Is There A Relationship Between Financial Performance and Health Services Performance? Evidence from Selected Countries

Year 2024, Volume: 8 Issue: 1, 300 - 309, 31.01.2024

İnci Merve Altan , Cansu Akça

https://doi.org/10.29023/alanyaakademik.1336526

Abstract

Utilising resources wisely and effectively is crucial because they are limited in the field of health. Effective health expenditures have a reducing effect on possible health problems that may be encountered in the future. For this reason, the performance evaluation of health services obtained as a result of health expenditures has gained importance. In addition, measuring financial performance, which is another performance evaluation tool for health institutions, is strategically extremely important. In this direction, the relationship between the health service performance and financial performance of Belgium, Denmark, Finland, Greece, Ireland, Luxembourg, Norway, Slovenia, and Sweden in the 2018–2022 period was analysed with the EDAS method. According to the findings, a positive relationship was observed between financial performance and health service performance. It has been determined that the health services performance of the countries with high financial performance is also high.

Keywords

Financial Performance, Health Services Performance, EDAS Method, Correlation

Is There A Relationship Between Financial Performance and Health Services Performance? Evidence from Selected Countries

Abstract

Sağlık alanında sınırlı olan kaynakların etkin ve verimli şekilde kullanılması son derece önemlidir. Etkin biçimde gerçekleştirilen sağlık harcamaları, gelecekte karşılaşılabilecek olası sağlık sorunlarında azaltıcı etkiye sahiptir. Bu nedenle sağlık harcamaları sonucu elde edilen sağlık hizmetlerinin performans değerlendirmesi önem kazanmıştır. Ayrıca sağlık kurumları için bir diğer performans değerlendirme aracı olan finansal performansın da ölçülmesi stratejik açıdan son derece önemlidir. Bu doğrultuda çalışmada 2018-2022 döneminde Belçika, Danimarka, Finlandiya, Yunanistan, İrlanda, Lüksemburg, Norveç, Slovenya ve İsveç ülkelerinin sağlık hizmetleri performansı ile finansal performansı arasındaki ilişki EDAS yöntemiyle analiz edilmiştir. Bulgulara göre finansal performans ile sağlık hizmetleri performansı arasında pozitif ilişki görülmüştür. Finansal açıdan yüksek performans gösteren ülkelerin sağlık hizmetleri performansının da yüksek olduğu elde edilmiştir.

