HASTANELERİN TÜRÜ VE GRUBU AÇISINDAN FİNANSAL ETKİNLİKLERİNİN VZA YÖNTEMİYLE DEĞERLENDİRİLMESİ - EVALUATION OF THE FINANCIAL EFFICIENCIES OF HOSPITALS THROUGH DATA ENVELOPMENT ANALYSIS METHOD IN TERMS OF THEIR TYPE AND GROUP

Yıl 2020, Cilt: 7 Sayı: 1, 20 - 41, 23.03.2020

Nazan Torun , Yildiz Ayanoğlu Murat Atan

https://doi.org/10.30798/makuiibf.565413

Cited By: 1

Öz

This study has been done with the aim of examining the financial operations of 825 hospitals affiliated to the Ministry of Health.For this purpose,the efficiencies of hospitals have been assessed based on their financial data according to their group and type.Selected 6 input and 3 output variables have been analysed through Charnes – Cooper – Rhodes (CCR) Input Oriented Primal Model, Banker – Charnes – Cooper (BCC) Input Oriented Primal Model and Super Efficiency Model.In the light of the results obtained, 73 hospitals in CCR Model and 143 hospitals in BCC Model have been determined financially efficient.The results of both CCR and BCC Model have been found to be the same according to hospital type and group;however,efficiency levels of hospitals according to their groups have shown differences.Furthermore;although it appears at the end of the study that all input should be reduced and output should be increased according to hospital group,it has been seen that the number of inputs and outputs to be reduced and increased are not the same in every hospital group.It is thought that the results obtained will be a guide to operate hospitals with more efficient financial policies throughout the country. 

Anahtar Kelimeler

Health Care, Hospital, Performance Evaluation, Financial Efficiency, Productivity

THE EVALUATION OF THE FINANCIAL EFFICIENCIES OF HOSPITALS THROUGH DATA ENVELOPMENT ANALYSIS METHOD IN TERMS OF THEIR TYPE AND GROUP - HASTANELERİN TÜRÜ VE GRUBU AÇISINDAN FİNANSAL ETKİNLİKLERİNİN VZA YÖNTEMİYLE DEĞERLENDİRİLMESİ

Öz

Bu çalışma Türkiye’de bulunan Sağlık Bakanlığı’na bağlı 825 hastanenin mali etkinliklerini incelenmek amacı ile yapıldı. Bu amaçla hastane grubu ve hastane türüne göre hastanelerin mali verilerinden hareketle etkinlikleri ölçüldü. Seçilen 6 girdi ve 3 çıktı değişkenleri Veri Zarflama Analizinde (VZA) kullanılan Charnes – Cooper – Rhodes (CCR) Girdi Yönlü Primal Modeli, Banker – Charnes – Cooper (BCC) Girdi Yönlü Primal Modeli ve Süper Etkinlik Modeli ile analiz edildi. Elde edilen sonuçlara göre CCR modelinde 73 hastane, BCC modelinde ise 143 hastane mali açıdan etkin olarak belirlendi. Bununla beraber hastanelerin türüne ve hastane grubuna göre hem CCR hem de BCC modeli sonuçları aynı bulundu, ancak hastane grubuna göre hastanelerin etkinlik düzeyleri farklılık gösterdi. Ayrıca çalışma sonucunda hastane grubuna göre bütün girdilerin azaltılması, çıktıların ise artırılması gerekliliği ortaya çıkmakla beraber her hastane grubunda artırılması ve azaltılması gereken çıktı ve girdilerin aynı oranda olmadığı görüldü. Dolayısıyla girdi minimizasyonu açısından yöneticilerin daha kolay kontrol edebilecekleri değişkenleri seçmekte serbest davranış gösterebilecekleri sonucunda varıldı. Elde edilen sonuçların ülke bazında hastanelerin daha etkili mali politikalar ile çalıştırılması için yol gösterici olacağı düşünülmektedir. 

