Assessment of Long-Term Care Efficiency: A Research on OECD Countries

Abstract

Increasing aging population has led to the emergence of some conditions that require special care for older people.
These conditions are called long-term care (LTC) conditions. LTC services should be used to meet the needs of
the elderly who face LTC conditions. With the increase in this usage, the efficiency of LTC services has become
a matter of debate. Data Envelopment Analysis (DEA) method which is used to measure relative efficiency of
input and output variables was used in this study which aims to examine the LTC efficiencies of OECD countries.
Population ratio of 65 and over, LTC expenditures, insufficient physical activity ratio, alcohol use amount,
smoking amount and obesity rate as input variables; the mortality rate of 65 years and older was included in the
analysis as an output variable. As a result of the analysis, Turkey, Sweden, Portugal, Slovakia, Mexico, Korea,
Japan, Israel, Iceland, Greece, Finland and Australia were found efficient in terms of input and output variables
were used. It has been thought that the inefficient countries are in a relatively worse situation in terms of the
variables used in this study play a role in this result. 

Keywords

• Aging
• Long-term Care
• Efficiency
• Data Envelopment Analysis
• OECD

Uzun Dönemli Bakım Etkinliğinin Değerlendirilmesi: OECD Ülkeleri Üzerinde Bir Araştırma

Öz

Her geçen gün yaşlanan nüfusun artması bu kişilere yönelik özel bakım gerektiren birtakım durumların ortaya
çıkmasına yol açmıştır. Bunlar uzun dönemli bakım (UDB) durumları olarak adlandırılmaktadır. UDB gerektiren
durumlarla karşı karşıya kalan yaşlıların ihtiyaçlarını karşılamak için UDB hizmetlerinin kullanılması
gerekmektedir. Bu kullanımın artmasıyla birlikte UDB hizmetlerinin etkinliği tartışma konusu haline gelmiştir.
OECD ülkelerinin UDB etkinliklerinin incelenmesi amaçlanan bu çalışmada girdi ve çıktı değişkenlerinin göreli
etkinliğini ölçmeye yarayan Veri Zarflama Analizi (VZA) yöntemi kullanılmıştır. 65 yaş ve üzeri nüfus oranı,
UDB harcamaları, yetersiz fiziksel aktivite oranı, alkol kullanım miktarı, sigara kullanım miktarı ve obezite oranı
girdi değişkenleri olarak; 65 yaş ve üzeri ölüm oranı ise çıktı değişkeni olarak analize dâhil edilmiştir. Analiz
sonucunda, Türkiye, İsveç, Portekiz, Slovakya, Meksika, Kore, Japonya, İsrail, İzlanda, Yunanistan, Finlandiya
ve Avustralya kullanılan girdi ve çıktı değişkenleri bakımından etkin bulunmuştur. Etkinsiz olan ülkelerin
kullanılan değişkenler bakımından nispeten daha kötü durumda olmalarının bu sonucun ortaya çıkmasında rol
oynadığı düşünülmektedir. 

