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EXAMINING THE RELATIONSHIP BETWEEN DISABILITY ADJUSTED LIFE YEARS (DALYs) AND CURRENT HEALTH EXPENDITURES PER CAPITA BY COUNTRY INCOME GROUPS

Yıl 2024, Cilt: 27 Sayı: 3, 481 - 498, 26.09.2024
https://doi.org/10.61859/hacettepesid.1441815

Öz

Efforts to control increasing healthcare expenditures of countries highlight the necessity to evaluate the relationship between health outcomes and healthcare spending. Within this context, the primary aim of this study is to determine the relationship between per capita current health expenditure and Disability-Adjusted Life Years (DALY) in country groups classified by income levels. In line with the main objective of the study, it is intended to determine the trends of per capita current health expenditure and DALY from the year 2000 to 2019. Data were collected from the databases of the World Bank, the Institute for Health Metrics and Evaluation (IHME), and the World Health Organization. The study covers the years 2000 to 2019. Initially, a trend analysis was conducted. The Spearman correlation coefficient was used to test the relationship between DALY and per capita current health expenditure. The Kruskal-Wallis H test method was used to test the relationship between DALY and per capita current health expenditure within country groups. When a significant difference was detected among three or more groups, the Bonferroni correction was applied for pairwise comparisons of the variables. According to the analysis results, while per capita current health expenditure increased across all country groups from 2000 to 2019, DALY rates decreased. A significant negative relationship was found between per capita current health expenditure and DALY rates. Within country groups, a significant relationship between per capita current health expenditure and DALY was not found only in low-income economies. It is considered that improvements in health outcomes can be achieved by increasing health expenditures. Additionally, it was concluded that the cost per preventable DALY might vary according to income groups. It is hypothesized that the cost per preventable DALY in low-income countries might be lower than in high-income countries. In this regard, it is recommended that future studies calculate the cost per preventable DALY according to country groups and consider the social determinants of health that may be related to DALY, especially in low-income economies.

