Behavioral Economics Approach in Healthcare: Recommendations for Health System in Turkey

Yıl 2021, Cilt: 12 Sayı: 32, 1352 - 1375, 20.11.2021

Havva Serim , Gamze Arıkan

https://doi.org/10.21076/vizyoner.872680

Öz

In Turkey, as well as all over the world, one of the most significant challenges faced by the health sector players such as governments, private enterprises and institutions is to make health expenses sustainable while ensuring the sustainability of healthcare services. Increasing obesity rates, aging of the population and increases in chronic diseases require urgent solutions. Although the causes and solutions of these health problems are shaped in line with enviromental conditions and public policies, individuals’ preferences and behaviors are among the primary determinants of their health status. Tobacco use, poor diet, physical inactivity and inadequate health protective behaviors often cause illness and death. For this reason, it is of great importance to change the health-related behavior of individuals. This is difficult, however, as health-related behaviors are very complex in that they are influenced by many factors. On the other hand, behavioral economics, which draws attention with the insights it has drawed on especially from psychology in recent years, offers a new approach to why people cannot make the best choice for themselves and cannot oppose their impulses at the expense of losing their health in the long term. In addition, it addresses the behavioral barriers in the healthcare comprehensively, taking into account the behavior of healthcare providers with a similar approach. Concordantly, the study, considering relevant insights, offers suggestions on how to use behavioral economics’s tools in designing more effective but low-cost health policies and programs in Turkey.

Anahtar Kelimeler

Health, Healthcare, Health Policies, Behavioral Economics

Sağlık Hizmetlerinde Davranışsal İktisat Yaklaşımı: Türkiye’deki Sağlık Sistemi İçin Öneriler

Öz

Tüm dünyada olduğu gibi Türkiye’de de hükümetler, özel işletmeler ve kurumlar gibi sağlık sektörü oyuncularının karşı karşıya oldukları en önemli zorluklardan biri, sağlık ve bakım hizmetlerinin sürdürülebilirliğini sağlarken, sağlık harcamalarını da sürdürülebilir kılmaktır. Artan obezite oranları, nüfusun yaşlanması ve kronik hastalıklardaki artışlar gibi sağlık sorunları ivedi çözümler gerektirmektedir. Her ne kadar söz konusu sağlık sorunlarının nedenleri ve çözümleri çevresel koşullar ve kamu politikaları ekseninde şekillense de kişilerin sağlık durumlarını belirleyenlerin başında kendi tercih ve davranışları gelmektedir. Tütün kullanımı, kötü beslenme, hareketsizlik ve uygun koruyucu önlemlerin alınmaması gibi davranışlar sıklıkla hastalıklara ve ölümlere neden olmaktadır. Bu nedenle, kişilerin sağlıkla ilgili davranışlarının değiştirilmesi büyük önem arz etmektedir. Ancak sağlıkla ilgili davranışlar birçok unsurdan etkilenmeleri bakımından karmaşık olduğu için, bu durum oldukça zordur. Son yıllarda özellikle psikolojiden yararlandığı içgörülerle dikkat çeken davranışsal iktisat ise insanların neden kendileri için en iyi tercihleri yapamadıklarına ve uzun dönemde sağlıklarını kaybetmek pahasına dürtülerine karşı gelemediklerine ilişkin yeni bir yaklaşım sunmaktadır. Ayrıca, benzer bir yaklaşımla sağlık hizmeti arz edenlerin davranışlarını da ele alarak, sağlık hizmetlerindeki davranışsal engelleri kapsamlı bir biçimde ortaya koymaktadır. Bu çalışmada söz konusu içgörüler dikkate alınarak, davranışsal iktisat araçlarının Türkiye’de daha etkili ancak düşük maliyetli sağlık politika ve programları tasarımında nasıl kullanılabileceği hakkında öneriler sunulmaktadır.

Anahtar Kelimeler

Sağlık, Sağlık Hizmetleri, Sağlık Politikaları, Davranışsal İktisat

Kaynakça

• Abaluck, J. ve Gruber, J. (2016). Evolving choice inconsistencies in choice of prescription drug insurance. American Economic Review, 106(8), 2145-84.
• Abaluck, J. ve Gruber, J. (2016). Evolving choice inconsistencies in choice of prescription drug insurance. American Economic Review, 106(8), 2145-84.