Keywords

Finansal Performans, Sağlık Hizmetleri Performansı, EDAS Yöntemi, Korelasyon

References

• Adam, A., Delis, M., & Kammas, P. (2010). Public sector efficiency: Leveling the playing field between OECD countries. Springer, Public Choice, 146(1-2), 163-183. https://link.springer.com/article/10.1007/s11127-009-9588-7#article-info
• Afonso, A., & Aubyn, M. (2005). Non-parametric approaches to education and health expenditure efficiency in OECD countries. Journal of Applied Economics, 8(2), 227-246. doi.org/10.1080/15140326.2005.12040626
• Alinezhad, A., & Khalili, J. (2019). EDAS method. New methods and applications in multiple attribute decision making (MADM), Springer.
• Arı, H.O. (2023). Analysis of financial performance of a private hospital group and Turkish private hospitals sector with Dupont model. Journal of Business Research-Turk, 15(1), 187-201. doi.org/10.20491/isarder.2023.1580
• Asandului, L., Roman, M., & Fatulescu, P. (2014). The efficiency of healthcare systems in Europe: A data envelopment analysis approach. Procedia Economics and Finance, 10, 261–268. doi.org/10.1016/S2212-5671(14)00301-3
• Ateş, Ç. (2014). Financial performance assessment in health care facilities (Diyarbakir Gazi Yaşargil Education And Research Hospital Sample) [Master thesis, Beykent University].
• Avcı, K., & Çınaroğlu, S. (2015). Clustering of the ministry of health hospitals in terms of organizational and financial performance ındicators. Hacettepe University Journal of Economics and Administrative Sciences, 33(2), 1-23. doi.org/10.17065/huiibf.75442
• Ayanoğlu, Y., Atan, B., & Beylik, U. (2010). Assessments and measurement of financial performance using the methodology of data envelopment analysis (dea) in hospitals. Journal of Performance and Quality in Health, 2(2), 40-62.
• Bal, V., & Bilge, H. (2013). Efficiency measurement with data envelopment analysis in education and research hospitals. Manas Journal of Social Studies, 2(2), 1-14.
• Beylik, U., & Pekcan, Y.A. (2012). Assesments of analysis efficiency in training and research hospitals. Journal of Performance and Quality in Health, 3(1), 119-156.
• Bozdemir, E., & Güley, A.Ö. (2022). Financial analysis of private enterprises providing health care: A study on central bank data. The Journal of Business Science, 10(3), 337-361. https://doi.org/10.22139/jobs.1145532
• Çakmak, M., Öktem, M.K., & Ömürgönülşen, U. (2009). The efficiency problem of Turkish public hospitals: the measurement of technical efficiency of maternity hospitals by data envelopment analysis. Hacettepe Journal of Health Administration, 12(1), 1-36.
• Çam, H. (2016). Evaluation of financial performans in health organizations: the case of Karaman state hospital. The Journal of International Scientific Researches, 1(1), 14-27. https://doi.org/10.23834/isrjournal.245515
• Çeçen, Z., & Akbulut, F. (2023). Evaluation of health indicators of low income countries by DEA method. Gumushane University Journal of Social Sciences, 14(1), 241-254.
• Çevik, S. (2013). The effect of public spending on the improvement of healthcare services: A comparative study. I. U. Journal of the Faculty of Political Sciences, 48, 113-133.
• Daştan, İ., & Çetinkaya V. (2015). Comparing health systems, health expenditures and health indicators in OECD countries and Turkey. Journal of Social Security, 5(1), 104-134.
• Demirci, Ş., Konca, M., & İlgün, G. (2020). The impact of health financing on health systems’ performance: An assessment for European Union and candidate countries. Socioeconomics, 28(43), 229-242. doi.org/10.17233/sosyoekonomi.2020.01.13.
• Dirik, C., & Şahin, S. (2020). Efficiency and productivity analysis of health services in Turkey: A comparison of radial and non-radial dea and MPI models. Süleyman Demirel University Visionary Journal, 11(28), 790-814. doi.org/10.21076/vizyoner.659548.
• Ekinci, G., & Bakır, İ. (2021). Financial performance analysis in health institution branch of A1 hospital. International Journal of Health Management and Strategies Research, 7(1), 1-18.
• Filmer, D., & Pritchett, L. (1999). The impact of public spending on health: does money matter? Social Science and Medicine, 49(10), 1309-1323. doi.org/10.1016/S0277-9536(99)00150-1
