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BİR SAĞLIK SORUNUNUN ÖTESİNDE: TÜRKİYE’DEKİ HASTA HAREKETLERİNİN SOSYOEKONOMİK BELİRLEYİCİLERİ

Yıl 2021, Cilt: 39 Sayı: 1, 121 - 131, 29.03.2021
https://doi.org/10.17065/huniibf.727481

Öz

Hasta hareketlerinin yapısının anlaşılması, sosyoekonomik olaylar arasındaki ilişkilerin daha iyi anlaşılmasını sağlayacaktır. Bu çalışmanın amacı, Türkiye’de şehirler arasındaki hasta hareketlerini etkileyen değişkenlerin tespit edilmesidir. Hasta hareketleri analiz edilirken sadece sağlık ile ilgili değişkenler değil, aynı zamanda sosyoekonomik, demografik ve coğrafik değişkenler de dikkate alındı. Kullanılan veri seti, 2010- 2013 yılları arasında yaşanan yer dışındaki sağlık merkezlerine başvuru yapan 40 milyondan fazla hastanın bilgilerinden oluşmaktadır. 70’ten fazla klinik arasından en çok başvuru yapılan kardiyoloji, çocuk hastalıkları, kadın doğum ve iç hastalıkları incelenmiştir. Zaman içerisinde değişmeyen değişkenlerin varlığından dolayı, Çekim Modeli temelinde Rassal Etkiler Regresyon Modeli kullanılarak tahminler yapılmıştır. Bütün kliniklerde, göç değişkeni ile hasta hareketleri arasında pozitif yönlü ve istatistiksel olarak anlamlı ilişki tespit edilmiştir. Şehirler arasındaki mesafe ile hasta hareketleri arasında negatif yönlü ilişki görülürken; komşu şehirlerde, bütün klinikler için, pozitif yönlü istatistiksel olarak anlamlı hasta hareketleri gözlemlenmiştir. Düşük gelirli illerden yüksek gelirli illere doğru bir hasta hareketi tespit edilmiştir. Sonuç olarak hasta hareketleri, sağlık ile ilgili değişkenlerin dışında, sosyoekonomik, demografik ve coğrafik değişkenlerden de etkilenmektedir. Çalışmadan elde edilen sonuçlar değerlendirilirken, sınırlı sayıda klinik değişkenlerinin dikkate alındığı da unutulmamalıdır.