Anahtar Kelimeler

• Yaşlanma
• Uzun Dönemli Bakım
• Etkinlik
• Veri Zarflama Analizi
• OECD

Kaynakça

1. Al-Mezeini, N. K., Oukil, A. ve Al-Ismaili, A. M. (2020). Investigating The Efficiency Of Greenhouse Production In Oman: A Two-Stage Approach Based On Data Envelopment Analysis And Double Bootstrapping. Journal Of Cleaner Production, 247, 119160.
2. Andryushchenko, G. I., Savina, M. V., Soldatov, A. A., Bikbulatova, A. A. ve Samofatova, K. A. (2019). Efficiency Improvement Of Long-Term Care For Senior Citizens İn The Russian Federation. Academic Journal Of Interdisciplinary Studies, 8(2), 58-67.
3. Barlow, J., Singh, D., Bayer, S. ve Curry, R. (2007). A Systematic Review Of The Benefits Of Home Telecare For Frail Elderly People And Those With Long-Term Conditions. Journal Of Telemedicine And Telecare, 13(4), 172–179. Doi:10.1258/135763307780908058.
4. Chang, S., Yang, W. ve Deguchi, H. (2020). Care Providers, Access To Care, And The Long-Term Care Nursing Insurance In China: An Agent-Based Simulation. Social Science & Medicine, 244, 112667.
5. Charnes, A., Cooper, W. W. ve Rhodes, E. (1978). Measuring The Efficiency Of Decision Making Units. European Journal Of Operational Research, 2(6), 429-444.
6. Csákvári, T., Turcsányi, K., Endrei, D., Vajda, R., Danku, N. ve Boncz, I. (2015). Assessing The Efficiency Of The Long-Term Care Hospital Units In Hungary Between 2006 And 2013. Value in Health, 18(7), A527-A528.
7. Demirci, Ş., Yetim, B. ve Konca, M. (2020). OECD Ülkelerinde Uzun Dönemli Bakım Hizmetlerinin Etkinliğinin Değerlendirilmesi. Anemon Muş Alparslan Üniversitesi Sosyal Bilimler Dergisi, 8(1): X-X.
8. Dintrans, P.V. (2020). Designing Long-Term Care Systems: Elements To Consider. Journal Of Aging & Social Policy, 32(1), 83-99.