• Frogner, B., K., Frech, H.E., & Parente, S.T. (2015). Comparing efficiency of health systems across industrialized countries: A panel analysis. BMC Health Services Research, 15(415), 1-12. doi.org/10.1186/s12913-015-1084-9, 18.07.2023.
• Gider, Ö. (2011). The effects of economical crisis periods on private hospitals: Overview of financial performance of a private hospital by using ratio analysis. Oneri Journal, 9(36), 87-103.
• Işıkçelik, F., & Ağırbaş, İ. (2022). Evaluation financial performance of health institutions by gray relational analysis. Alanya Academic Review Journal, 6(3), 2565-2582. doi.org/10.29023/alanyaakademik.1062654.
• Işıkçelik, F., Durur, F., & Günaltay, M.M. (2021). Evaluation financial performance of private hospital by Dupont financial analysis method. Alanya Academic Review Journal, 5(2), 773-791. https://doi.org/10.29023/alanyaakademik.874789.
• Işıkçelik, F., Turgut, M., & Ağırbaş, İ. (2022). Evaluation of financial performance in hospitals with different analysis methods. Süleyman Demirel University Visionary Journal, 13(34), 505-519. https://doi.org/10.21076/vizyoner.948785.
• İnam, B., & Murat, D. (2023). Evaluation of OECD countries health expenditure performances with Vikor method. Journal of Financial Politic & Economic Reviews, 60(663), 105-126.
• Kaçak, H. (2022). Effects of public health services on health systems performance: An application with dynamic network data envelopment analysis. Turkish Journal of Hygiene and Experimental Biology, 79(3), 531-548. doi.org/10.5505/TurkHijyen.2022.70194.
• Kar, A., Özer, Ö., & Avcı, K. (2019). The assessment of financial performance of the oral and dental health centers in Turkey. Dumlupinar University Journal of Social Sciences, (60), 87-99.
• Karabasevic, D., Zavadskas, E. K., Stanujkıc, D., Popovic, G., & Brzakovic, M. (2018). An approach to personnel selection in the IT industry based on the EDAS method. Transformations in Business & Economics, 17(2), 54-65.
• Karadeniz, E. (2016). An investigation of hospital activities subsectors’ financial performance: A research of Central Bank of the Republic of Turkey company accounts. Hacettepe Journal of Health Administration, 19(2), 101-114.
• Karaman, S., Ürek. D., Bilgin. İ., Uğurluoğlu. Ö., & Işık. O. (2020). The impact of healthcare spending on health outcomes: new evidence from OECD countries. Erciyes Medical Journal, 42(2), 218-222.
• Kaufman, K. (1994). The financially competitive healthcare organizations. Mark Hall, Healthcare Financial Management Association. New York: Irwin Publishing.
• Kefe, İ. (2023). The financial performance of the healthcare sector in the covid-19 pandemic: Evidence from Turkey. Hacettepe Journal of Health Administration, 26(2), 461-478.
• Keleş, N. (2023). Evaluation of health performance of 81 provinces of Turkey with current decision-making methods. Dumlupınar University Journal of Social Sciences, (75), 120-141. doi.org/10.51290/dpusbe.11346082.
• Keshavarz G., Zavadskas, E.K., Olfat, L., & Turskis, Z. (2015). Multi-criteria inventory classification using a new method of evaluation based on distance from average solution (EDAS). Informatica, 26(3), 435-451.
• Kocaman A.M., Mutlu, M.E., Bayraktar, D., & Araz, Ö.M. (2012). Healthcare sytem efficiency analysis of OECD countries. Journal of Industrial Engineering, 23(4), 14-31.
• Koçyiğit, S.Ç., Bıyık, E., & Ertaş, Ş. (2022). Evaluation of the financial performance of a private health enterprise with trend analysis. Journal of Abant Social Sciences, 22(1), 165-180. doi.org/10.11616/asbi.1015793.
• Mazgit, İ. (2002). Information society and the increasing importance of health. I. National Information. Economy and Management Congress, Kocaeli, 405-415. https://www.academia.edu/2136517/Bilgi_toplumu_ve_sa%C4%9Fl%C4%B1%C4%9F%C4%B1n_artan_%C3%B6nemi, 22.05.2023.
• Medeiros, J., & Schwierz, C. (2015). Efficiency estimates of health care systems. Directorate general economic and financial affairs. European Economy Economic Papers, 549. https://ec.europa.eu/economy_finance/publications/economic_paper/2015/pdf/ecp549_en.pdf,10.06.2023 . OECD, (2023). OECD Health statistics. https://stats.oecd.org/, 20.07.2023.
