. A., & Bulan, S. O. (2021). The effect of accessibility and availability of health infrastructure on maternal healthcare utilization in Indonesia to achieve Sustainable Development Goals. IOP Conference Series: Earth and Environmental Science, 716(1), 012110. https://doi.org/10.1088/1755-1315/716/1/012110
  • Rothenberg, R., Stauber, C., Weaver, S., Dai, D., Prasad, A., & Kano, M. (2015). Urban health indicators and indices - Current status. BMC Public Health, 15(1), 1–14. https://doi.org/10.1186/S12889-015-1827-X
  • Sandman, L. and Hofmann, B. (2018). Why we don’t need “unmet needs”! on the concepts of unmet need and severity in health-care priority setting. Health Care Analysis, 27(1), 26-44. https://doi.org/10.1007/s10728-018-0361-2
  • Šídlo, L., & Maláková, K. (2022). Spatial Healthcare Accessibility: A District-Level Analysis of Travel for Outpatient Diabetology in Czechia. Healthcare, 10(2), 395. https://doi.org/10.3390/HEALTHCARE10020395
  • Staudinger, U., Fleeson, W., & Baltes, P. (1999). Predictors of subjective physical health and global well-being: similarities and differences between the united states and germany. Journal of Personality and Social Psychology, 76(2), 305-319. https://doi.org/10.1037/0022-3514.76.2.305
  • Sundararaman, T., Muraleedharan, V. R., & Ranjan, A. (2021). Pandemic resilience and health systems preparedness: lessons from COVID-19 for the twenty-first century. Journal of Social and Economic Development, 23(S2), 290–300. https://doi.org/10.1007/S40847-020-00133-X
  • Taqi, M., Bidhuri, S., Sarkar, S., Suhail Ahmad, W., Wangchok, P., Bidhuri, M., Sarkar, S., Ahmad, S., & Wangchok, W. (2017). Rural Healthcare Infrastructural Disparities in India: a Critical Analysis of Availability and Accessibility. Journal of Multidisciplinary Research in Healthcare, 3(2), 125–149. https://doi.org/10.15415/JMRH.2017.32011
  • Tatar, M., Mollahaliloǧlu, S., Sahin, B., Aydin, S., Maresso, A., & Hernández-Quevedo, C. (2011). Turkey: Health system review 2011. Health Systems in Transition, 13(6).
  • Tressel, T., & Ding, X. (2021). Global Corporate Stress Tests—Impact of the COVID-19 Pandemic and Policy Responses. IMF Working Papers, 2021(212), 1. https://doi.org/10.5089/9781513590820.001
  • TURKSTAT. (2023). Turkish Statistical Institute. https://www.tuik.gov.tr/
  • WB, & WHO. (2021). Tracking Universal Health Coverage. Tracking Universal Health Coverage. World Health Organization and World Bank. https://doi.org/10.1596/36724
  • Wilhelm, D., Lohmann, J., Allegri, M., Chinkhumba, J., Muula, A., & Brenner, S. (2019). Quality of maternal obstetric and neonatal care in low-income countries: development of a composite index. BMC Medical Research Methodology, 19(1). https://doi.org/10.1186/s12874-019-0790-0
  • World Health Organization. (2022). WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. World Health Organization (1–5). https://covid19.who.int/
  • Wulandari, R. D., Laksono, A. D., Rohmah, N., & Ashar, H. (2023). Regional differences in primary healthcare utilization in Java Region—Indonesia. Plos One, 18(3). https://doi.org/10.1371/JOURNAL.PONE.0283709
  • Zhu, D., Shi, X., Nicholas, S., & He, P. (2020). Regional disparities in health care resources in traditional Chinese medicine county hospitals in China. Plos One, 15(1). https://doi.org/10.1371/journal.pone.0227956
Toplam 49 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Yönetimi
Bölüm Makaleler
Yazarlar

Ahmet Bahadır Şimşek 0000-0002-7276-2376

Yayımlanma Tarihi 26 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 27 Sayı: 3

Kaynak Göster

APA Şimşek, A. B. (2024). ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX. Hacettepe Sağlık İdaresi Dergisi, 27(3), 363-384. https://doi.org/10.61859/hacettepesid.1341813
AMA Şimşek AB. ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX. HSİD. Eylül 2024;27(3):363-384. doi:10.61859/hacettepesid.1341813
Chicago Şimşek, Ahmet Bahadır. “ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX”. Hacettepe Sağlık İdaresi Dergisi 27, sy. 3 (Eylül 2024): 363-84. https://doi.org/10.61859/hacettepesid.1341813.
EndNote Şimşek AB (01 Eylül 2024) ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX. Hacettepe Sağlık İdaresi Dergisi 27 3 363–384.
IEEE A. B. Şimşek, “ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX”, HSİD, c. 27, sy. 3, ss. 363–384, 2024, doi: 10.61859/hacettepesid.1341813.
ISNAD Şimşek, Ahmet Bahadır. “ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX”. Hacettepe Sağlık İdaresi Dergisi 27/3 (Eylül 2024), 363-384. https://doi.org/10.61859/hacettepesid.1341813.
JAMA Şimşek AB. ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX. HSİD. 2024;27:363–384.
MLA Şimşek, Ahmet Bahadır. “ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX”. Hacettepe Sağlık İdaresi Dergisi, c. 27, sy. 3, 2024, ss. 363-84, doi:10.61859/hacettepesid.1341813.
Vancouver Şimşek AB. ASSESSMENT OF TÜRKİYE’S PROVINCES WITH HEALTH INFRASTRUCTURE INDICATORS USING DESCRIPTIVE ANALYSIS AND HEALTH INDEX. HSİD. 2024;27(3):363-84.
 Kapak Resmi İndir