Sağlık İnsangücünün Sağlık Kurumuna Başvuru Sayısı Üzerine Etkisinin Değerlendirilmesi

Year 2023, Volume: 25 Issue: 1, 257 - 274, 11.04.2023

Nazan Kartal , Gülsün Erigüç

https://doi.org/10.26745/ahbvuibfd.1186766

Cited By: 1

Abstract

Sağlık sistemlerinin temel bileşeni olan insangücünün planlaması, sağlık hizmetlerinin sürdürülebilirliği açısından önemlidir. Sağlık insangücünün mevcut durumu da sağlık himzet kullanımını etkilemektedir. Bu çalışmanın temel amacı; Türkiye’de sağlık insangücünün, sağlık kurumuna başvuru sayısına etkisini ölçmektir. Çalışma kapsamında kullanılacak veriler, Sağlık İstatistikleri Yıllığı’nın 2012-2019 yılları arasında yayınladığı veriler kullanılarak elde edilmiştir. Araştırmada kullanılacak değişkenlere ilişkin veriler iller düzeyinde alınmıştır. Araştırma modeline göre sağlık insangücü değişkeni olarak; hekim, hemşire-ebe, diş hekimi ve eczacı sayıları seçilmiştir. Sağlık hizmet kullanımı değişkeni olarak ise bir yıl boyunca birinci, ikinci ve üçüncü basamakta sağlık kurumlarına başvuru sayıları baz alınmıştır. Araştırma verilerinin analizinde panel regresyon analizi kullanılmıştır. Analizler sonucunda, modelde yer alan hekim sayısı, diş hekimi sayısı ve eczacı sayısı değişkenlerinin istatistiksel olarak sağlık kurumlarına toplam başvuru üzerinde anlamlı ve pozitif etkiye sahip olduğu, hemşire-ebe sayısındaki değişimin ise toplam başvuru sayısı üzerinde anlamlı bir etkisinin bulunmadığı görülmüştür. Bu araştırmanın sonuçları, sağlık insangücü planlamasının gerekliliğini bir kez daha ortaya koyması açısından önemlidir.

Keywords

sağlık insangücü, sağlık hizmet kullanımı, sağlık kurumuna başvuru, panel regresyon

Evaluation of the Effect of Health Manpower on ohe Number of Applications to Health Institutions

Abstract

The planning of manpower, which is the basic component of health systems, is important for the sustainability of health services. The current situation of the health manpower also affects health services utilization. The main purpose of this study; it is to measure the effect of health manpower on the number of applications to health institutions in Turkey. The data to be used within the scope of the study were obtained by using the data published by the Health Statistics Yearbook between 2012-2019. The data on the variables to be used in the study were obtained at the provincial level. According to the research model, as a health manpower variable; the numbers of physicians, nurses-midwives, dentists and pharmacists were selected. As the variable of health service utilization, the number of applications to health institutions in the primary, secondary and tertiary care institutions during one year was taken as basis. Panel regression analysis was used in the analysis of the research data. As a result of the analyzes, it was seen that the variables of the number of physicians, the number of dentists and the number of pharmacists in the model had a statistically significant and positive effect on the total application to health institutions, while the change in the number of nurses-midwives did not have a significant effect on the total number of applications. The results of this research are important in terms of revealing once again the necessity of health manpower planning.

Keywords

health manpower, healthcare utilization, application of health care services, panel regression