Kaynakça

  • Allotey, P., Reidpath, D., Kouame, A., & Cummins, R. (2003). The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegia in Australia an Cameroon. Social Science & Medicine, 57, 949-958.
  • Amiri, A., & Ventelou, B. (2012). Granger causality between total expenditure on health and GDP in OECD: evidence from the toda-yamamoto approach. Economic Latters, 116(3), 541-544.
  • Blum, D., & Holling, H. (2017). Spearman’s law of diminshing returns. A meta-analysis. Intelligence, 65, 60-66.
  • Bobadilla, J. L., Cowley, P., Musgrove, P., & Saxenian, H. (1994). Design, content and financing of an essential national package of health services. Bulletin of the World Health Organization, 72(4), 653-662.
  • Braveman, P., & Gottlieb, L. (2014). The social determinats of health: it’s time to consider the causes of the causes. Public Health Reports, 129, 19-31.
  • Chireshe, J., & Ocran M. K. (2020). Health care expenditure and health outcomes in sub-Saharan African countries. African Development Review, 32(3), 349-361.
  • Choi, I. A., Lee, J. S., Song, Y. W., & Lee, E. Y. (2019). Mortality, disability, and healthcare expenditure of patients with seropositive rheumatoid arthritis in Korea: a nationwide population-based study. PLoS One, 14(1), 1-12.
  • Cutler, D. M., & Ly, D. P. (2011). The (paper) work of medicine: understanding international medical coss. Journal of Economic Perspectives, 25(2), 3-25.
  • Daroudi, R., Sari, A. A., Nahvijou, A., & Faramarzi, A. (2021). Cost per DALY averted in low, middle- and high-income countries: evidence from the global burden of disease study to estimate the cost-effectiveness thresholds. Cost effectiveness and Resource Allocation, 19, 1-9.
  • Devleesschauwer, B., Havelaar, A. H., de Noordhout, C. M., Haagsma, J. A., Praet, N., Dorny, P., Duchateau, L., Torgerson, P. R., Van Oyen, H., & Speybroeck, N. (2014a). DALY calculation in practice: a stepwise approach. International Journal of Public Health, 59(3), 571-574.
  • Devleesschauwer, B., de Noordhout, C. M., Smit, G. S. A., Duchateau, L., Dorny, P., Stein, C., Van Oyen, H., & Speybroeck N. (2014b). Quantifying burden of disease to support public health policy in Belgium: opportunities and constraints. BMC Public Health, 14, 1-8.
  • Dieleman, J. L., Templin, T., Sadat, N., Reidy, P., Chapin, A., Foreman, K., Haakenstad, A., Evans, T., Murray, C. J. L., & Kurowski C. (2016). National spending on health by source for 184 countries between 2013 and 2040. Lancet, 387, 2521-2535.
  • Dragos, S. L., Mare, C., Dragos, C. M., Muresan, G. M., & Purcel, A. A. (2022). Does voluntary health insurance improve health and longevity? Evidence from European OECD countries. The European Journal of Health Economics, 23, 1397-1411.
  • Gallet, C. A., & Doucouliagos, H. (2017). The impact of heathcare spending on health outcomes: a meta-regression analysis. Social Science & Medicine, 179, 9-17.
  • GBD 2017 DALYs and HALE Collaborators (2018). Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet, 392, 1859-1922.
  • Houeninvo, H. G. (2022). Effects of health expenditures on infant and child mortality rates: a dynamic panel data analysis of 37 African countries. African Development Review, 34(2), 255-267. IHME (2023, Ekim 15). Global burden of disease results. https://vizhub.healthdata.org/gbd-results/
  • Jakovljevic, M., & Getzen, T. E. (2016). Growth of global health spending share in low and middle income coutries. Front. Pharmacol., 7(21), 1-4.
  • Khan, M. A. B., Soteriades, E. S., King, J., Govender, R., Hashim, M. J., Masood-Husain, S., Javaid, S. F., Al Darei, S. D. M. S., Al Sheryani, S. D., & Nauman J. (2020). Global trends and forecast of the burden of adverse effects of medical treatment: epidemiological analysis based on the global burden of disease study. Cureus, 12(3), 1-16.
  • Kothari, V. N., & Gulati, I. S. (1997). Disability-adjusted life year as a guide for heath policy. Economic and Political Weekly, 32(41), 2612-2617.
  • Krieger, N. (2001). A glossary for social epidemiology. J Epidemiol Community Health, 55(10), 693-700.
  • Lai, T., Habicht, J., & Kiivet, R. A. (2009). Measuring burden of disease in Estonia to support public health policy. European Journal of Public Health, 19(5), 541-547.
  • Linden, M., & Ray, D. (2017). Life expectancy effects of public and private health expenditures in OECD countries 1970-2012: panel time series approach. Economic Analysis and Policy, 56, 101-113.
  • Lopez, A. D., & Murray, C. J. L. (1998). The global burden of disease, 1990-2020. Nature Medicine, 4, 1241-1243. Mor, N. (2022). Lessons for developing countries from outlier country health systems. Frontiers in Public Health, 10, 1-12.
  • Murray, C. J. L. (1994). Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bulletin of the World Health Organizations, 72(3), 429-445.
  • Murray, C. J. L., & Acharya, A. K. (1997). Understanding DALYs (disability-adjusted life years). Journal of Health Economics, 16(6), 703-730.
  • Murray, C. J. L., & Lopez, A. D. (1996). Evidence-based health policy-lessons from the global burden of disease study. Science, 274(5288), 740-743.
  • Murray, C. J. L., Govindaraj, R., & Musgrove, P. (1994). National health expenditures: a global analysis. Bulletin of the World Health Organization, 72(4), 623-637.
  • Murray, C. J. L., Phil, D., & Lopez, A. D. (2013). Measuring the global burden of disease. The New England Journal of Medicine, 369, 448-457.
  • Neumann, P. J., Thorat, T., Zhong, Y., Anderson, J., Farquhar, M., Salem, M., Sandberg, E., Saret, C. J., Wilkinson, C., & Cohen J. T. (2016). A systematic review of cost-effectiveness studies reporting cost-per-DALY averted. PloS ONE, 11(12), 1-14.
  • Nghiem, S. H., & Connelly, L. B. (2017). Convergence and determinants of health expenditures in OECD countries. Health Economics Review, 7(1), 1-11.
  • Nixon, J., & Ulmann, P. (2006). The relationship between health care expenditure and health outcomes. The European Journal of Health Economics, 7, 7-18.
  • Ochalek, J., Lomas, J., & Claxton, K. (2018). Estimating health opportunity costs in low-income and middle-income countries: a noval approach and evidence from cross-country data. BMJ Global Health, 3, 1-10
  • OECD (2024, Ocak 7). Health at a glance 2023: OECD indicators. OECD Publishing, Paris. https://doi.org/10.1787/7a7afb35-en
  • Omri, A., Kahouli, B., & Montassar, K. (2023). Impacts of health expenditures and environmental degradation on health status – disability-adjusted life years and infant mortality. Frontiers in Public Health, 11, 1-15.
  • Prüss-Ustün, A., Wolf, J., Corvalan, C., Neville, T., Bos, R., & Neira, M. (2017). Diseases due to unhealthy environments: an updated estimate of the global burden of disease attributable to environmental determinants of health. Journal of Public Health, 39(3), 464-475.
  • Rezapour, A., Mousavi, A., Lotfi, F., Movahed, M. S., & Alipour, S. (2019). The effects of health expenditure on health outcomes based on the classification of public health expenditure: a panel data approach. Shiraz E-Medical Journal, 5, 1-7.
  • Roser, M., Ritchie, H., & Spooner, F. (2023, Eylül 10). Burden of disease. https://ourworldindata.org/burden-of-disease
  • Self, S., & Grabowski, R. (2003). How effective is public health expenditure in improving overall health? A cross-country analysis. Applied Economics, 35, 835-845.
  • Thornton, J. (2002). Estimating a health production function fort he US: some new evidence. Applied Economics, 34, 59-62.
  • Varbanova, V., Hens, N., & Beutels, P. (2023). Determinants of life-expectancy and disability-adjusted life years (DALYs) in European and organisation for economic co-operation and development (OECD) countries: a longitudinal analysis (1990-2019). SMM – Population Health, 24, 2-14.
  • Weaver, M. R., Joffe, J., Ciarametaro, M., Dubois, R. W., Dunn, A., Singh, A., Sparks, G. W., Stafford, L., Murray, C. J. L., & Dieleman, L. (2022). Health care spending effectiveness: estimates suggest that spending improved US health from 1996 to 2016. Health Affairs, 41(7), 994-1004.
  • WHO (2023, Ekim 15). Global health expenditure database. https://apps.who.int/nha/database/Select/Indicators/en
  • WHO (2024, Şubat 19). Social determinansts of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
  • World Bank (1993). World development reports, 1993: ınvesting in health. Oxford University Press.
  • World Bank (2023a, Ekim 15). Word bank country and lending groups. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups
  • World Bank (2023b, Aralık 5). Current Health Expenditure per capita (current US$). https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD
  • Xi, J. Y., Lin, X., & Hao, Y. T. (2022). Measurement and projection of the burden of disease attribute to population aging in 188 countries, 1990-2050: a population-based study. Journal of Global Health, 12, 1-14.

ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ

Yıl 2024, Cilt: 27 Sayı: 3, 481 - 498, 26.09.2024
https://doi.org/10.61859/hacettepesid.1441815

Öz

Ülkelerin artan sağlık harcamalarını kontrol altına alma çabası sağlık sonuçları ile sağlık harcamaları arasındaki ilişkinin değerlendirilmesi gerekliliğini ortaya çıkarmaktadır. Bu kapsamda çalışmanın temel amacı gelir düzeyine göre belirlenen ülke gruplarında kişi başı cari sağlık harcaması ve DALY arasındaki ilişkinin belirlenmesidir. Çalışmanın temel amacına bağlı olarak 2000 yılından 2019 yılına kadar kişi başı cari sağlık harcaması ve DALY eğiliminin belirlenmesi amaçlanmıştır. Dünya Bankası, Sağlık Ölçümleri ve Değerlendirme Enstitüsü (Institute for Health Metrics and Evaluation – IHME) ve Dünya Sağlık Örgütü veri tabanlarından veriler toplanmıştır. Veriler 2000 – 2019 yıllarını kapsamaktadır. Çalışmada öncelikle eğilim analizi gerçekleştirilmiştir. DALY ve kişi başı cari sağlık harcaması arasındaki ilişkinin test edilmesinde Spearman korelasyon katsayısı kullanılmıştır. Ülke grupları içerisinde DALY ve kişi başı cari sağlık harcaması arasındaki ilişkinin test edilmesinde ise Kruskal-Wallis H test yöntemi kullanılmıştır. Üç veya daha fazla grup arasında anlamlı fark tespit edildiğinde değişkenlerin ikili kıyaslanmasında Bonferroni düzeltmesi uygulanmıştır. Analiz sonuçlarına göre tüm ülke gruplarında 2000 – 2019 yılları arasında kişi başı cari sağlık harcaması artarken; DALY oranları azalmıştır. Kişi başı cari sağlık harcaması ile DALY oranı arasında negatif yönde anlamlı ilişki saptanmıştır. Ülke grupları içerisinde sadece düşük gelirli ekonomilerde kişi başı cari sağlık harcaması ve DALY arasında anlamlı ilişki tespit edilmemiştir. Sağlık harcamalarının artırılmasıyla sağlık sonuçlarında iyileşmelerin yaşanabileceği düşünülmektedir. Ayrıca gelir gruplarına göre önlenebilir DALY başı maliyetin de farklılaşabileceği sonucuna varılmıştır. Düşük gelirli ülkelerde DALY başı maliyetin yüksek gelirli ülkelere göre daha düşük olabileceği varsayılmaktadır. Bu doğrultuda sonraki çalışmalarda ülke gruplarına göre önlenebilir DALY başı maliyetin hesaplanması ve özellikle düşük gelirli ekonomilerde DALY ile ilişki olabilecek sağlığın sosyal belirleyicilerinin de değerlendirilmeye alınması önerilmektedir.