• Arshad, A., Anderson, B. ve Sharif, A. (2019). Comparison of organ donation and transplantation rates between opt-out and opt-in systems. Kidney International, 95(6), 1453-1460.
• Arshad, A., Anderson, B. ve Sharif, A. (2019). Comparison of organ donation and transplantation rates between opt-out and opt-in systems. Kidney International, 95(6), 1453-1460.
• Axelrod, D.A., Schnitzler, M.A., Xiao, H., Irish, W., Tuttle‐Newhall, E., Chang, S.H., ... ve Lentine, K.L. (2018). An economic assessment of contemporary kidney transplant practice. American Journal of Transplantation, 18(5), 1168-1176.
• Aydın, M., Koyuncuoğlu, C.Z., Kılboz, M.M., ve Akıcı, A. (2017). Diş hekimliğinde akılcı antibiyotik kullanımı. Türkiye Klinikleri Dishekimligi Bilimleri Dergisi, 23(1), 33-47.
• Balin, Ş.Ö. ve Denk, A. (2016). Harput devlet hastanesi yoğun bakım ünitesinde 2013-2014 yılı invaziv alet ilişkili hastane enfeksiyonlarının değerlendirilmesi. Fırat Tıp Dergisi, 21(1), 24-28.
• Barnes A.J., Rice, T. ve Hanoch, Y. (2017). Using behavioral economics to ımprove people’s decisions about purchasing health insurance. Y. Hanoch, A. J. Barnes ve T. Rice (Ed.), Behavioral economics and healthy behaviors: key concepts and current research içinde (600-655), Routledge: New York.
• Barnes, A.J., Hanoch, Y. ve Rice, T (2016). Can plan recommendations ımprove the coverage decisions of vulnerable populations in health ınsurance marketplaces?. PLoS ONE, 11(3), e0151095.
• Barnes, A.J., Hanoch, Y. ve Rice, T. (2015). Determinants of coverage decisions in health ınsurance marketplaces: consumers’ decision-making abilities and the amount of ınformation in their choice environment, Health Services Research, 50(1), 58-80.
• Barnes, A.J., Hanoch, Y., Wood, S., Liu, P.J. ve Rice, T. (2012). One fish, two fish, red fish, blue fish: effects of price frames, brand names, and choice set size on medicare part d ınsurance plan decisions. Medical Care Research and Review, 69(4), 460-473.
• Bayın Donar, G. (2019). Sağlık yönetiminde kanıta dayalı yaklaşım. G. Erigüç (Ed.), Sağlık kurumlarında örgüt yapısı ve güncel yönetsel yaklaşımlar içinde (274-275), Ankara: Siyasal Kitabevi.
• Behavioural Insights Team. (2013). Applying behavioural insights to organ donation: preliminary results from a randomised controlled trial. Depertment of Health, London: Cabinet Office.
• Blavin, F., Dorn, S., Dev, J., Act, A.C. ve Landey, A. (2014). Using behavioral economics to ınform the integration of human services and health programs under the affordable care act. Washington, DC: Urban Institute.
• Bleich, S.N. ve Sturm, R. (2009). Developing policy solutions for a more active nation: ıntegrating economic and public health perspectives. Preventive medicine, 49(4), 306-308.
• Blomqvist, Å. ve Léger, P.T. (2005). Information asymmetry, insurance, and the decision to hospitalize. Journal of Health Economics, 24(4), 775-793.
• Blumberg, L.J., Long, S.K., Kenney, G.M. ve Goin, D. (2013, 2 Ocak). Public understanding of basic health ınsurance concepts on the eve of health reform. Urban Institute. Erişim adresi: http://hrms.urban.org/briefs/hrms_literacy.html, (02.01.2020).
• Borowitz, S.M., Waggoner-Fountain, L.A., Bass, E.J. ve Sledd, R.M. (2008). Adequacy of ınformation transferred at resident sign-out (inhospital handover of care): A prospective survey. Bmj Quality & Safety, 17(1), 6-10.
• Burke, L.E., Styn, M.A., Sereika, S.M., Conroy, M.B., Ye, L., Glanz, K., ... ve Ewing, L.J. (2012). Using mhealth technology to enhance self-monitoring for weight loss: a randomized trial. American Journal of Preventive Medicine, 43(1), 20-26.
