The Relationship Between the Health Transformation Program and Health Expenditures: Evidence From an Autoregressive Distributed Lag Testing Approach.

OBJECTIVES: As health expenditure increases every year, countries try to provide accessible health services to society and try to protect individuals from the expenses they cannot overcome by investigating the reason for this increase. Especially with the arrangements made in the health systems in developing countries such as Turkey, it has been tried to take the control of dramatic increases in health expenditure. Based on this issue, in this study, we aimed to evaluate the effect of income per capita, annual inflation, and health reform called as Health Transformation Program on the health expenditure per capita in Turkey. METHODS: This study reflected the effects of income, inflation, and the reform on the total health expenditure through the autoregressive distributed lag. This study covered the years between 1985 and 2016 for Turkey. RESULTS: As a result of this study, there was a positive relationship between health expenditure and income and a negative relationship with the reform (P < .05). CONCLUSION: According to the results of this study, it is suggested that health expenditures can be kept under control with improvements such as encouraging individuals to use more primary healthcare services than curative health services and increasing the quality of service without compromising the equity in financing.

Prioritization of neurologic rehabilitation interventions by ELECTRE-III analysis in subacute stroke patients.

BACKGROUND: Elimination and Choice Translating Reality (ELECTRE) III is a commonly used multicriteria decision-making (MCDM) method when alternatives are being prioritized in health sciences. The selection of the rehabilitation approach is the key factor to improve the upper extremity functions of stroke patients. Thus, choosing a reasonably good treatment approach will directly reduce the patient's cost to the government and caregivers, while also improving quality of life. The aim of our study was to prioritize the six different methods used in the rehabilitation of stroke patients with mild or moderate upper extremity dysfunction, using one of the MCDM methods based on experts' opinions. METHODS: A three-stage face-to-face interview across Turkey, based on the ELECTRE-III method, was conducted with 18 physiotherapists specializing in the rehabilitation of mild or moderate stroke-induced upper extremity disorders. RESULTS: According to ELECTRE-III, Circuit Class Therapy (CCT) is the best choice for treating upper extremity functional loss in general. It is also the best alternative in both the ascending and descending distillation processes of ELECTRE-III. On the other hand, Bobath neurodevelopmental treatment (NDT) has a similar success level according to ascending distillation. Mirror therapy and constraint-induced movement therapy are the third-best methods in the analysis. However, robotic rehabilitation is the least preferable treatment method according to the experts' judgments. CONCLUSIONS: The results showed that rehabilitation interventions such as Bobath-NDT and proprioceptive neuromuscular facilitation, which are frequently used in developing countries, are still useful, and CCT is the most appropriate intervention for the transition from conventional methods to innovative models in these countries.

Does Efficiency of Oral and Dental Health Centers Change by the Development Level of Regions?

OBJECTIVES: This study aimed to analyze the efficiency levels of oral and dental health centers (ODHCs) affiliated to the Ministry of Health from the perspective of the development levels in the regions. METHODS: Within the framework of this study, the efficiencies of 127 ODHCs are evaluated with the data envelopment analysis based on Charnes, Cooper, Rhodes (CCR); Banker, Charnes, Cooper (BCC); and scale efficiency methods. RESULTS: It is found that CCR, BCC, and scale efficiencies of the 42 ODHCs located in the first region, the highest development region, are efficient by 31%, 50%, and 38% whereas 13%, 26%, and 26% of other 85 ODHCs located in other regions are efficient, respectively. Additionally, the average efficiency scores of 42 ODHCs in the first region by CCR (0.82), BCC (0.89), and score efficiency (0.93) are much higher than the average efficiency scores of 85 ODHCs in other regions by CCR (0.73), BCC (0.80), and scale efficiency (0.92). CONCLUSIONS: According to the findings, it is considered that the individuals from the first region use the oral and dental healthcare more than the individuals do in other regions because the access to oral and dental healthcare is higher in the first region and the individuals living in this region have better predisposing and enabling factors. The study results are thought to present evidence-based information to health policy makers regarding the regional planning of oral and dental healthcare.

Measuring the efficiency of Turkish maternal and child health hospitals: A two-stage data envelopment analysis.

This study aims to examine the changes in efficiency and efficiency levels of the maternal and child health hospitals in Turkey from 2014 to 2017, by applying two-stage data envelopment analysis (DEA). At the first stage of the study, the efficiency of the hospitals was evaluated with input-oriented CCR (Charnes, Cooper, Rhodes) and Malmquist Productivity Index (MPI). At the second stage, panel Tobit regression analysis was utilized to find out the factors that affect the efficiency scores specified at the first stage. According to the results of the first stage, the mean efficiency values calculated for 2014, 2015, 2016, and 2017 were 0.83, 0.90, 0.86, and 0.80, respectively. At the second stage, it was revealed that the variables of not being in a metropolis and having 200 beds at least had statistically a significant effect on the efficiency score (p < 0.05) whereas being a training and research hospital was ineffective (p > 0.05). The number of the studies which assess the efficiency of maternal and child health hospitals in Turkey was quite limited. Moreover, such studies do not contain second-stage analyses. Lastly, it is thought that those results will provide health policy-makers substantial and evidence-based information in the allocation of the resources for the related services.

Socio-demographic characteristics affect health information seeking on the Internet in Turkey.