Etik Beyan

Çalışmaya dahil edilen ve analiz edilen veriler açık veri kaynaklarından elde edildiği için etik kurul iznine gerek bulunmamaktadır.

Destekleyen Kurum

Çalışma gerçekleştirilirken herhangi bir ticari kuruluştan veya kar amacı gütmeyen bir kuruluştan finansal destek alınmamıştır.

Kaynakça

  • Allotey, P., Reidpath, D., Kouame, A., & Cummins, R. (2003). The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegia in Australia an Cameroon. Social Science & Medicine, 57, 949-958.
  • Amiri, A., & Ventelou, B. (2012). Granger causality between total expenditure on health and GDP in OECD: evidence from the toda-yamamoto approach. Economic Latters, 116(3), 541-544.
  • Blum, D., & Holling, H. (2017). Spearman’s law of diminshing returns. A meta-analysis. Intelligence, 65, 60-66.
  • Bobadilla, J. L., Cowley, P., Musgrove, P., & Saxenian, H. (1994). Design, content and financing of an essential national package of health services. Bulletin of the World Health Organization, 72(4), 653-662.
  • Braveman, P., & Gottlieb, L. (2014). The social determinats of health: it’s time to consider the causes of the causes. Public Health Reports, 129, 19-31.
  • Chireshe, J., & Ocran M. K. (2020). Health care expenditure and health outcomes in sub-Saharan African countries. African Development Review, 32(3), 349-361.
  • Choi, I. A., Lee, J. S., Song, Y. W., & Lee, E. Y. (2019). Mortality, disability, and healthcare expenditure of patients with seropositive rheumatoid arthritis in Korea: a nationwide population-based study. PLoS One, 14(1), 1-12.
  • Cutler, D. M., & Ly, D. P. (2011). The (paper) work of medicine: understanding international medical coss. Journal of Economic Perspectives, 25(2), 3-25.
  • Daroudi, R., Sari, A. A., Nahvijou, A., & Faramarzi, A. (2021). Cost per DALY averted in low, middle- and high-income countries: evidence from the global burden of disease study to estimate the cost-effectiveness thresholds. Cost effectiveness and Resource Allocation, 19, 1-9.
  • Devleesschauwer, B., Havelaar, A. H., de Noordhout, C. M., Haagsma, J. A., Praet, N., Dorny, P., Duchateau, L., Torgerson, P. R., Van Oyen, H., & Speybroeck, N. (2014a). DALY calculation in practice: a stepwise approach. International Journal of Public Health, 59(3), 571-574.
  • Devleesschauwer, B., de Noordhout, C. M., Smit, G. S. A., Duchateau, L., Dorny, P., Stein, C., Van Oyen, H., & Speybroeck N. (2014b). Quantifying burden of disease to support public health policy in Belgium: opportunities and constraints. BMC Public Health, 14, 1-8.
  • Dieleman, J. L., Templin, T., Sadat, N., Reidy, P., Chapin, A., Foreman, K., Haakenstad, A., Evans, T., Murray, C. J. L., & Kurowski C. (2016). National spending on health by source for 184 countries between 2013 and 2040. Lancet, 387, 2521-2535.
  • Dragos, S. L., Mare, C., Dragos, C. M., Muresan, G. M., & Purcel, A. A. (2022). Does voluntary health insurance improve health and longevity? Evidence from European OECD countries. The European Journal of Health Economics, 23, 1397-1411.
  • Gallet, C. A., & Doucouliagos, H. (2017). The impact of heathcare spending on health outcomes: a meta-regression analysis. Social Science & Medicine, 179, 9-17.
  • GBD 2017 DALYs and HALE Collaborators (2018). Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet, 392, 1859-1922.
  • Houeninvo, H. G. (2022). Effects of health expenditures on infant and child mortality rates: a dynamic panel data analysis of 37 African countries. African Development Review, 34(2), 255-267. IHME (2023, Ekim 15). Global burden of disease results. https://vizhub.healthdata.org/gbd-results/
  • Jakovljevic, M., & Getzen, T. E. (2016). Growth of global health spending share in low and middle income coutries. Front. Pharmacol., 7(21), 1-4.
  • Khan, M. A. B., Soteriades, E. S., King, J., Govender, R., Hashim, M. J., Masood-Husain, S., Javaid, S. F., Al Darei, S. D. M. S., Al Sheryani, S. D., & Nauman J. (2020). Global trends and forecast of the burden of adverse effects of medical treatment: epidemiological analysis based on the global burden of disease study. Cureus, 12(3), 1-16.
  • Kothari, V. N., & Gulati, I. S. (1997). Disability-adjusted life year as a guide for heath policy. Economic and Political Weekly, 32(41), 2612-2617.
  • Krieger, N. (2001). A glossary for social epidemiology. J Epidemiol Community Health, 55(10), 693-700.
  • Lai, T., Habicht, J., & Kiivet, R. A. (2009). Measuring burden of disease in Estonia to support public health policy. European Journal of Public Health, 19(5), 541-547.
  • Linden, M., & Ray, D. (2017). Life expectancy effects of public and private health expenditures in OECD countries 1970-2012: panel time series approach. Economic Analysis and Policy, 56, 101-113.