• Carter, P. (2015, 15 Ocak). Review of operational productivity in nhs providers. Interim report, june. Erişim adresi: https://Assets.Publishing.Service.Gov.Uk/Government/Uploads/System/Uploads/Attachment_Data/File/434202/Carter-İnterim-Report.Pdf, (15.01.2020).
• Cass, A.D., Talavera, G.A., Gresham, L.S., Moser, K.S. ve Joy, W. (2005). Structured behavioral intervention to increase children's adherence to treatment for latent tuberculosis infection. The International Journal of Tuberculosis and Lung Disease, 9(4), 415-420.
• Chan, K.S., Morton, S.C. ve Shekelle, P.G. (2004). Systematic reviews for evidence-based management: how to find them and what to do with them. Am J Manag Care, 10(11 Pt 1), 806-12.
• Chapman, G.B., Li, M., Colby, H. ve Yoon, H. (2010). Opting in vs opting out of influenza vaccination. Jama, 304(1), 43-44.
• Çelik, Y. (2011). Sağlık ekonomisi. Ankara: Siyasal Kitabevi, 58-140.
• Çelik, Y. (2011). Sağlık ekonomisi. Ankara: Siyasal Kitabevi, 58-140.
• Dana, J. ve Loewenstein, G. (2003). A social science perspective on gifts to physicians from industry. The Journal of the American Medical Association, 290(2), 252–255.
• Dew, M.A., Switzer, G.E., Goycoolea, J.M., Allen, A.S., DiMartini, A., Kormos, R.L. ve Griffith, B.P. (1997). Does transplantation produce quality of life benefits? A quantitative analysis of the literature. Transplantation, 64(9), 1261-1273.
• Doku, Organ Nakli ve Diyaliz Hizmetleri Dairesi Başkanlığı. (2019). İstatistikler, Erişim adresi: https://Organkds.Saglik.Gov.Tr/Dss/Publıc/Wl_Lung.Aspx, (16.01.2020).
• Downs, J.S., Loewenstein, G. ve Wisdom, J. (2009). Strategies for promoting healthier food choices. American Economic Review, 99(2), 159-164.
• Dünya Sağlık Örgütü. (2003). Adherence to long-term therapies: Evidence for action. Geneva: World Health Organization Publishing.
• Dünya Sağlık Örgütü. (2014). Basic document. Forty-eighth edition: World Health Organization. Erişim Adresi: https://apps.who.int/gb/bd/PDF/bd48/basic-documents-48th-edition-en.pdf, (03.09.2020).
• Easthall, C., Song, F. ve Bhattacharya, D. (2013). A meta-analysis of cognitive-based behaviour change techniques as interventions to ımprove medication adherence. Bmj Open, 3(8), E002749.
• Farhan, M., Brown, R., Woloshynowych, M. ve Vincent, C. (2012). The abc of handover: a qualitative study to develop a new tool for handover in the emergency department. Emergency Medicine Journal, 29(12), 941-946.
• Finkelstein, E.A., Brown, D.S., Brown, D.R. ve Buchner, D.M. (2008). A randomized study of financial incentives to ıncrease physical activity among sedentary older adults. Preventive Medicine, 47(2), 182-187.
• Fischer, M.A., Stedman, M.R., Lii, J., Vogeli, C., Shrank, W.H., Brookhart, M.A. ve Weissman, J.S. (2010). Primary medication non-adherence: analysis of 195,930 electronic prescriptions. Journal of General Internal Medicine, 25(4), 284-290.
• Fischer, M.A., Vogeli, C., Stedman, M., Ferris, T., Brookhart, M.A. ve Weissman, J.S. (2008). Effect of electronic prescribing with formulary decision support on medication use and cost. Archives of Internal Medicine, 168(22), 2433-2439.
• Ford, E.S., Bergmann, M.M., Kröger, J., Schienkiewitz, A., Weikert, C. ve Boeing, H. (2009). Healthy living is the best revenge: findings from the european prospective investigation ınto cancer and nutrition-potsdam study. Archives of internal medicine, 169(15), 1355-1362.
• Galizzi, M.M. (2014). What is really behavioral in behavioral health policy? and does it work? Applied Economic Perspectives and Policy, 36(1), 25-60.
