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MODELING OF ACCESS TO HEALTH SERVICES IN TURKEY: THE COUNT DATA MODELS WITH A POISSON DISTRIBUTION

Yıl 2021, Cilt: 6 Sayı: 1, 397 - 426, 20.03.2021

Öz

In simple terms, access refers to people's ability to obtain and use quality health care technologies when they need. In this study, data collected by TurksStat, Turkish Statistical Institute, through Turkey Health Survey which was applied across the country was analyzed. This survey was carried out every two years, for the first time in 2008 and the last time in 2016. The aim of this study is to examine the level of access to health services in terms of some socio-demographic variables such as gender, age, education, health status and income in Turkey between the years 2008-2016. The results obtained with the analysis show that all variables differ according to years and they are statistically significant. According to the analysis conducted as part of the study, it was concluded that, in Turkey, the status of income and health insurance do not constitute a risk factor on the access to health services. It is thought that the presence of a social security system involving the whole country has an effect on this result. Considering from this point of view, in countries that do not have a strong social security system, out-of-pocket health spending and private health insurance increase the inequalities among the social segments. Therefore, private health insurances and income systems to reduce dependence on out-of-pocket health spending should be developed, and access to health services should not be an indicator of income. In this respect, more research is needed in which access to health services is evaluated from all aspects.

Kaynakça

  • Akaike, H. (1973). Information Theory and an Extension of the Maximum Likelihood Principle. In B. N. Petrov, & F. Csaki (Eds.), Proceedings of the 2nd International Symposium on Information Theory (pp. 267-281). Budapest: Akademiai Kiado
  • Cameron, A.C., Trivedi, P. K. (1998). Regression Analysis of Count Data, Cambridge University Press, United Kingdom. Committee on Economic, Social and Cultural Rights. The right to the highest attainable standard of health: 11/08/2000. E/C.12/2000/4, CESCR General Comment 14. Twenty-second session Geneva, 25 April–12 May 2000 Agenda item 3
  • Donabedian A. (1972). Models for organising the delivery of personal health services and criteria for evaluating them. Milbank Memorial Fund Quarterly 1972; 50: 103–154
  • Frost, L. J. and Reich. M. R. (2008). Access- How do good health technologies get to poor people in poor countries? Massachusetts: Harvard University Press
  • Goddard, M., Smith, P. (2001). Equity of access to health care services: Theory and evidence from the UK. Social Science & Medicine 53 (2001): 1149–1162. Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., Hudson, M. (2002). What does `access to health care’ mean? Journal of Health Services Research & Policy, 7(3):186–188.
  • Hofstetter, H., Dusseldorp, E., Zeileis, A., Schuller, A. A. (2016). Modeling Caries Experience: Advantages of the Use of the Hurdle Model. Caries Res; 50, 517-526. doi: https://doi.org/10.1159/000448197 .
  • Hogerzeil, H. V. And Mirza, Z. (2011). Access to Essential Medicines as Part of The Right to Health- The World Medicines Situation Report, 3rd edition http://www.who.int/medicines/areas/policy/world_medicines_situation/en/