  • Lopez, A. D., & Murray, C. J. L. (1998). The global burden of disease, 1990-2020. Nature Medicine, 4, 1241-1243. Mor, N. (2022). Lessons for developing countries from outlier country health systems. Frontiers in Public Health, 10, 1-12.
  • Murray, C. J. L. (1994). Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bulletin of the World Health Organizations, 72(3), 429-445.
  • Murray, C. J. L., & Acharya, A. K. (1997). Understanding DALYs (disability-adjusted life years). Journal of Health Economics, 16(6), 703-730.
  • Murray, C. J. L., & Lopez, A. D. (1996). Evidence-based health policy-lessons from the global burden of disease study. Science, 274(5288), 740-743.
  • Murray, C. J. L., Govindaraj, R., & Musgrove, P. (1994). National health expenditures: a global analysis. Bulletin of the World Health Organization, 72(4), 623-637.
  • Murray, C. J. L., Phil, D., & Lopez, A. D. (2013). Measuring the global burden of disease. The New England Journal of Medicine, 369, 448-457.
  • Neumann, P. J., Thorat, T., Zhong, Y., Anderson, J., Farquhar, M., Salem, M., Sandberg, E., Saret, C. J., Wilkinson, C., & Cohen J. T. (2016). A systematic review of cost-effectiveness studies reporting cost-per-DALY averted. PloS ONE, 11(12), 1-14.
  • Nghiem, S. H., & Connelly, L. B. (2017). Convergence and determinants of health expenditures in OECD countries. Health Economics Review, 7(1), 1-11.
  • Nixon, J., & Ulmann, P. (2006). The relationship between health care expenditure and health outcomes. The European Journal of Health Economics, 7, 7-18.
  • Ochalek, J., Lomas, J., & Claxton, K. (2018). Estimating health opportunity costs in low-income and middle-income countries: a noval approach and evidence from cross-country data. BMJ Global Health, 3, 1-10
  • OECD (2024, Ocak 7). Health at a glance 2023: OECD indicators. OECD Publishing, Paris. https://doi.org/10.1787/7a7afb35-en
  • Omri, A., Kahouli, B., & Montassar, K. (2023). Impacts of health expenditures and environmental degradation on health status – disability-adjusted life years and infant mortality. Frontiers in Public Health, 11, 1-15.
  • Prüss-Ustün, A., Wolf, J., Corvalan, C., Neville, T., Bos, R., & Neira, M. (2017). Diseases due to unhealthy environments: an updated estimate of the global burden of disease attributable to environmental determinants of health. Journal of Public Health, 39(3), 464-475.
  • Rezapour, A., Mousavi, A., Lotfi, F., Movahed, M. S., & Alipour, S. (2019). The effects of health expenditure on health outcomes based on the classification of public health expenditure: a panel data approach. Shiraz E-Medical Journal, 5, 1-7.
  • Roser, M., Ritchie, H., & Spooner, F. (2023, Eylül 10). Burden of disease. https://ourworldindata.org/burden-of-disease
  • Self, S., & Grabowski, R. (2003). How effective is public health expenditure in improving overall health? A cross-country analysis. Applied Economics, 35, 835-845.
  • Thornton, J. (2002). Estimating a health production function fort he US: some new evidence. Applied Economics, 34, 59-62.
  • Varbanova, V., Hens, N., & Beutels, P. (2023). Determinants of life-expectancy and disability-adjusted life years (DALYs) in European and organisation for economic co-operation and development (OECD) countries: a longitudinal analysis (1990-2019). SMM – Population Health, 24, 2-14.
  • Weaver, M. R., Joffe, J., Ciarametaro, M., Dubois, R. W., Dunn, A., Singh, A., Sparks, G. W., Stafford, L., Murray, C. J. L., & Dieleman, L. (2022). Health care spending effectiveness: estimates suggest that spending improved US health from 1996 to 2016. Health Affairs, 41(7), 994-1004.
  • WHO (2023, Ekim 15). Global health expenditure database. https://apps.who.int/nha/database/Select/Indicators/en
  • WHO (2024, Şubat 19). Social determinansts of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
  • World Bank (1993). World development reports, 1993: ınvesting in health. Oxford University Press.
  • World Bank (2023a, Ekim 15). Word bank country and lending groups. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups
  • World Bank (2023b, Aralık 5). Current Health Expenditure per capita (current US$). https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD
  • Xi, J. Y., Lin, X., & Hao, Y. T. (2022). Measurement and projection of the burden of disease attribute to population aging in 188 countries, 1990-2050: a population-based study. Journal of Global Health, 12, 1-14.
Toplam 47 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Ekonomisi, Sağlık Yönetimi
Bölüm Makaleler
Yazarlar