• Giné, X., Karlan, D. ve Zinman, J. (2010). Put your money where your butt is: a commitment contract for smoking cessation. American Economic Journal: Applied Economics, 2(4), 213-35.
• Grant, A.M. ve Hofmann, D.A. (2011). It’s not all about me: motivating hand hygiene among health care professionals by focusing on patients. Psychological Science, 22(12), 1494-1499.
• Greene, J., Hibbard, J.H. ve Sacks, R.M. (2016). Summarized costs, placement of quality stars, and other online displays can help consumers select high-value plans. Health Affairs, 35(4), 671–679.
• Guyatt, G.H., Haynes, R B., Jaeschke, R.Z., Cook, D.J., Green, L., Naylor, C.D., ... ve Evidence-Based Medicine Working Group. (2000). Users' guides to the medical literature: xxv. evidence-based medicine: principles for applying the users' guides to patient care. Jama, 284(10), 1290-1296.
• Haas, J.S., Phillips, K.A., Gerstenberger, E.P. ve Seger, A.C. (2005). Potential savings from substituting generic drugs for brand-name drugs: Medical expenditure panel survey, 1997–2000. Annals of Internal Medicine, 142(11), 891-897.
• Hallsworth, M., Berry, D., Sanders, M., Sallis, A., King, D., Vlaev, I. ve Darzi, A. (2015). Stating appointment costs in sms reminders reduces missed hospital appointments: findings from two randomised controlled trials. PloS One, 10(9), 1-14.
• Halpern, S.D., Ubel, P.A., ve Asch, D.A. (2007). Harnessing the power of default options to improve health care. The New England Journal of Medicine, 357, 1340-1344.
• Hanks, A.S., Just, D.R., Smith, L.E., ve Wansink, B. (2012). Healthy convenience: nudging students toward healthier choices in the lunchroom. Journal of Public Health, 1-7.
• Hanks, A.S., Just, D.R. ve Wansink, B. (2013). Smarter lunchrooms can address new school lunchroom guidelines and childhood obesity. The Journal of Pediatrics, 162(4), 867-869.
• Hanoch, Y., Wood, S., Barnes, A., Liu, P.J. ve Rice, T. (2011). Choosing the right medicare prescription drug plan: the effect of age, strategy selection, and choice set size. Health Psychology, 30(6), 719.
• Helder, O.K., Weggelaar, A.M., Waarsenburg, D.C., Looman, C.W., Van Goudoever, J.B., Brug, J. ve Kornelisse, R.F. (2012). Computer screen saver hand hygiene information curbs a negative trend in hand hygiene behavior. American Journal Of İnfection Control, 40(10), 951-954.
• Hesselink, G., Zegers, M., Vernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M., ... ve Suñol, R. (2014). Improving patient discharge and reducing hospital readmissions by using intervention mapping. Bmc Health Services Research, 14(1), 389.
• Howell, J.L., ve Shepperd, J.A. (2013). Reducing health-information avoidance through contemplation. Psychological Science, 24(9), 1696-1703.
• Huis, A., Van Achterberg, T., De Bruin, M., Grol, R., Schoonhoven, L. ve Hulscher, M. (2012). A systematic review of hand hygiene improvement strategies: A behavioural approach. Implementation Science, 7(1), 92.
• IMS Tıbbi Bilişim Enstitüsü. (2012). Advancing the responsible use of medicines: applying levers for change. IMS Institute For Healthcare Informatics, Erişim adresi: https://Ssrn.Com/Abstract=2222541, (03.01.2020).
• İlaç Bilincini Geliştirme ve Akılcı İlaç Derneği. (2018). Türkiye’de kronik hastalıklarda tedavi uyumu. Erişim adresi: https://www.Akilciilacdernegi.Com/Ckfinder/Userfiles/Files/Kronikhastalardatedavi.Pdf, (14.01. 2020).
• İngiltere Ulusal Sağlık Hizmetleri. (2014). Using technology to beat cost of missed appointments. NHS: England, Erişim adresi: https://www.England.Nhs.Uk/2014/03/Missed-Appts/, (28.12.2020).
• John L., Loewenstein G., Troxel A., Norton L., Fassbender J. ve Volpp K. (2011). Financial incentives for extended weight loss: a randomized, controlled trial. Journal of General Internal Medicine, 621-626.
