Türkiye’de sağlık göstergelerine dayalı bölgesel kümeleme analizlerine ilişkin kapsamlı bir derleme

Öz

Arka Plan— Ulusal ve uluslararası düzeylerde sağlık göstergelerinin karşılaştırmalı analizi, bölgesel eşitsizliklerin belirlenmesi ve sağlık hizmetlerine erişim, kalite, kapasite ve sonuçlar açısından farklılıkların değerlendirilmesi için gereklidir. Kümeleme analizi, benzer sağlık profillerine sahip bölgeleri gruplamak ve kanıta dayalı bölgesel sağlık planlamasını desteklemek amacıyla yaygın olarak kullanılmaktadır. Türkiye’de sağlık göstergelerindeki bölgesel eşitsizlikler devam etmekle birlikte, bu konudaki çalışmalar kapsam ve yöntem bakımından parçalı bir görünüm sergilemektedir. Veri erişilebilirliği ve analitik kapasitedeki artışa rağmen, Türkiye’de yürütülen bölgesel kümeleme çalışmalarını inceleyen kapsamlı bir derleme bulunmamaktadır. Bu nedenle, bu alandaki metodolojik eğilimleri, baskın uygulamaları ve çözülmemiş boşlukları netleştirmek ve mevcut araştırmaların bölgesel sağlık politikası geliştirmeye nasıl katkı sağladığını değerlendirmek üzere yapılandırılmış bir senteze ihtiyaç vardır. Amaç— Bu çalışmanın amacı, sağlık göstergelerine dayalı olarak Türkiye’de gerçekleştirilen bölgesel kümeleme çalışmalarına ilişkin ilk kapsamlı derlemeyi sunmaktır. Derleme, gelecekteki araştırma yönelimlerini bilgilendirmeyi ve politika yapıcıların veriye dayalı ve bölgesel olarak hedeflenmiş sağlık hizmeti stratejileri geliştirmesine yardımcı olmayı amaçlamaktadır. Yöntem— Sağlık göstergelerine dayanarak Türkiye’de illerin ve bölgelerin kümelenmesine ilişkin çalışmaları belirlemek amacıyla kapsamlı bir derleme gerçekleştirilmiştir. 2025 yılına kadar yayımlanan literatür, hem İngilizce hem de Türkçe ilgili anahtar kelimeler kullanılarak Google Scholar üzerinden taranmıştır. Çalışma; yayın eğilimlerini, coğrafi kapsamı, kümeleme tekniklerini, küme sayısının belirlenmesinde kullanılan yöntemleri, seçilen sağlık göstergelerini, veri kaynaklarını, çalışma dönemlerini ve yazılım araçlarını incelemektedir. Bulgular— Son yıllarda çalışma sayısı belirgin biçimde artmış olsa da, konunun önemine kıyasla toplam araştırma hacmi sınırlı kalmaktadır. Ayrıca, geleneksel kümeleme yöntemlerine baskın ölçüde dayanılması; bölgesel sağlık analizlerinin geçerliliğini ve pratik önemini güçlendirmek için daha fazla yöntem çeşitliliğine, disiplinlerarası iş birliğine ve gelişmiş algoritmaların entegrasyonuna ihtiyaç olduğunu göstermektedir. Sonuç— Bu derleme, mevcut çalışmalarda metodolojik bir yoğunlaşma olduğunu ortaya koymaktadır. Analitik sağlamlığı ve politika ile ilişkilendirilebilirliği artırmak için yöntem çeşitliliğinin genişletilmesi gereklidir. Bu iyileştirmeler, Türkiye’de daha doğru sağlık değerlendirmelerini destekleyecek ve adil sağlık hizmeti planlamasına katkı sağlayacaktır.

Anahtar Kelimeler

• Kümeleme analizi
• Sağlık eşitsizlikleri
• Sağlık göstergeleri
• Literatür derlemesi
• Bölgesel analiz
• Türkiye

A comprehensive review of regional clustering analyses based on health indicators in Türkiye

Öz

Context—Comparative analysis of health indicators at national and international levels is essential for identifying regional disparities and evaluating differences in healthcare access, quality, capacity, and outcomes. Clustering analysis is widely used to group regions with similar health profiles and to support evidence-based regional health planning. In Türkiye, regional inequalities in health indicators persist, yet related studies remain fragmented in scope and methodology. Despite increasing data availability and analytical capacity, no comprehensive review has examined regional clustering studies conducted in Türkiye. A structured synthesis is therefore required to clarify methodological trends, dominant practices, and unresolved gaps in this field, and to assess how existing research contributes to regional health policy development. Objective—The objective of this study is to present the first comprehensive review of regional clustering studies in Türkiye based on health indicators. The review aims to inform future research directions and assist policymakers in developing data-driven and regionally targeted healthcare strategies. Method—A comprehensive review was conducted to identify studies on the clustering of provinces and regions in Türkiye based on health indicators. Literature published up to 2025 was retrieved from Google Scholar using relevant keywords in both English and Turkish. The study examines publication trends, geographical coverage, clustering techniques, methods used to determine the number of clusters, selected health indicators, data sources, study periods, and software tools. Results—Although the number of studies has increased notably in recent years, the overall research volume remains limited given the importance of the subject. Moreover, the predominant reliance on conventional clustering methods highlights the need for greater methodological diversity, interdisciplinary collaboration, and the integration of advanced algorithms to strengthen the validity and practical relevance of regional health analyses. Conclusion—This review highlights methodological concentration in existing studies. Expanding methodological diversity is essential to enhance analytical robustness and policy relevance. These improvements will support more accurate health assessments and contribute to equitable healthcare planning in Türkiye.

Anahtar Kelimeler

• Clustering analysis
• Health disparities
• Health indicators
• Literature review
• Regional analysis
• Türkiye

Kaynakça

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