Kaynakça

  • Akarca, A. T., Tansel, A. (2015). “Impact of internal migration on political participation in Turkey”, IZA Journal of Migration, 4(1), 1.
  • Akdağ, R. (2011). Turkey health transformation program evaluation report, 2003-2010 (MoH Publ, 839). Ankara: Republic of Turkey Ministry of Health.
  • Bruni, Lippi, M., Nobilio, L., Ugolini, C. (2008). “The analysis of a cardiological network in a regulated setting: a spatial interaction approach”, Health Economics, 17(2), 221-233.
  • Cantarero, D. (2006). “Health care and patients’ migration across Spanish regions. The European Journal of Health Economics”, 7(2), 114-116.
  • Casalino, L. P., Elster, A., Eisenberg, A., Lewis, E., Montgomery, J., Ramos, D. (2007). “Will pay-for-performance and quality reporting affect health care disparities?”, Health Affairs, 26(3), 405-414.
  • Dawson D, Jacobs R, Martin S, Smith P. (2004). “Is patient choice an effective mechanism to reduce waiting times?” Applied Health Economics and Health Policy, 3(4), 195-203.
  • Glinos IA, Baeten R, Helble M, Maarse H. (2010). “A typology of cross-border patient mobility”, Health & Place, 16 (6), 1145-1155.
  • Laugesen MJ, Vargas-Bustamante A. (2010). “A patient mobility framework that travels: European and United States–Mexican comparisons”, Health Policy, 97 (2-3), 225-231.
  • Legido-Quigley H, Glinos I, Baeten R, McKee M. (2007). “Patient mobility in the European Union”, BMJ, 334, 188.
  • Levaggi, R., Zanola, R. (2004). “Patients' migration across regions: the case of Italy”, Applied Economics, 36(16), 1751-1757.
  • Lewer, J. J., Van den Berg, H. (2008). “A gravity model of immigration”, Economics Letters, 99(1), 164-167.
  • Lunt N. (2015). “International patients on operation vacation: medical refuge and health system crisis”, International Journal of Health Policy and Management, 4(5): 323–325.
  • Paolella, G. (2012). “Pediatric health mobility: Is it only an Italian problem?”, Translational Medicine @ UniSa, 4, 57-61.
  • Ramos R. (2016). “Gravity Models: A tool for migration analysis”, IZA World of Labors, 239, 1-10.
  • Ringard, A., Hagen, T. P. (2011). “Are waiting times for hospital admissions affected by patients' choices and mobility?”, BMC Health Services Research, 11(1), 170.
  • Swan, M., Zwi, A. (1997). “Private practitioners and public health: close the gap or increase the distance?”, London: London school of hygiene & tropical medicine.
  • Tatar M, Mollahaliloglu S, Şahin B, Aydın S, Maresso A, Hernández-Quevedo C. (2011). “Turkey: Health system review”, Health Systems in Transition, 13(6):1–186.
  • Vrangbæk, K., Østergren, K., Birk, H. O., Winblad, U. (2007). “Patient reactions to hospital choice in Norway, Denmark, and Sweden”, Health Economics, Policy and Law, 2(2), 125-152.
  • Zuvekas, S. H., Taliaferro, G. S. (2003). “Pathways to access: health insurance, the health care delivery system, and racial/ethnic disparities, 1996–1999”, Health Affairs, 22(2), 139-153.

BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY

Yıl 2021, Cilt: 39 Sayı: 1, 121 - 131, 29.03.2021
https://doi.org/10.17065/huniibf.727481

Öz

Detecting and explaining patient mobility patterns allows us to better understand linkages between socioeconomic facts. This research aims to reveal variables that affect the patient mobility among cities in Turkey. It considers not only the health–related factors but also socioeconomic, demographic, and geographic variables to analyze the patient mobility. The data covers 40 million external patient admission to health facilities between 2010 and 2013. The most common clinics (cardiology, pediatric, obstetric, and internal diseases) selected to focus on branch level differences. The random effects regression model was used due to the presence of time-invariant variables on the basis of gravity model. There are statistically significant positive relationships between migration and patient mobility for all the clinics studied. The distance between two provinces has a negative impact on patient movements. Statistically significant relationships in patient mobility are observed for all clinics when two provinces are contiguous. It is observed that patients are moving from the low-income provinces to those having higher income. As a result, apart from the health-related variables, socioeconomic, demographic and geographical factors also have a substantial effect on patient mobility. While generalizing the results, it should be kept in mind that a limited number of clinics are studied.