OBJECTIVE: The objective of this paper was to determine the effects of certain socio-demographic characteristics of Turkish individuals who seek health information on the Internet. METHODS: This study was granted permission to use data obtained by the Turkish Statistical Institute (TSI) in 2018 under their Household Information Technology Use (HITU) study. The original sample for this research comprised 19,389 participants. RESULTS: Age, gender, educational level, place of residence and frequency of Internet use were all found to impact the participants' health information seeking behaviour on the Internet. Health information was sought more frequently by women than men, by younger than older people and by those with higher levels of education. Also, health information searches were conducted more often in developed regions than in less-developed regions. In addition, it was also found that the habit of seeking health information was more common among those who use the Internet more frequently. CONCLUSION: Several socio-demographic characteristics of individuals affect their health information seeking behaviour on the Internet. All individuals should be granted equivalent access to reliable health information by taking sociodemographic characteristics and discrepancies into consideration.

Evaluating the Technical Efficiency of Hospitals Providing Tertiary Health Care in Turkey: An Application Based on Data Envelopment Analysis.

Tertiary care hospitals use more resources compared to other hospitals, which makes technical efficiency measurements specific to these hospitals important. This study explored the factors affecting the efficiencies of training and research hospitals affiliated to the Ministry of Health (n = 41) and university hospitals (n = 51) in Turkey via Data Envelopment Analysis, Malmquist Total Factor Productivity Index and panel Tobit Regression. The results showed that hospital size and the status of being a training and research or a university hospital affected the technical efficiency (p < 0.05). The size and the status of the hospitals should be taken into consideration while allocating the resources.

Prioritization of the policies and practices applied in Turkey to fight against covid-19 through AHP technique / Priorização das políticas e práticas aplicadas na Turquia para o combate ao covid-19 através da técnica AHP

Abstract Concerns about covid-19 become deeper globally. Due to these concerns, all countries, international health institutions, health authorities and health care professionals in the world take several measures through policies or practices to control and handle covid-19 pandemic. For example; different types of policies in the fight against covid-19 have been launched in Turkey. Therefore, in this study, we sought to determine how policies and practices against covid-19 were prioritized by health care professionals and other segments of society via AHP method. We observed that the order of importance of health care professionals and other segments of the society regarding the policies and practices used in combating the covid-19 outbreak was quite similar between the groups. The covid-19 test policy was revealed as the most important one of both groups. However, social welfare programs have more significance than economic measures for society, while health care professionals are more concerned with economic measures. With this study, we intend to provide evidence-based information to decision-makers in combating the pandemic.

Resumo As preocupações com a covid-19 se aprofundam globalmente. Devido a essas preocupações, todos os países, instituições internacionais de saúde, autoridades de saúde e profissionais de saúde em todo o mundo tomam várias medidas por meio de políticas ou práticas para controlar e lidar com a pandemia de covid-19. Por exemplo, diferentes tipos de políticas na luta contra a covid-19 foram lançados na Turquia. Portanto, neste estudo, o objetivo é determinar como as políticas e práticas contra a covid-19 foram priorizadas pelos profissionais de saúde e outros segmentos da sociedade por meio do método AHP. De acordo com os resultados, foi observado que a ordem de importância dos profissionais de saúde e demais segmentos da sociedade quanto às políticas e práticas utilizadas no combate ao surto de covid-19 foi bastante semelhante. A política de teste da covid-19 foi apresentada como a política mais importante de ambos os grupos, no entanto, os programas de bem-estar social têm mais importância do que as medidas econômicas para a sociedade, enquanto os profissionais de saúde se preocupam mais com as medidas econômicas. Com este estudo, pretendemos que as informações baseadas em evidências serão fornecidas para os tomadores de decisão no combate à pandemia.

Effect of economic crisis on suicide cases: An ARDL bounds testing approach.

BACKGROUND: Suicide events observed in various groups, community or countries, especially in the periods of economic recession. It is thought that suicide cases increase when people's income decreases dramatically and they lose their jobs. AIM/OBJECTIVE: In this study, it was aimed to investigate whether the 2008 economic crisis had any effect on suicides in the United States. METHODS: Autoregressive distributed lag method was used. For the purpose of the study, the number of suicide-related deaths was taken as the dependent variable, while unemployment rates and 2008 economic crisis were taken as independent variables. FINDINGS: The short-term and long-term relationships obtained within the scope of the study indicated that the 2008 economic crisis had a statistically significant effect on suicide cases in the United States. RESULTS AND CONCLUSION: It can be said that the results of this study are consistent with the information which emphasizes that economic crises increase suicide cases in the literature.

Individual and socio-demographic determinants of suicide: An examination on WHO countries.

BACKGROUND: Suicide cases have psychological, socio-economic and cultural aspects, and such cases may have catastrophic impacts in societies due to their outcomes. PURPOSE: This study was aimed to reflect the effect of psychological, behavioral, socio-demographic and economic determinants on suicide. METHODS: The Ordinary Least Square (OLS) Regression Analysis was utilized for the purposes of this study. Five models were established. In this contex, the first model includes the variables on psychological determinants; the second model with the variables on behavioral determinants; the third model with the variables on socio-demographic determinants; the fourth model with the variables on economic determinants and finally the fifth model with all of the independent variables. CONCLUSION: According to the results, the variables of depression prevalence, alcohol consumption and unemployment rates had statistically significant effect on the suicide cases (p < .05). The study's outcomes are considered to contribute on the evidence-based policy development process.