Deniz Tugay Arslan 0000-0002-9654-2263

Yayımlanma Tarihi 26 Eylül 2024
Gönderilme Tarihi 23 Şubat 2024
Kabul Tarihi 22 Temmuz 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 27 Sayı: 3

Kaynak Göster

APA Arslan, D. T. (2024). ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ. Hacettepe Sağlık İdaresi Dergisi, 27(3), 481-498. https://doi.org/10.61859/hacettepesid.1441815
AMA Arslan DT. ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ. HSİD. Eylül 2024;27(3):481-498. doi:10.61859/hacettepesid.1441815
Chicago Arslan, Deniz Tugay. “ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ”. Hacettepe Sağlık İdaresi Dergisi 27, sy. 3 (Eylül 2024): 481-98. https://doi.org/10.61859/hacettepesid.1441815.
EndNote Arslan DT (01 Eylül 2024) ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ. Hacettepe Sağlık İdaresi Dergisi 27 3 481–498.
IEEE D. T. Arslan, “ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ”, HSİD, c. 27, sy. 3, ss. 481–498, 2024, doi: 10.61859/hacettepesid.1441815.
ISNAD Arslan, Deniz Tugay. “ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ”. Hacettepe Sağlık İdaresi Dergisi 27/3 (Eylül 2024), 481-498. https://doi.org/10.61859/hacettepesid.1441815.
JAMA Arslan DT. ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ. HSİD. 2024;27:481–498.
MLA Arslan, Deniz Tugay. “ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ”. Hacettepe Sağlık İdaresi Dergisi, c. 27, sy. 3, 2024, ss. 481-98, doi:10.61859/hacettepesid.1441815.
Vancouver Arslan DT. ENGELLİLİĞE AYARLANMIŞ YAŞAM YILLARI (DALY) İLE KİŞİ BAŞI CARİ SAĞLIK HARCAMASI İLİŞKİSİNİN ÜLKE GELİR GRUPLARINA GÖRE İNCELENMESİ. HSİD. 2024;27(3):481-98.