• Johnson, E.J. ve Goldstein, D.G. (2003). Do defaults save lives?. Science, 302, 1338-1339.
• Johnson, E.J., Hassin, R., Baker, T., Bajger, A.T. ve Treuer, G. (2013). Can consumers make affordable care affordable? the value of choice architecture. PloS one, 8(12), e81521.
• Kahneman, D. (2003). Maps of bounded rationality: psychology for behavioral economics. American Economic Review, 93(5), 1449-1475.
• Kahneman, D. (2003). Maps of bounded rationality: psychology for behavioral economics. American Economic Review, 93(5), 1449-1475.
• Kahneman, D. (2011). Thinking fast and slow. Farrar, Strauss, Giroux: New York.
• Kahneman, D. (2011). Thinking fast and slow. Farrar, Strauss, Giroux: New York.
• Karagöl, V. (2020). COVID-19 salgını ile mücadelede davranışsal iktisadın rolü. Düzce İktisat Dergisi, 1(1), 1-10.
• Karagöl, V. (2020). COVID-19 salgını ile mücadelede davranışsal iktisadın rolü. Düzce İktisat Dergisi, 1(1), 1-10.
• Kennedy, J., Tuleu, I. ve Mackay, K. (2008). Unfilled prescriptions of medicare beneficiaries: Prevalence, reasons, and types of medicines prescribed. Journal of Managed Care Pharmacy, 14(6), 553-560.
• Kenney, G.M., Lynch, V., Haley, J.M. ve Huntress, M. (2013). Variation in medicaid eligibility and participation among adults: implications for the affordable care act. Inquiry, 49, 231-253.
• Kling, J.R., Mullainathan, S., Shafir, E., Vermeulen, L.C. ve Wrobel, M.V. (2012). Comparison friction: experimental evidence from medicare drug plans. The Quarterly Journal of Economics, 127, 199-235.
• Kocatürk, E., Canik, A. ve Alataş, Ö. (2015). Gereksiz test istemlerinin spsa ve serum lipidleri testleri üzerinden incelenmesi. Türk Klin Biyokim, 13, 101-106.
• Koşucu, S.N., Göktaş, S.B. ve Yıldız, T. (2015). Sağlık personelinin el hijyeni uyum oranı. Clinical and Experimental Health Sciences, 5(2), 105-108.
• Lacetera, N. ve Macis, M. (2010). Social image concerns and prosocial behavior: Field evidence from a nonlinear incentive scheme. Journal of Economic Behavior & Organization, 76(2), 225-237.
• Lacetera, N. ve Macis, M. (2013). Time for blood: the effect of paid leave legislation on altruistic behavior. The Journal of Law, Economics, & Organization, 29(6), 1384-1420.
• Larkin, I. ve Loewenstein, G. (2017). Business model–related conflicts of interests in medicine: problems and potential solutions. Jama, 317, 1745–1746.
• Lester, R.T., Ritvo, P., Mills, E.J., Kariri, A., Karanja, S., Chung, M. H., ... ve Marra, C. A. (2010). Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (weltel Kenya1): A randomised trial. The Lancet, 376(9755), 1838-1845.
• Litzelman, D., Dittus, R. S., Miller, M.E. ve Tierney, W.M. (1993). Requiring physicians to respond to computerized reminders improves their compliance with preventive care protocols, Journal of General Internal Medicine, 8(6), 311–317.
• Loewenstein, G., Hagmann, D., Schwartz, J., Ericson, K., Kessler, J.B., Bhargava, S., ... ve Nussbaum, D. (2017). A behavioral blueprint for improving health care policy. Behavioral Science & Policy, 3(1), 52-66.
• Luoto, J. ve Carman, K.G. (2014). Behavioral economics guidelines with applications for health interventions. Inter-American Development Bank.Technical Note: No. IDB-TN-665.
• Meeker, D. ve Doctor, J.N. (2017). Applications of behavioral economics to clinical quality imrovement. Y. Hanoch, A. J. Barnes ve T. Rice (Ed.), Behavioral economics and healthy behaviors: key concepts and current research içinde (543-599), Routledge: New York.