  • Hu, M.C., Pavlicova, M., Nunes, E., (2011). Zero-Inflated and Hurdle Models of Count Data with Extra Zeros: Examples from an HIV-Risk Reduction Intervention Trial. The American journal of drug and alcohol abuse, 37, 367-75. https://doi.org/10.3109/00952990.2011.597280.
  • Hunt, P., and Khosla, R. (2008). "The human right to medicines", SUR 8 (2008), accessed October 15, 2020, https://sur.conectas.org/en/human-right-medicines/
  • J.F. Levesque, M.F. Harris and G. Russell. Patient-center access to health care: conceptual access of the interface of health system and populations. International Journal for Equity in Health, 12-18, 2013
  • Mechanic D. Illness behaviour. In: Medical sociology. A comprehensive text, 2nd edn. New York: The Free Press, 1978: 249–289
  • Millman ML. (1993). Access to health care in America. Washington, DC: Institute of Medicine, National Academy Press,
  • Mooney GH. Equity in health care: confronting the confusion. Effective Health Care 1983; 1: 179–185.
  • Mooney GH. And now for vertical equity? Some concerns arising from aboriginal health in Australia. Health Economics 1996; 5: 99–103
  • Mullahy, J. (1986). Spcification and testing in some modificd count data models. Journal of Econometrics, 33:341–365.
  • Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care 1981;19:127-40.
  • Penchansky R. The Concept of Access, a Definition. National Health Planning Information Center, Bureau of Health Planning Resources Development, Department of Health, Education and Welfare 1977.
  • Racher FE, Vollman AR. Exploring the dimensions of access to health services: implications for nursing research and practice. Res Theory Nurs Pract 2002;16:77-90.
  • Schwarz, G. (1978) Estimating the Dimension of a Model. Annals of Statistics, 6, 461-464. http://dx.doi.org/10.1214/aos/1176344136.
  • Sheu, M. L., Hu, T. W., Keeler, T. E., Ong, M., & Sung, H. Y. (2004). The effect of a major cigarette price change on smoking behavior in California: A zero-inflated negative binomial model. Health Economics, 13(8), 781-791. https://doi.org/10.1002/hec.849.
  • Stepurko, T., Pavlova, M., Groot, W. (2016). Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries BMC Health Services Research, 16(342):1-13. DOI 10.1186/s12913-016-1585-1
  • Thomas JW, Penchansky R. Relating satisfaction with access to utilization of services. Med Care 1984;22:553.
  • Zeileis, A., Kleiber, C., Jackman, S. (2008). Regression Models for Count Data in R. Journal of Statistical Software, 27(8), 1 - 25. http://dx.doi.org/10.18637/jss.v027.i08.
  • Vuong, Q. H., (1989), Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses, Econometrica,57(2),307-33, https://EconPapers.repec.org/RePEc:ecm:emetrp:v:57:y:1989:i:2:p:307-33.
  • WHO (2004). The World Medicines Situation
  • WHO (2008). Closing the gap in a generation : health equity through action on the social determinants of health : final report of the commission on social determinants of health
  • Xu, T., Zhu, G., Han, S. (2017). Study of depression influencing factors with zero-inflated regression models in a large-scale population survey. BMJ open, 7(11), e016471. https://doi.org/10.1136/bmjopen-2017-016471 .
Yıl 2021, Cilt: 6 Sayı: 1, 397 - 426, 20.03.2021