References

• Abu-Zeid, H. A. (1989). Health services utilization patterns of two urban communities in Abha, Saudi Arabia. Journal of Community Health, 14(2), 65-77.
• Adam, V. Y., & Awunor, N. S. (2014). Perceptions and factors affecting utilization of health services in a rural community in Southern Nigeria. Journal of Medicine and Biomedical Research, 13(2), 117-124.
• Aday, L.A., & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 9(3), 208-220.
• Ahadinezhad, B., Khosravizadeh, O., Rafiei, S., & Maleki, A. (2022). Healthcare services utilization in Iran: a systematic review and meta-analysis. International Journal of Human Rights in Healthcare, 1-12.
• Andersen, R. (1968). A behavioral model of families’ use of health services. Research Series No. 25. Chicago: Center for Health Administration Studies.
• Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter?. Journal of Health and Social Behavior, 36(1), 1-10.
• Andersen, R., & Newman, J. F. (1973). Societal and individual determinants of medical care utilization in the United States. The Milbank Memorial Fund Quarterly. Health and Society, 51, 95-124.
• Australian Health Workforce Advisory Committee. (2004). Nursing workforce planning in Australia: A guide to the process and methods used by the the Australian health workforce advisory committee. Australian Health Workforce Advisory Committee.
• Baker, J. B., & Liu, L. (2006). The determinants of primary health care utilization: a comparison of three rural clinics in Southern Honduras. GeoJournal, 66(4), 295-310.
• Bernstein, A. B., Hing, E., Moss A. J., Allen, K. F., Siller A. B., Tiggle R. B. (2004). Health care in America: Trends in utilization. National Center for Health Statistics, Hyattsville, Maryland.
• Birch, S. (2002). Health human resource planning for the new millennium: inputs in the production of health, illness, and recovery in populations. The Canadian Journal of Nursing Research= Revue Canadienne de Recherche en Sciences Infirmieres, 33(4), 109-114.
• Birkmeyer, J. D., Sharp, S. M., Finlayson, S. R., Fisher, E. S., & Wennberg, J. E. (1998). Variation profiles of common surgical procedures. Surgery, 124(5), 917-923.
• Bosak, S., Yazdani, S., Ayati, M. H., & Koohpayezade, J. (2022). Modeling health workforce planning in specialties and subspecialties: A need-adjusted demand model. Journal of Medical Education, 21(1), 1-6.
• Chen, X., Orom, H., Hay, J. L., Waters, E. A., Schofield, E., Li, Y., & Kiviniemi, M. T. (2019). Differences in rural and urban health information access and use. The Journal of Rural Health, 35(3), 405-417.
• Clewley, D., Rhon, D., Flynn, T., Koppenhaver, S., & Cook, C. (2018). Health seeking behavior as a predictor of healthcare utilization in a population of patients with spinal pain. PLoS One, 13(8), e0201348.
• Davidovitch, N., Levi, B., & Arazi, R.(2021). The health workforce in Israel during the Covid-19 pandemic: An overview. State of the Nation Report: Society, Economy and Policy 2021.
• Duckett, S. (2000). The Australian health workforce: facts and futures. Australian Health Review, 23(4), 60-77.
• Gambhir, R. S., Brar, P., Singh, G., Sofat, A., & Kakar, H. (2013). Utilization of dental care: An Indian outlook. Journal of Natural Science, Biology, and Medicine, 4(2), 292-297.
• Gitobu, C. M., Gichangi, P. B., & Mwanda, W. O. (2018). The effect of Kenya’s free maternal health care policy on the utilization of health facility delivery services and maternal and neonatal mortality in public health facilities. BMC Pregnancy and Childbirth, 18(1), 1-11.
• Haghi, M., & Rajabi, G. (2017). Health care services utilization in Iran. Iranian Journal of Public Health, 46(6), 863-864. Hogart, J. (1975). Glossary of health care terminology. WHO, Copenhagen.
• Hulka, B. S., & Wheat, J. R. (1985). Patterns of utilization: the patient perspective. Medical Care, 23(5), 438-460.