9. Fu, L., Sun, Z., He, L., Liu, F. ve Jing, X. (2019). Global Long-Term Care Research: A Scientometric Review. International Journal Of Environmental Research And Public Health, 16(12), 2077.
10. George, J. ve Martin, F. (2014). Living With Long-Term Conditions. London: British Medical Association.
11. Ghiyasi, M. (2019). A Dea Production Technology And Its Usage For Incorporation Of Collaboration In Efficiency Analysis:An Axiomatic Approach. International Transactions İn Operational Research, 26, 1118–1134.
12. Golany, B. ve Roll, Y. (1989). An Application Procedure For DEA. Omega, 17(3), 237-250.
13. Hirose, K. ve Czepulis-Rutkowska, Z. (2016). Challenges İn Long-Term Care Of The Elderly İn Central And Eastern Europe. Switzerland: International Labour Organization Publishing.
14. Huber, M., Rodrigues, R., Hoffmann, F., Gasior, K. ve Marin, B. (2009). Facts And Figures On Long-Term Care: Europe And North America; Occasional Reports Series 6. Vienna: European Center.
15. International Actuarial Association. (2017). Long-Term Care: An Actuarial Perspective On Societal And Personal Challeng. Canada: International Actuarial Association.
16. Kane, R.A. (2001). Long-Term Care And A Good Quality Of Life: Bringing Them Closer Together. Gerontologist, 41, 293–304. Kaye, H.S., Harrington, C. ve Laplante, M.P. (2010). Long-Term Care: Who Gets It, Who Provides It, Who Pays, And How Much?. Health Aff. 29, 11–21.
17. Kocaman, A. M., Mutlu, M. E., Bayraktar, D. ve Araz, Ö. M. (2012). OECD Ülkelerinin Sağlık Sistemlerinin Etkinlik Analizi. Endüstri Mühendisliği Dergisi, 23(4), 14-31.
18. Konca, M., Gözlü, M. ve Çakmak, C. (2019). G-20 Ülkelerinin Sağlık Harcamaları Yönünden Etkinliğinin Değerlendirilmesi. Verimlilik Dergisi, 2, 119-141.
19. Laıne, J., Fınne-Soverı, U. H., Björkgren, M., Lınna, M., Noro, A. ve Häkkınen, U. (2005). The Association Between Quality Of Care And Technical Efficiency In Long-Term Care. International Journal For Quality in Health Care, 17(3), 259-267.
20. Laine, J., Linna, M., Häkkinen, U. ve Noro, A., (2005). Measuring The Productive Efficiency And Clinical Quality Of Institutional Long‐Term Care For The Elderly. Health Economics, 14(3), 245-256.
21. Lloyd-Sherlock, P. (2014). Beyond Neglect: Long-Term Care Research In Low And Middle Income Countries. Int. J. Gerontol. 8, 66–69.
22. Luasa, S. N., Dineen, D. ve Zieba, M. (2018). Technical And Scale Efficiency In Public And Private Irish Nursing Homes–A Bootstrap Dea Approach. Health Care Management Science, 21(3), 326-347.
23. Lunney, J.R., Lynn, J., Foley, D.J., Lipson, S. ve Guralnik, J.M. (2003). Patterns Of Functional Decline At The End Of Life. Jama, 289, 2387–2392. Mitchell, S.L., Teno, J.M., Kiely, D.K., Shaffer, M.L., Jones, R.N., Prigerson, H.G., Volicer, L., Gıvens, J.L. ve Hamel, M.B. (2009). The Clinical Course Of Advanced Dementia. Nejm, 361, 1529–1538.
24. Moreno, P. ve Lozano, S. (2018). Super SBI Dynamic Network DEA Approach To Measuring Efficiency In The Provision Ofpublic Services. International Transactions in Operational Research, 25, 715–735.
25. OECD. (2011). Long-Term Care: Growing Sector, Multifaceted Systems. Help Wanted, 37-60.
26. OECD. (2017). Health At A Glance 2017: Oecd Indicators. Paris: OECD Publishing.
27. OECD. (2019). Safe Long-Term Care In Health At A Glance 2019: Oecd Indicators. Paris: OECD Publishing.
28. OECD. (2020). Long-Term Care. https://Www.Oecd.Org/Els/Health-Systems/Long-Term-Care.Htm. Erişim Tarihi: 13.02.2020.
29. Ozbugday, F. C., Tirgil, A. ve Kose, E. G. (2019). Efficiency Changes In Long-Term Care İn Oecd Countries: A Non-Parametric Malmquist Index Approach. Socio-Economic Planning Sciences, 100733.
30. Roddis, J. K., Holloway, I., Bond, C. ve Galvin, K. T. (2016). Living With A Long-Term Condition: Understanding Well-Being For Individuals With Thrombophilia Or Asthma. International Journal Of Qualitative Studies On Health And Well-Being, 11(1), 31530.
31. Shabanpour, H., Fathi, A., Yousefi, S., ve Saen, R. F., (2019). Ranking Sustainable Suppliers Using Congestion Approach Of Data Envelopment Analysis. Journal Of Cleaner Production, 240, 118190.
32. Sohn, M., ve Choi, M., (2014). Association Between Efficiency And Quality Of Health Care In South Korea Long-Term Care Hospitals: Using The Data Envelopment Analysis And Matrix Analysis. Journal Of Korean Academy Of Nursing, 44(4), 418-427.
33. Tsutsui, T., Muramatsu, N., (2007), “Japan’s Universal Long-Term Care System Reform Of 2005: Containing Costs And Realizing A Vision”, J. Am. Geriatr. Soc., 55, 1458–1463.
34. WHO. (2003). Key Policy Issues In Long-Term Care. Switzerland: Who Library Cataloguing-in-Publication,
35. WHO. (2015). World Report On Ageing And Health. Geneva: World Health Organization.
36. Wichmann, A.B, Adang, E.M.M., Vissers, K.C.P., Szczerbińska, K., Kylänen, M. (2018). Correction: Technical-Efficiency Analysis Of End-Of-Life Care In Long-Term Care Facilities Within Europe: A Cross-Sectional Study Of Deceased Residents İn 6 Eu Countries (Pace). Plos One, 13(11): E0208199.
37. Xia, M., Chen, J. ve Zeng, X. J. (2020). Data Envelopment Analysis Based On Team Reasoning. International Transactions in Operational Research, 27(2), 1080-1100.
38. Yu, M.M. ve Hsiao, B., (2018). Single-Phase Slack-Based Centralized Dea For Resource Reallocation. International Transac-Tions in Operational Research, 25, 737–751.
39. Zhang, L., Zeng, Y. ve Fang, Y., (2019). Evaluating The Technical Efficiency Of Care Among Long-Term Care Facilities In Xiamen, China: Based On Data Envelopment Analysis And Tobit Model. BMC Public Health, 19(1), 1230.