• Meeker, D., Knight, T.K., Friedberg, M.W., Linder, J.A., Goldstein, N.J., Fox, C. R., ... ve Doctor, J.N. (2014). Nudging guideline-concordant antibiotic prescribing: A randomized clinical trial. Jama Internal Medicine, 174(3), 425-431.
• Meeker, D., Linder, J.A., Fox, C.R., Friedberg, M.W., Persell, S.D., Goldstein, N.J., ... ve Doctor, J.N. (2016). Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: A randomized clinical trial. Jama, 315(6), 562-570.
• Memişoğlu, D. (2018). Bir kamu politikası analizi örneği: Sağlıkta dönüşüm programı. Yasama Dergisi, 34, 62-93.
• Meredith, S.E. ve Petry, N.M. (2017). Imroving medication adherence with behavioral economics. Y. Hanoch, A.J. Barnes ve T. Rice (Ed.), Behavioral economics and healthy behaviors: Key concepts and current research içinde (343-397), Routledge: New York.
• Messing, J. (2015). Improving handover from intensive care to ward medical teams with simple changes to paperwork. Bmj Open Quality, 4(1), U206467-W2913.
• Mete, C. ve Tarim, M. (2020). Davranışsal ekonomi kapsamında demografik özelliklerin sağlık hizmetlerinde tüketici kararlarına etkisi: İstanbul ilinde bir uygulama. Turan: Stratejik Arastirmalar Merkezi, 12(45), 289-297.
• Nihal, T.Ö., Elif, A., Serpil, K., Zafer, K. ve Özgür, Y. (2015). Sağlık kuruluşlarında yalın yönetim anlayışının değerlendirilmesinde bir eğitim araştırma hastanesi örneği. Sağlık Akademisyenleri Dergisi, 2(1), 34-39.
• Nuckols, T.K., Smith-Spangler, C., Morton, S.C., Asch, S.M., Patel, V.M., Anderson, L.J., ... ve Shekelle, P.G. (2014). The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis. Systematic Reviews, 3(1), 56.
• Olson, J., Hollenbeak, C., Donaldson, K., Abendroth, T. ve Castellani, W. (2015). Default settings of computerized physician order entry system order sets drive ordering habits. Journal of Pathology Informatics, 6.
• Osterberg, L. ve Blaschke, T. (2005). Adherence to medication. New England journal of medicine, 353(5), 487-497.
• Öcek, Z., Sahin, H., Baksi, G. ve Apaydin, S. (2008). Development of a rational antibiotic usage course for dentists. European Journal of Dental Education, 12(1), 41-47.
• Öcek, Z., Sahin, H., Baksi, G. ve Apaydin, S. (2008). Development of a rational antibiotic usage course for dentists. European Journal of Dental Education, 12(1), 41-47.
• Özdemir, S. (2019). Sağlık iletişiminde davranışsal müdahale tasarımı: İngiltere online hastane randevu sistemi örneği. Cumhuriyet Üniversitesi İktisadi ve İdari Bilimler Dergisi, 20(1), 348-365.
• Özdemir, S. (2019). Sağlık iletişiminde davranışsal müdahale tasarımı: İngiltere online hastane randevu sistemi örneği. Cumhuriyet Üniversitesi İktisadi ve İdari Bilimler Dergisi, 20(1), 348-365.
• Paez, K.A. ve Mallery, C.J. (2014). A little knowledge is a risky thing: wide gap in what people think they know about health insurance and what they actually know. American Institutes for Research Issue Brief, 1-6.
• Panidi, K. (2015). Ostrich effect in health care decisions: Theory and empirical evidence. Available at SSRN 2932181.
• Perry, C., Chhatralia, K., Damesick, D., Hobden, S. ve Volpe, L. (2015). Behavioural insights in health care: Nudging to reduce inefficiency and waste. London: The Health Foundation.
• Ratner, R.K. ve Riis, J. (2014). Communicating science-based recommendations with memorable and actionable guidelines. Proceedings of the National Academy of Sciences, 111(Supplement 4), 13634-13641.
• Rice, T. ve Cummings, J. (2010). Reducing the number of drug plans for seniors: a proposal and analysis of three case studies. Journal of Health Politics, Policy and Law, 35(6), 961-997.
• Roberts, N.J., Kerr, S.M. ve Smith, S.M. (2013). Behavioral interventions associated with smoking cessation in the treatment of tobacco use. Health Services Insights, 6, 79-85.