• Jin, Y., Zhu, W., Yuan, B., & Meng, Q. (2017). Impact of health workforce availability on health care seeking behavior of patients with diabetes mellitus in China. International Journal for Equity in Health, 16(1), 1-10.
• Kılıç, D., & Çalışkan, Z. (2013). Sağlık hizmetleri kullanımı ve davranışsal model. Nevşehir Hacı Bektaş Veli Üniversitesi SBE Dergisi, 2(2), 192-206.
• Léonard, C., Stordeur, S., & Roberfroid, D. (2009). Association between physician density and health care consumption: a systematic review of the evidence. Health Policy, 91(2), 121-134.
• Li, J., Shi, L., Liang, H., Ding, G., & Xu, L. (2018). Urban-rural disparities in health care utilization among Chinese adults from 1993 to 2011. BMC Health Services Research, 18(1), 1-9.
• Millman, M. (1993). Access to health care in America. Committee on monitoring access to personal health care services. Institute of Medicine, National Academy Press, Washington, DC.
• Nuako, A., Liu, J., Pham, G., Smock, N., James, A., Baker, T., ... & Chen, L. S. (2022). Quantifying rural disparity in healthcare utilization in the United States: Analysis of a large midwestern healthcare system. PloS One, 17(2), e0263718.
• Ono T, Lafortune G, Schoenstein M. (2013). Health workforce planning in OECD countries: a review of 26 projection models from 18 countries. Paris,France: Organisation for Economic Cooperation and Development (OECD).
• Özdoğan, S. (2018). Türkiyede illere göre sağlık hizmet kalitesini etkileyen faktörler (Yüksek Lisans Tezi, Beykent Üniversitesi, İstanbul.
• Öztaş, D., Demiralp, K., Bozcuk Güzeldemirci, G., Üstü, Y., Karahan, S., Özgül, E., ... & Uğurlu, M. (2016). Türkiye’de ağız ve diş sağlığı merkezlerinde çalışan diş hekimlerinin sağlık insan gücü ve iş yükü açısından değerlendirilmesi. International Refereed Academic Journal of Sports, Health and Medical Sciences, 18, 29-44.
• Rafiei, S., Abdollahzade, S., & Hashemi, F. (2019). Health manpower forecasting: A systematic review for models and approaches. Bangladesh Journal of Medical Science, 18(3), 458-472.
• Roberfroid, D., Leonard, C., & Stordeur, S. (2009). Physician supply forecast: better than peering in a crystal ball?. Human Resources for Health, 7(1), 1-13.
• Roberfroid, D., Stordeur, S., Camberlin, C., Van de Voorde, C., Vrijens, F., & Leonard, C. (2008). Physician workforce supply in Belgium: current situation and challenges. Health Care Knowledge Center: Brussels, Belgium.
• Sağlık Bakanlığı (2021, 10 Aralık). Sağlık istatistikleri yıllıkları. https://www.saglik.gov.tr/TR,84930/saglik-istatistikleri-yilliklari.html
• Scott, A. (2011). Alternative approaches to health workforce planning. School of Population Health, University of Queensland.
• Shapiro, N., Kayam, A., Kovetz, A., Belinsky, A., & Brenner Shalem, R. (2021). The number of physicians in Israel: Trends and policy recommendations. Ministry of Health.
• Smits, M., Slenter, V., & Geurts, J. (2010). Improving manpower planning in health care. BLED 2010 Proceedings, 31, 144-153.
• Stokker, J., & Hallam, G. (2009). The right person, in the right job, with the right skills, at the right time: A workforce planning model that goes beyond metrics. Library Management, 15(8/9), 561-571.
• Wennberg, D. E., Lucas, F. L., Birkmeyer, J. D., Bredenberg, C. E., & Fisher, E. S. (1998). Variation in carotid endarterectomy mortality in the Medicare population: trial hospitals, volume, and patient characteristics. Jama, 279(16), 1278-1281.
• Xu, Z., & Tian, S. (2022). Study on the relationship between the richness and utilization efficiency of health manpower resources. In International Conference on Computer Application and Information Security (ICCAIS 2021) (Vol. 12260, pp. 608-615). SPIE.
• Zhang, X., Yu, B., He, T., & Wang, P. (2018). Status and determinants of health services utilization among elderly migrants in China. Global Health Research and Policy, 3(1), 1-10.
• Zurn, P., Dal Poz, M. R., Stilwell, B., & Adams, O. (2004). Imbalance in the health workforce. Human Resources for Health, 2(1), 1-12.