Üniversite Hastanesi Yataklı Tedavi Servislerinin Verimliliğinin Değerlendirilmesi

Abstract

Sağlık hizmeti sunumunda önemli bir yeri olan hastanelerin kesintisiz hizmet sunumu için verimli çalışmaları önemlidir. Bu bağlamda ilk yapılması gereken hastanelerin verimliliklerinin ölçülmesidir. Nitekim, ölçülen bir kurumun yönetimi de kolaydır. Özellikle, artan sağlık harcamaları nedeniyle önemli hale gelen verimli hizmet sunumu için mevcut durumun değerlendirilmesi avantajdır. Bu kapsamda çalışmada Türkiye’deki bir üniversite hastanesinin yataklı tedavi servislerinin verimliliğini değerlendirmek amaçlanmıştır. İlgili hastanenin verimliliği Pabon Lasso modeli ile analiz edilmiştir. Araştırma dönemi ulaşılabilen en güncel veri dönemi olarak 2020-2024 yılları şeklinde belirlenmiştir. Bu yıllara ait yatak sayısı, yatak doluluk oranı, yatak devir hızı ve ortalama kalış günü verileri alınmıştır. Araştırma verileri Ocak 2025 döneminde elde edilmiştir. Elde edilen veriler her yıl için ayrı ayrı Pabon Lasso modeliyle değerlendirilerek, yataklı tedavi servisleri yatak kullanım verimlilikleri yıllık bazda kıyaslanmıştır. En komplike vakaların tedavi edildiği üniversite hastanelerinin sağlık hizmeti sunumundaki konumu göz önüne alındığında verimliliğe yönelik bir değerlendirmenin önemi anlaşılmaktadır. Bu konudaki sınırlı literatür düşünüldüğünde araştırmanın özgün değeri ortaya çıkmaktadır. Araştırma kapsamındaki hastanenin en yüksek yatak sayısı Dahiliye, en düşük yatak sayısı ise Dermatoloji kliniğine aittir. Hastanenin yıllara göre ortalama kalış günü ortalaması 2020 yılında 10.17, 2021’de 11.45, 2022’de 11.40, 2023’te 10.93 ve 2024 yılında 11.34’tür. Hastanenin ortalama yatak devir hızı 2020’de 38.04, 2021’de 38.29, 2022’de 37.50, 2023’te 35.48 ve 2024 döneminde 34.31’dir. Hastanenin yatak doluluk oranı ortalaması ise 2020’de 69.58, 2021’de 69.59, 2022’de, 66.35, 2023’te 65.75 ve 2024’te 65.39’dur. Yatak doluluk oranı, yatak devir hızı ve ortalama kalış günü verileri Pabon Lasso modeliyle analiz edilerek klinikler verimlilik düzeylerine göre dört bölgeye ayrılmıştır. Buna göre kliniklerin 2020’de %31.82’si, 2021 ve 2022’de %22.73’ü, 2023’te %13.64’ü ve 2024’te %18.18’i verimsiz bölge olan 1. bölgede konumlanmıştır. Kliniklerin 2020’de %13.64’ü, 2021 ve 2022’de %4.55’i, 2023 ve 2024’te %27.27’si yatak doluluk oranı açısından verimsiz, yatak devir hızı açısından verimli olan 2. bölgede yer almaktadır. Verimli olan 3. bölgede ise 2020’de kliniklerin %22.73’ü konumlanmaktayken 2021’de bu oran %36.36’ya yükselmiş, 2022’de %27.27’ye gerilemiş, 2023’te %13.64’e ve 2024’te %9.09’a gerileyerek düşüş devam etmiştir. Kliniklerin 2020’de %31.82’si, 2021’de %36.36’sı, 2022-2024 döneminde %45.45’i yatak doluluk oranı açısından verimli, yatak devir hızı açısından verimsiz olan 4. bölgede konumlanmıştır. Hastanenin uzun ortalama kalış gününe ve düşük yatak devir hızına sahip olduğu; verimli bölgedeki kliniklerin zamanla azaldığı, Üroloji, Ortopedi, Kulak Burun Boğaz ve Çocuk Cerrahisi kliniklerinin nispeten daha verimli olduğu; Dermatoloji, Nöroşirurji ve Çocuk Enfeksiyon kliniklerinin verimsiz olduğu sonucuna ulaşılmıştır. Gelecek çalışmalarda, hastalık veya tanı türleri gibi daha detaylı kategorilere yönelik verimlilik araştırmaları faydalı olacaktır. Verimsizliği etkileyen çeşitli faktörlerin tespit edilmesine yönelik araştırmalar yapılması önerilmektedir.