• Rothman, A.J., Martino, S.C., Bedell, B.T., Detweiler, J.B. ve Salovey, P. (1999). The systematic influence of gain-and loss-framed messages on interest in and use of different types of health behavior. Personality and Social Psychology Bulletin, 25(11), 1355-1369.
• Rothman, A.J. ve Salovey, P. (1997). Shaping perceptions to motivate healthy behavior: the role of message framing. Psychological Bulletin, 121(1), 3.
• Samuelson, W. ve Zeckhauser, R. (1988). Status quo bias in decision making. Journal of risk and uncertainty, 1(1), 7-59.
• Schnitzler, M.A., Whiting, J.F., Brennan, D.C., Lentine, K.L., Desai, N.M., Chapman, W., ... ve Kalo, Z. (2005). The life‐years saved by a deceased organ donor. American Journal of Transplantation, 5(9), 2289-2296.
• Shepherd, L., O’Carroll, R.E., ve Ferguson, E. (2014). An international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: a panel study. BMC medicine, 12(1), 131.
• Sims, H., Sanghara, H., Hayes, D., Wandiembe, S., Finch, M., Jakobsen, H., Tsakanikos, E., Chike Okocha, C.I. ve Kravariti, E. (2012). Text message reminders of appointments: a pilot intervention at four community mental health clinics in London. Psychiatric Services, 63(2), 161-168.
• Stanovich, K.E. ve West, R.F. (2000). Individual differences in reasoning: implications for the rationality debate? Behavioral and Brain Sciences, 23(5), 645–665.
• Staring, A.B., Mulder, C.L., ve Priebe, S. (2010). Financial incentives to improve adherence to medication in five patients with schizophrenia in the Netherlands. Psychopharmacology Bulletin, 43(1), 5-10.
• Sunstein, C.R. (2014). Nudging: A very short guide. Journal of Consumer Policy, 37(4), 583-588.
• Şahin, B. (2004). Sağlık kaynaklarının kullanımında değişkenlik sorunu: neden yönetemiyoruz? Nasıl yönetebiliriz?. Hacettepe Sağlık İdaresi Dergisi, 7(2), 202-232.
• T.C. Sağlık Bakanlığı. (2003). Sağlıkta Dönüşüm. Ankara.
• T.C. Sağlık Bakanlığı. (2012). Türkiye Sağlıkta Dönüşüm Programı Değerlendirme Raporu (2003-2011). Ankara.
• T.C. Sağlık Bakanlığı. (2018). Faaliyet raporu, 2018. Ankara: Yayın No: 1121.
• T.C. Sağlık Bakanlığı. (2019). Sağlık istatistikleri yıllığı, 2018. Sağlık Bilgi Sistemleri Genel Müdürlüğü: Ankara
• T.C. Sağlık Bakanlığı. (2020). Sağlık Bakanlığı Strateji Geliştirme Başkanlığı davranışsal kamu politikaları tanıtım toplantısı. Erişim adresi: https://sgb.saglik.gov.tr/TR,63576/davranissal-kamu-politikalari-tanitim-toplantisi-28012020.html, (25.12.2020).
• T.C. Ticaret Bakanlığı. (2019). 1. Ulusal Davranışsal Kamu Politikaları Konferansı. Erişim adresi: https://ticaret.gov.tr/haberler/1-ulusal-davranissal-kamu-politikalari-konferansi, (25.12.2020).
• Tezcan, C. (2016). Sağlığa yenilikçi bir bakış açısı: Mobil sağlık. TÜSİAD Yayınları, Yayın No: TÜSİAD, 2016-03.
• Thaler, R.H. ve Sunstein, C.R. (2008). Nudge: Improving decisions about health, wealth, and happiness. Yale University Press: USA.
• Thaler, R.H. (2016). Behavioral economics: past, present, and future. American Economic Review, 106(7), 1577-1600.
• Thorndike, A.N., Riis, J., Sonnenberg, L.M. ve Levy, D.E. (2014). Traffic-light labels and choice architecture: promoting healthy food choices. American Journal of Preventive Medicine, 46(2), 143-149.
