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Öğe Determinants of health expenditure in OECD countries: A decision tree model(Professional Medical Publications, 2017) Akca, Nesrin; Sonmez, Seda; Yilmaz, AliObjective: This study aimed to identify the major variables in the estimation of health expenditure in OECD member countries with the decision tree method and to categorize the member countries by health expenditure. Methods: The study population comprised the 2014 data of the 35 OECD countries. In the study, health expenditure as a share of gross domestic product was the dependent variable while gross domestic product per capita, percentage of total population covered by public and private insurance, out-of-pocket health expenditure as percentage of total expenditure on health, age dependency ratio, life expectancy at birth, number of hospitals per million population, number of physicians per 1000 population/head counts, pharmaceutical sales and perceived health status were designated as independent variables. The decision tree model was constructed with the CART algorithm using the Orange data mining software package. Results: In the study, GDP per capita, life expectancy at birth, age dependency ratio, number of hospitals and percentage of the population with a bad perceived health status were identified as the major variables in the estimation of health expenditure. OECD countries were categorized in 6 groups according to the decision tree model. According to the CART algorithm used in the model, the classification accuracy rate and the precision of estimation were computed as 80.56% and 81.25%, respectively. Conclusion: The study results revealed that the most important determinant for estimating the share of GDP allocated to health expenditure was GDP per capita. Future studies should be conducted with the inclusion of different variables in the model.Öğe Determining the factors affecting the technical efficiency scores of public hospitals using different regression methods(Emerald Group Publishing Ltd, 2021) Sahin, Bayram; Ilgun, Gulnur; Sonmez, SedaPurpose This study aims to identify the efficiency scores of hospitals affiliated to the Ministry of Health in Turkey between the years of 2010-2015 at provincial level and to reveal the factors that affect the efficiency scores. Design/methodology/approach The two-stage data envelopment analysis (DEA) method was used to achieve the study purpose. In the first stage, DEA method based on input-oriented Charnes-Cooper-Rhodes (CCR) model was performed to calculate the efficiency scores of public hospitals at the provincial level between 2010 and 2015, and in the second stage, Tobit regression and linear regression analyses were used to identify whether the efficiency scores of provinces are affected by the input, output and control variables. Findings Upon the analysis, the average efficiency scores of 81 provinces by years were found to vary between 0.79 and 0.89. According to both regression analyses, all of the input and output variables were found to have significant effects on the efficiency scores of provinces while only the population of province among the control variables was identified as the factor with an effect on the efficiency scores of provinces (p < 0.05). Practical implications The results of this study are thought to guide health policymakers and managers in terms of both determining efficient and inefficient hospitals at the provincial level and revealing which variables should be taken into account in order to increase efficiency. Originality/value The study differs from previous studies on the efficiency of hospitals. First, although previous studies were generally descriptive studies to determine the efficiency level of hospitals, this study is an analytical study that tries also to show the factors affecting the efficiency of hospitals. In addition, while examining the effect of input and output variables on efficiency scores, control variables were also included in the study.Öğe An Evidence-Based Approach to Outcome Measurement in Oral and Dental Health Services: Oral Health-Related Quality of Life and Oral Health Impact(Wiley, 2019) Top, Mehmet; Sonmez, Seda; Aslan, HuseyinPurpose The purpose of this study was to examine the Oral Health-Related Quality of Life (OHRQOL) and Oral Health Impact Profile (OHIP) of oral and dental health patients in terms of gender, educational status, and the reason for coming to the oral health center. Also, we investigated the relationships between OHRQOL and OHIP. Methods This cross-sectional study was conducted and planned for dental patients in Turkey. OHRQOL-United Kingdom (OHRQOL-UK) and OHIP-14 were used for data collection. Descriptive statistics, correlation analysis, student t-tests, and ANOVA were used for data analyses. Results Of 527 respondents, 62.8% were female, and 37.2% were male. One-hundred-forty-one (26.8%) participants were illiterate. Three-hundred-fifty-four (67.20%) dental patients had an elementary school degree. Only 32 (6.10%) participants graduated from college and bachelor programs. For dimensions of the OHIP-14 and OHRQOL-UK, we detected statistically significant differences in personal characteristics. We found that gender, marital status, age, education status, and reasons for coming to the hospital have a significant impact on OHRQOL and OHIP. Linking Evidence to Action These results are expected to provide important evidence-based information to health managers and decision-makers in health planning and reimbursement policies. Clinicians and health managers should use OHIP, quality of life (QOL), and evidence-based practice to determine individual treatments and approaches to improve oral health. QOL is an outcome indicator in healthcare services and evidence-based practice. Measurements of evidence-based health outcomes in national health systems can be made, and global comparisons and policies in oral and dental health can be developed.Öğe Measuring the efficiency of Turkish maternal and child health hospitals: A two-stage data envelopment analysis(Pergamon-Elsevier Science Ltd, 2022) Ilgun, Gulnur; Sonmez, Seda; Konca, Murat; Yetim, BirolThis 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.Öğe Mediating Effect of Employee Performance on the Relationship Between Emotional Labour and Intent to Leave Among Nurses(Sage Publications India Pvt Ltd, 2023) Sahin, Bayram; Ilgun, Gulnur; Sonmez, SedaIn this study, it was aimed to examine the effect of nurses' emotional labor levels on their intention to leave and to determine whether employee performance plays a mediating role in this relationship. The study is of descriptive cross-sectional type, which was conducted through a questionnaire on nurses. The surface acting has positive effect on the intent to leave among nurses, whereas deep acting has negative effect; employee performance has partial mediating role on the relationship between the surface acting and intent to leave, and the relationship between deep acting and intent to leave. The study is considered to provide significant tips in the identification of nurses with higher risk to leave the work, and in deciding managerial interventions that would be realised against such circumstances. It is suggested that it may be beneficial for nurse managers to organise training in their units, to evaluate the performance of nurses at regular intervals and thus to determine the reason for the increase and decrease, to plan activities that will reduce emotional burden.Öğe Quality of life and oral health impact profile in Turkish dental patients(Elsevier Sci Ltd, 2016) Sonmez, Seda; Top, MehmetBackground: OHRQoL, oral health impact assessment and QoL in oral health have become central to dental and oral health research. Researchers studying oral health problems have used OHRQoL as an outcome measure to determine the effect of treatment on QoL in health technology assessment. Aim: Here we aimed to evaluate the effect of oral health related quality of life and oral health impact dimensions on general health related quality of life. Method: Outpatients (n=527) at a public dental hospital were incorporated into the study. Data were collected using a survey, including questions addressing socio-demographic features, oral health related quality of life (Oral Health Impact Profile-14 [OHIP14] and Oral Health Related Quality of Life - United Kingdom [OHRQoL-UK]) and general health related quality of life (SF-36). Results: We found that OHIP-14, OHRQoL-UK responses significantly correlated with the physical and mental health dimensions of the SF-36. Our data will be useful for health managers and decision makers in health planning and reimbursement policies. Conclusion: The research results are expected to provide important evidence based information to health managers and decision makers in health planning, health technology assessment, and reimbursement policies. (C) 2016 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.