• Özata, M., & Sevinç, İ. (2010). Evaluation of efficiency levels of health centers in Konya by data envelopment analysis method. Atatürk University Journal of Economics and Administrative Sciences, 24(1), 77-87.
• Pakdil, F., Akgül, S., Doruk, T.Ç., & Keçeci, B. (2010). Use of data envelopment analysis results in institutional performance management: comparison of university hospitals. II. Proceedings of the International Congress of Performance and Quality in Health.
• Palamutçu, S. (2013). Financial performance measurement and comparison by ratio analysis at public and private health institutions. Master Thesis, Beykent University Institute of Social Sciences, Istanbul.
• Pehlivan, D., & Yiğit, A. (2022). Evaluation of health services performance of provinces with metropolitan status in Turkey. Giresun University Journal of Economics and Administrative Sciences, 8(2), 194-211. doi.org/10.46849/guiibd.1191919.
• Pekkaya, M., & Dökmen, G. (2019). OECD countries public healthcare expenditure performance evaluation via multi-criteria decision-making methods. Int. Journal of Management Economics and Business, 15(4), 923-950.
• Pourmohammadi, K., Shojaei, P., Rahimi, H., & Bastani, P. (2018). Evaluating the health system financing of the Eastern Mediterranean Region (EMR) countries using grey relation analysis and Shannon Entropy. Cost Effectiveness and Resource Allocation, 16, 1-9.
• Roberts, D.R., Chang, C.F., & Rubin R.M. (2004). Technical efficiency in the use of health care resources: A comparison of OECD countries. Health Policy, 69(1), 55-72. doi.org/10.1016/j.healthpol.2003.12.002
• Sonğur, C., Kar, A., Top, M., Gazi, A., & Babacan, A. (2016). The evaluation of the financial performance of Turkish public hospital unions hospitals: Analysis of financial statements. Journal of the Turkish Court of Accounts, (100), 1-26.
• Spinks, J., & Hollingsworth, B. (2005). Health production and the socioeconomic determinants of health in OECD Countries: The use of efficiency models. Monash University, Centre for Health Economics, Working Paper 151.
• Stefko, R., Gavurova, B., & Kocisova, K. (2018). Healthcare efficiency assessment using DEA analysis in the Slovak Republic. Health Economics Review, 8(1), 6.
• Şantaş, F., Şantaş, G., & Demirgil, B. (2021). The effect of public health expenditure on three main health indicators: A panel regression analysis on OECD countries. Dicle University Journal of Economics and Administrative Sciences, 11(21), 73-84. doi.org/10.53092/duiibfd.869689.
• Taşar, S.A., Demir, Ö., & Diğer, H. (2019). The financial performance measurement of health institutions: A case of city and district state hospitals. Journal of Health Management, 3(2), 1-15.
• Temür, Y. (2008). A performance evaluation of public expenditure management: An application of health care expenses and public hospitals. Phd Thesis, Marmara University Institute of Social Sciences, Istanbul.
• Tutar, M. (2022). The effect of the Covid-19 pandemic on the financial performance of public hospitals: The example of Mersin Toros State Hospital, Master Thesis, Nevşehir Hacı Bektaş Veli University, Institute of Social Sciences.
• Uyar, M., & Şahin, T.K. (2015). Evaluation of efficiency of primary health cares in Konya city centre, TAF Preventive Medicine Bulletin, 14 (1), 1-6.
• Yazıcı, Ö. (2023). Investigation of the effects of the Covid-19 pandemic process on the financial structure of private hospitals in Turkey [Master thesis, Ordu University].
• Yılmaz, V., & Yentürk, N. (2015). A historical overview of health expenditures in Turkey. Istanbul Bilgi University Center for Civil Society Studies. https://stk.bilgi.edu.tr/media/uploads/2015/11/08/saglikHarcamalari.pdf
• Yiğit, A. (2019). Analysis of performance of education and research hospitals in Turkey by TOPSIS method. Journal of Ankara Health Sciences, 8(2), 72-85.
• Yiğit, V., & Bayrakcıoğlu, S. (2020). Financial performance of university hospitals: Case of Ankara, International Journal of Business, Economics and Management Perspectives, 4(2), 153-164.
• Yiğit, V. (2020). Financial performance analysis of hospital services subsector. International Journal of Health Management and Strategies Research, 6(3), 609-624.