Keywords

• Klinik
• hastane
• Pabon Lasso
• performans
• verimlilik

Evaluation of the Efficiency of Inpatient Treatment Services of University Hospital

Abstract

It is important that hospitals, which play an important role in providing health care, operate efficiently to ensure continuity of service. The first step is to measure the efficiency of hospitals. It is easy to manage a measured institution. In particular, evaluating the current situation for efficient service delivery is advantageous and has become important due to increasing health expenditure. In this context, this study aims to evaluate the efficiency of inpatient services at a university hospital in Turkey. The efficiency of the relevant hospital was analysed using the Pabon Lasso model. The research period was determined as the most recent data period available, covering the years 2020-2024. The following data were collated: the number of beds, the bed occupancy rate, the bed turnover rate, and the average length of stay for the specified years. The research data was obtained in January 2025. The data obtained was evaluated separately for each year using the Pabon Lasso model, and the bed utilisation efficiency of inpatient treatment services was compared on an annual basis. Considering the position of university hospitals, where the most complicated cases are treated, in health care delivery, the importance of evaluating efficiency is understood. Considering the limited literature on the subject, the original value of the research becomes apparent. The hospital with the most beds in the study is the internal medicine clinic, and the dermatology clinic has the lowest number. The average length of stay in the hospital by year is 10.17 in 2020, 11.45 in 2021, 11.40 in 2022, 10.93 in 2023, and 11.34 in 2024. The hospital's average bed turnover rate is 38.04 in 2020, 38.29 in 2021, 37.50 in 2022, 35.48 in 2023 and 34.31 in 2024. The hospital's average bed occupancy rate is 69.58 in 2020, 69.59 in 2021, 66.35 in 2022, 65.75 in 2023 and 65.39 in 2024. The bed occupancy rate, bed turnover rate, and average length of stay data were analyzed using the Pabon Lasso model, and clinics were divided into four regions based on their efficiency levels. Accordingly, 31.82% of clinics were located in Region 1, which was identified as the least efficient region in 2020, 22.73% in 2021 and 2022, 13.64% in 2023, and 18.18% in 2024. In 2020, 13.64% of clinics were located in Region 2, 4.55% in 2021 and 2022, and 27.27% in 2023 and 2024. The region was found to be inefficient in terms of bed occupancy rate, but efficient in terms of bed turnover rate. In Region 3, which was adjudged to be efficient, the % of clinics located there increased from 22.73% in 2020 to 36.36% in 2021, then declined to 27.27% in 2022, and continued to decline to 13.64% in 2023 and 9.09% in 2024. In 2020, 31.82% of clinics were located in Region 4, 36.36% in 2021, and 45.45% in the period from 2022 to 2024. While Region 4 demonstrated high efficiency in terms of bed occupancy rate, it exhibited inefficiency in terms of bed turnover rate. It was concluded that the hospital has a long average length of stay and low bed turnover rate; clinics in the efficient zone are decreasing over time; urology, orthopedics, otorhinolaryngology, and pediatric surgery clinics are relatively more efficient; and dermatology, Neurosurgery, and Pediatric Infection clinics are inefficient. In future studies, efficient research on more detailed categories, such as disease or diagnosis types, would be helpful. It is recommended that research be conducted to identify the various factors that contribute to inefficiency.

Keywords

• Clinic
• hospital
• Pabon Lasso
• performance
• productivity

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