Öz

Kaynakça

  • Akaike, H. (1973). Information Theory and an Extension of the Maximum Likelihood Principle. In B. N. Petrov, & F. Csaki (Eds.), Proceedings of the 2nd International Symposium on Information Theory (pp. 267-281). Budapest: Akademiai Kiado
  • Cameron, A.C., Trivedi, P. K. (1998). Regression Analysis of Count Data, Cambridge University Press, United Kingdom. Committee on Economic, Social and Cultural Rights. The right to the highest attainable standard of health: 11/08/2000. E/C.12/2000/4, CESCR General Comment 14. Twenty-second session Geneva, 25 April–12 May 2000 Agenda item 3
  • Donabedian A. (1972). Models for organising the delivery of personal health services and criteria for evaluating them. Milbank Memorial Fund Quarterly 1972; 50: 103–154
  • Frost, L. J. and Reich. M. R. (2008). Access- How do good health technologies get to poor people in poor countries? Massachusetts: Harvard University Press
  • Goddard, M., Smith, P. (2001). Equity of access to health care services: Theory and evidence from the UK. Social Science & Medicine 53 (2001): 1149–1162. Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., Hudson, M. (2002). What does `access to health care’ mean? Journal of Health Services Research & Policy, 7(3):186–188.
  • Hofstetter, H., Dusseldorp, E., Zeileis, A., Schuller, A. A. (2016). Modeling Caries Experience: Advantages of the Use of the Hurdle Model. Caries Res; 50, 517-526. doi: https://doi.org/10.1159/000448197 .
  • Hogerzeil, H. V. And Mirza, Z. (2011). Access to Essential Medicines as Part of The Right to Health- The World Medicines Situation Report, 3rd edition http://www.who.int/medicines/areas/policy/world_medicines_situation/en/
  • Hu, M.C., Pavlicova, M., Nunes, E., (2011). Zero-Inflated and Hurdle Models of Count Data with Extra Zeros: Examples from an HIV-Risk Reduction Intervention Trial. The American journal of drug and alcohol abuse, 37, 367-75. https://doi.org/10.3109/00952990.2011.597280.
  • Hunt, P., and Khosla, R. (2008). "The human right to medicines", SUR 8 (2008), accessed October 15, 2020, https://sur.conectas.org/en/human-right-medicines/
  • J.F. Levesque, M.F. Harris and G. Russell. Patient-center access to health care: conceptual access of the interface of health system and populations. International Journal for Equity in Health, 12-18, 2013
  • Mechanic D. Illness behaviour. In: Medical sociology. A comprehensive text, 2nd edn. New York: The Free Press, 1978: 249–289
  • Millman ML. (1993). Access to health care in America. Washington, DC: Institute of Medicine, National Academy Press,
  • Mooney GH. Equity in health care: confronting the confusion. Effective Health Care 1983; 1: 179–185.
  • Mooney GH. And now for vertical equity? Some concerns arising from aboriginal health in Australia. Health Economics 1996; 5: 99–103
  • Mullahy, J. (1986). Spcification and testing in some modificd count data models. Journal of Econometrics, 33:341–365.
  • Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care 1981;19:127-40.
  • Penchansky R. The Concept of Access, a Definition. National Health Planning Information Center, Bureau of Health Planning Resources Development, Department of Health, Education and Welfare 1977.
  • Racher FE, Vollman AR. Exploring the dimensions of access to health services: implications for nursing research and practice. Res Theory Nurs Pract 2002;16:77-90.
  • Schwarz, G. (1978) Estimating the Dimension of a Model. Annals of Statistics, 6, 461-464. http://dx.doi.org/10.1214/aos/1176344136.
  • Sheu, M. L., Hu, T. W., Keeler, T. E., Ong, M., & Sung, H. Y. (2004). The effect of a major cigarette price change on smoking behavior in California: A zero-inflated negative binomial model. Health Economics, 13(8), 781-791. https://doi.org/10.1002/hec.849.
  • Stepurko, T., Pavlova, M., Groot, W. (2016). Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries BMC Health Services Research, 16(342):1-13. DOI 10.1186/s12913-016-1585-1
  • Thomas JW, Penchansky R. Relating satisfaction with access to utilization of services. Med Care 1984;22:553.
  • Zeileis, A., Kleiber, C., Jackman, S. (2008). Regression Models for Count Data in R. Journal of Statistical Software, 27(8), 1 - 25. http://dx.doi.org/10.18637/jss.v027.i08.
  • Vuong, Q. H., (1989), Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses, Econometrica,57(2),307-33, https://EconPapers.repec.org/RePEc:ecm:emetrp:v:57:y:1989:i:2:p:307-33.
  • WHO (2004). The World Medicines Situation
  • WHO (2008). Closing the gap in a generation : health equity through action on the social determinants of health : final report of the commission on social determinants of health
  • Xu, T., Zhu, G., Han, S. (2017). Study of depression influencing factors with zero-inflated regression models in a large-scale population survey. BMJ open, 7(11), e016471. https://doi.org/10.1136/bmjopen-2017-016471 .
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Makaleler
Yazarlar

Şükrü Anıl Toygar Bu kişi benim 0000-0002-3444-3243

Nihan Potas Bu kişi benim 0000-0002-0393-3135

Yayımlanma Tarihi 20 Mart 2021
Gönderilme Tarihi 13 Ekim 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 6 Sayı: 1

Kaynak Göster

APA Toygar, Ş. A., & Potas, N. (2021). MODELING OF ACCESS TO HEALTH SERVICES IN TURKEY: THE COUNT DATA MODELS WITH A POISSON DISTRIBUTION. International Journal of Health Management and Tourism, 6(1), 397-426.