• TOBB. (2017). Türkiye sağlık sektörüne genel bir bakış, Aralık. Türkiye Odalar ve Borsalar Birliği: Ankara
• Turhan, B., Çalık, B.T. ve Demirin, H. (2010). Kanıta dayalı tıp laboratuvar testleri ve preanalitik değişkenler. Konuralp Tıp Dergisi, 2(3), 29-33.
• TÜİK. (2019). Ölüm nedeni istatistikleri, 2018. Haber Bülteni, Sayı: 30626.
• Türkiye Sigortalar Birliği. (2015). Tamamlayıcı Özel sağlık sigortası: Dünya uygulamalarından örneklerin incelenmesi ve Türkiye için öneriler raporu. Erişim adresi: https://www.Tsb.Org.Tr/Document/Yonetmelikler/20151023-Tamamlayıcı_Sağlık_Sigortası-Final%20(1).Pdf, (18.01.2020).
• TÜSİAD. (2012). Sağlık sektörünün öncelikli sorunlarına ilişkin görüş ve öneriler. Tüsiad Sağlık Çalışma Grubu, Kasım 2012: İstanbul.
• Vervloet, M., Linn, A.J., van Weert, J.C., De Bakker, D.H., Bouvy, M. L. ve Van Dijk, L. (2012). The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. Journal of the American Medical Informatics Association, 19(5), 696-704.
• Volpp K, Troxel, A.B., Pauly, M.V., Glick, H.A., Ash, D.A., Galvin, R., Zhu, J., Wan, F., DeGuzman, J., Corbett, E., Weiner, J. ve Audrain-McGovern, J. (2009): A randomized, controlled trial of financial incentives for smoking cessation. New England Journal of Medicine, 360, 699-709.
• Volpp, K.G., John, L.K., Troxel, A.B., Norton, L., Fassbender, J. ve Loewenstein, G. (2008a). Financial incentive–based approaches for weight loss: a randomized trial. Jama, 300(22), 2631-2637.
• Volpp, K.G., Loewenstein, G., Troxel, A.B., Doshi, J., Price, M., Laskin, M. ve Kimmel, S.E. (2008b). A test of financial incentives to improve warfarin adherence. BMC health services research, 8(1), 272.
• Wang, J.Y., Probst, J.C., Stoskopf, C.H., Sanders, J.M. ve McTigue, J.F. (2011). Information asymmetry and performance tilting in hospitals: a national empirical study. Health economics, 20(12), 1487-1506.
• Wansink, B. ve Pope, L. (2014). When do gain-framed health messages work better than fear appeals?. Nutrition Reviews, 73(1), 4-11.
• Yalçın, A., Tosun, E. ve Topaloğlu, O. (2008). Solunum yolu enfeksiyonları: Antibiyotik kullanım oranı ve tedavi maliyeti. Türkiye Aile Hekimliği Dergisi, 12(1), 25-30.
• Yayar, R. ve Eker Karaca, Ö. (2019). Davranışsal iktisat bağlamında kamu çalışanlarının tüketim davranış eğilimleri. Akdeniz University Faculty of Economics & Administrative Sciences Faculty Journal/Akdeniz Universitesi Iktisadi ve Idari Bilimler Fakultesi Dergisi, 19(1), 1-29.
• Yayar, R. ve Eker Karaca, Ö. (2019). Davranışsal iktisat bağlamında kamu çalışanlarının tüketim davranış eğilimleri. Akdeniz University Faculty of Economics & Administrative Sciences Faculty Journal/Akdeniz Universitesi Iktisadi ve Idari Bilimler Fakultesi Dergisi, 19(1), 1-29.
• Yıldırım, H.H. (2013). Türkı̇ye sağlık sı̇stemı̇: sağlıkta dönüşüm programı değerlendı̇rme raporu. SASAM, Sağlık-Sen Yayınları: Ankara.
• Yıldırım, H.H. ve Yıldırım, T. (2013). Türkiye sağlık reformları ve politikaları: politika analizi çerçevesinde bir değerlendirme. M. Yıldız ve M.Z. Sobacı (Ed.). Kamu politikası: Kuram ve uygulama içinde (364-397), Adres Yayınları: Ankara.
• Yılmaz, M., Alıcı, H. ve Karaman, M. (2017). Sağlık kurumlarında israf giderme yöntemleriyle yalın düşünce. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 5(2), 54-70.