Kaynakça

  • Akarca, A. T., Tansel, A. (2015). “Impact of internal migration on political participation in Turkey”, IZA Journal of Migration, 4(1), 1.
  • Akdağ, R. (2011). Turkey health transformation program evaluation report, 2003-2010 (MoH Publ, 839). Ankara: Republic of Turkey Ministry of Health.
  • Bruni, Lippi, M., Nobilio, L., Ugolini, C. (2008). “The analysis of a cardiological network in a regulated setting: a spatial interaction approach”, Health Economics, 17(2), 221-233.
  • Cantarero, D. (2006). “Health care and patients’ migration across Spanish regions. The European Journal of Health Economics”, 7(2), 114-116.
  • Casalino, L. P., Elster, A., Eisenberg, A., Lewis, E., Montgomery, J., Ramos, D. (2007). “Will pay-for-performance and quality reporting affect health care disparities?”, Health Affairs, 26(3), 405-414.
  • Dawson D, Jacobs R, Martin S, Smith P. (2004). “Is patient choice an effective mechanism to reduce waiting times?” Applied Health Economics and Health Policy, 3(4), 195-203.
  • Glinos IA, Baeten R, Helble M, Maarse H. (2010). “A typology of cross-border patient mobility”, Health & Place, 16 (6), 1145-1155.
  • Laugesen MJ, Vargas-Bustamante A. (2010). “A patient mobility framework that travels: European and United States–Mexican comparisons”, Health Policy, 97 (2-3), 225-231.
  • Legido-Quigley H, Glinos I, Baeten R, McKee M. (2007). “Patient mobility in the European Union”, BMJ, 334, 188.
  • Levaggi, R., Zanola, R. (2004). “Patients' migration across regions: the case of Italy”, Applied Economics, 36(16), 1751-1757.
  • Lewer, J. J., Van den Berg, H. (2008). “A gravity model of immigration”, Economics Letters, 99(1), 164-167.
  • Lunt N. (2015). “International patients on operation vacation: medical refuge and health system crisis”, International Journal of Health Policy and Management, 4(5): 323–325.
  • Paolella, G. (2012). “Pediatric health mobility: Is it only an Italian problem?”, Translational Medicine @ UniSa, 4, 57-61.
  • Ramos R. (2016). “Gravity Models: A tool for migration analysis”, IZA World of Labors, 239, 1-10.
  • Ringard, A., Hagen, T. P. (2011). “Are waiting times for hospital admissions affected by patients' choices and mobility?”, BMC Health Services Research, 11(1), 170.
  • Swan, M., Zwi, A. (1997). “Private practitioners and public health: close the gap or increase the distance?”, London: London school of hygiene & tropical medicine.
  • Tatar M, Mollahaliloglu S, Şahin B, Aydın S, Maresso A, Hernández-Quevedo C. (2011). “Turkey: Health system review”, Health Systems in Transition, 13(6):1–186.
  • Vrangbæk, K., Østergren, K., Birk, H. O., Winblad, U. (2007). “Patient reactions to hospital choice in Norway, Denmark, and Sweden”, Health Economics, Policy and Law, 2(2), 125-152.
  • Zuvekas, S. H., Taliaferro, G. S. (2003). “Pathways to access: health insurance, the health care delivery system, and racial/ethnic disparities, 1996–1999”, Health Affairs, 22(2), 139-153.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi
Yazarlar

Sayın San

Selman Delil

Yayımlanma Tarihi 29 Mart 2021
Gönderilme Tarihi 27 Nisan 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 39 Sayı: 1

Kaynak Göster

APA San, S., & Delil, S. (2021). BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY. Hacettepe Üniversitesi İktisadi Ve İdari Bilimler Fakültesi Dergisi, 39(1), 121-131. https://doi.org/10.17065/huniibf.727481
AMA San S, Delil S. BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. Mart 2021;39(1):121-131. doi:10.17065/huniibf.727481
Chicago San, Sayın, ve Selman Delil. “BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY”. Hacettepe Üniversitesi İktisadi Ve İdari Bilimler Fakültesi Dergisi 39, sy. 1 (Mart 2021): 121-31. https://doi.org/10.17065/huniibf.727481.
EndNote San S, Delil S (01 Mart 2021) BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 39 1 121–131.
IEEE S. San ve S. Delil, “BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY”, Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, c. 39, sy. 1, ss. 121–131, 2021, doi: 10.17065/huniibf.727481.
ISNAD San, Sayın - Delil, Selman. “BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY”. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 39/1 (Mart 2021), 121-131. https://doi.org/10.17065/huniibf.727481.
JAMA San S, Delil S. BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 2021;39:121–131.
MLA San, Sayın ve Selman Delil. “BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY”. Hacettepe Üniversitesi İktisadi Ve İdari Bilimler Fakültesi Dergisi, c. 39, sy. 1, 2021, ss. 121-3, doi:10.17065/huniibf.727481.
Vancouver San S, Delil S. BEYOND A HEALTH-RELATED ISSUE: SOCIOECONOMIC DETERMINANTS OF PATIENT MOBILITY IN TURKEY. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 2021;39(1):121-3.

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