Anahtar Kelimeler

Sağlık, Hastane, Performans Değerlendirme, Finansal(Mali) Etkinlik, Verimlilik

Kaynakça

• ATMACA, E., TURAN, F., KARTAL, G., & ÇIĞDEM, E. S. (2012). Efficiency Measurement Using Data Envelopment Analysis in Ankara Private Hospitals. Cukurova University Journal of Economics and Administrative Sciences, 16(2).
• AYANOĞLU, Y., ATAN, M., & BAYRAM, A. (2008). Measurement of Financial Performance and Application of Data Envelopment Analysis in a University Hospital. Journal of Dialogue with Taxes and Accountants, 238, 104-115.
• AYANOĞLU, Y., ATAN, M., & 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. (2013). Data Envelopment Analysıs And Medıcal Image Archıvıng And Communıcatıon Systems To Investıgate The Effects Of The Performance Of Publıc Hospıtals. Journal of Süleyman Demirel University Institute of Social Sciences(17), 31-50.
• BAYRAKTUTAN, Y., & PEHLIVANOĞLU, F. (2012). An Efficiency Analysis In Health Businesses: The Case Of Kocaeli Kocaeli University Journal of the Institute of Social Sciences(23), 127-162.
• BEHDIOĞLU, S., & ÖZCAN, G. (2009). Data Envelopment Analysis and an Application in Banking Sector. Süleyman Demirel University, Journal of Faculty of Economics and Administrative Science, 14(3), 301-326.
• COOPER, W. W., SEIFORD, L. M., & ZHU, J. (2011). Handbook on Data Envelopment Analysis (Vol. 2): Springer Science+Business Media, LLC.
• CZYPIONKA, T., KRAUS, M., MAYER, S., & ROHRLING, G. (2014). Efficiency, ownership, and financing of hospitals: the case of Austria. Health Care Manag Sci, 17(4), 331-347. doi: 10.1007/s10729-013-9256-9
• DARAIO C, & L., S. (2007). Advanced Robust and Nonparametric Methods in Efficiency Analysis: Methodology and Applications. New York: Springer.
• FERRIER, G. D., & VALDMANIS, V. (1996). Rural hospital performance and its correlates. Journal of Productivity Analysis, 7(1), 63-80.
• FRANCO MIGUEL, J. L., FULLANA BELDA, C., & RUA VIEITES, A. (2018). Analysis of the technical efficiency of the forms of hospital management based on public-private collaboration of the Madrid Health Service, as compared with traditional management. Int J Health Plann Manage. doi: 10.1002/hpm.2678
• GOK, M. S., & ALTINDAG, E. (2015). Analysis of the cost and efficiency relationship: experience in the Turkish pay for performance system. Eur J Health Econ, 16(5), 459-469. doi: 10.1007/s10198-014-0584-6
• GÜLCÜ, A., COŞKUN, A., YEŞILYURT, C., COŞKUN, S., & ESENER, T. (2004). The Relative Efficiency Analysis Of Cumhuriyet University Dentistry Faculty By Data Envelopment Analysis Method C.U. Journal of Economics and Administrative Sciences, 5(2), 87-104.
• GÜLSEVIN, G., & TÜRKAN, A. H. (2012). Evaluation of Efficiencies of Hospitals in Afyonkarahisar Using Data Envelopment Analysis. Afyon Kocatepe University Journal of Sciences, 12(2), 1-8.
• KOCAKOÇ DEVECI, İ. (2003). Use of Analytic Hierarchy Process in Determining Weight Restrictions in Data Envelopment Analysis. Journal of Dokuz Eylul University Faculty of Economics and Administrative Sciences, 18(2).
• KUTLAR, A., & SALAMOV, F. (2016). Evaluation of Effectiveness of Azerbaijan Public Hospitals with Data Envelopment Analysis (DEA). Kocaeli University Journal of the Institute of Social Sciences(31), 1-17.
• LAVERS, R. J., & WHYNES, D. K. (1978). A production function analysis of English maternity hospitals. Socio-economic planning sciences, 12(2), 85-93.
• LEE, K. H., YANG, S. B., & CHOI, M. (2009). The association between hospital ownership and technical efficiency in a managed care environment. J Med Syst, 33(4), 307-315.
• LI, H., & DONG, S. (2015). Measuring and Benchmarking Technical Efficiency of Public Hospitals in Tianjin, China: A Bootstrap-Data Envelopment Analysis Approach. Inquiry, 52. doi: 10.1177/0046958015605487
• ÖZDEN, Ü. H. (2008). Veri zarflama analizi (VZA) ile Türkiye'deki vakıf üniversitelerinin etkinliğinin ölçülmesi. Istanbul University Journal of the School of Business, 37(2), 167-185.
• PIRANI, N., ZAHIRI, M., ENGALI, K. A., & TORABIPOUR, A. (2018). Hospital Efficiency Measurement Before and After Health Sector Evolution Plan in Southwest of Iran: a DEA-Panel Data Study. Acta Inform Med, 26(2), 106-110. doi: 10.5455/aim.2018.26.106-110
• RATES, A. (2018). http://www.muhasebex.com/2018-amortisman-oranlari. Retrieved 10.12.2018
• SIBBEL, R., & NAGARAJAH, B. (2012). [Are privately owned hospitals more efficient? Results of a survey of the international literature]. Gesundheitswesen, 74(6), 379-386. doi: 10.1055/s-0031-1280844
• TEMUR, Y. (2010). İllerin gelişmişlik derecelerine göre hastanelerin etkinlik analizi. Uludağ Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 19(2)
• TEMÜR, Y., & BAKIRCI, F. (2008). Türkiye’de sağlık kurumlarının performans analizi: bir VZA uygulaması.Sosyal Bilimler Dergisi, 10(3).
• WAGSTAFF, A. (1989). Estimating Efficiency in the Hospital Sector: A Comparison of Three Statistical Cost Frontier Models (Vol. 21).
• YEŞILYURT, Ö., & SALAMOV, F. (2017). Evaluation of Efficiency and Factors influencing the Efficiency in the Health Systems of Turkic States with Super-efficiency and Tobit Models. Balkan and Near Eastern Journal of Social Sciences, 3(2), 128-138.
• YIĞIT, V. (2016). Technical Efficiency Analysis in Hospitals: An Application of Public Hospitals Association. SDU Journal of Health Sciences, 7(2), 9-16.