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Prioritization of the policies and practices applied in Turkey to fight against covid-19 through AHP technique
(Univ Sao Paulo, Fac Saude Publica, 2021) Yetim, Birol; Sönmez, Seda; Konca, Murat; İlgün, Gülnur
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.
Benchmarking countries' technical efficiency using AHP-based weighted slack-based measurement (W-SBM): A cross-national perspective
(Elsevier Sci Ltd, 2023) Yetim, Birol; Sönmez, Seda; Konca, Murat; İlgün, Gülnur
Objectives: The objective of the research is to assess the technical efficiency of national health systems in OECD member countries and to provide ideas to improve the efficiency of health systems in countries that have been identified as having a lower degree of efficiency as a result of the findings.Methods: The technical efficiency scores were calculated using one of the data envelopment analyses (DEA), the Weighted Slack-Based Measure (W-SBM). The Analytic Hierarchy Process was used to establish the aforementioned weights (AHP). Weights are calculated separately for both input and output variables.Results: The technical efficiency of the relevant countries' health systems is around 0.79, according to the data, and just 13 (36.1%) of the 36 countries have a fairly efficient health system.Conclusions: The outcomes of the study were supposed to aid health policymakers and management in improving system efficiency. In addition, since the number of studies examining the health systems of OECD countries with the W-SBM method is limited, it is thought that this study will make an important contribution to the literature.
A phenomenological study of nurses' experiences with maternal guilt in Turkey
(Wiley, 2021) Karakaya, Pınar Öke; Sönmez, Seda; Aşık, Elif
Aim: This study aims to describe nurses' views on what it is like to be a working mother in Turkey. Background: Most mothers are in the workforce but continue to fulfil their traditional roles at home. This emerges as an important factor causing mothers to try to find a balance between work and home. Method: For this purpose, a semi-structured form was used in face-to-face interviews conducted with 17 participants. A phenomenological design was preferred in this qualitative study. Results: The findings obtained from the study revealed the six themes of `the sense of inadequacy/helplessness, the sense of responsibility, the strong desire to have a positive effect, gender role stereotypes, the choice between achieving a successful career and being a good mother, but with a sense of depletion'. Conclusion: The results obtained from the study of nurses in Turkey have shed light on how policies should be developed to eliminate work-life barriers in realizing the roles of motherhood. Implications for Nursing Management: The study results will guide nurse managers in taking the steps needed to incorporate arrangements that will result in balanced conduct of work and home for nurses.
The cost of one unit blood transfusion components and cost-effectiveness analysis results of transfusion improvement program
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2021) İndelen, Cenk; Kizmaz, Yecim Uygun; Kar, Ahmet; Shander, Aryeh; Kirali, Kaan
Background: This study aims to analyze the cost of the entire transfusion process in Turkey including evaluation of the cost of transfusion from the perspective of hospital management and determination of savings achieved with the transfusion improvement program. Methods: Invoices, labor, material costs were calculated with micro-costing method, while general production expenses were calculated with gross costing method between January 2018 and December 2019. Unit costs for each blood product were calculated separately by collecting unit acquisition costs, material costs, labor costs, and general production expenses and, then, distributed into six different blood products as follows: erythrocyte suspension, fresh frozen plasma, pooled platelet, apheresis platelet, cryoprecipitate, fresh whole blood. The total costs for 2018 and 2019 were calculated and the savings achieved were estimated. The Turkish Lira was converted into the United States Dollar ($) currency using the purchasing power parity. Results: In 2018/2019, the blood component transfusion cost was $240.90/251.18 for erythrocyte suspension, $120.00/128.67 for fresh frozen plasma, $313.50/322.19 for pooled platelet, $314.24/325.73 for apheresis platelet, $104.95/113.99 for cryoprecipitate, and $189.91/209.09 for fresh whole blood. The total transfusion cost was $6,224,208.33 in 2108 and $5,308,148.43 in 2019. As a result of the transfusion improvement program launched in 2019, the amount of blood components decreased by 23.24%, compared to the previous year, and a saving of $916,059.9 was achieved. Conclusion: The transfusion is a burden for both the hospital management systems and the country's economy. To accurately calculate and manage this economic burden is important for sustainable healthcare services.
Trust in the Healthcare System and Social Coronavirus Anxiety; A Study in the Turkish Society
(Dokuz Eylul Univ Inst Health Sciences, 2022) Saygılı, Meltem; Tekin, Rukiye Numanoğlu
Purpose: The aim of this research is to determine the level of trust in the healthcare system and coronavirus anxiety of the Turkish society during the COVID-19 pandemic. Methods: To obtain the data; Multidimensional Trust in Health-Care Systems Scale (MTHCSS) and Coronavirus Anxiety Scale (CAS) were used. The research was carried out with 1185 people living in Turkey between August and September 2020, using an online questionnaire. Two-Sample Independent TTest, One-Way Analysis of Variance (ANOVA) and correlation analysis were used in the analysis of the data. Results: It was determined that the mean scale scores of the participants the MTHCSS was high (59.06 +/- 13.76) and the mean score of the CAS was (1.86 +/- 3.30) low. Analyses carried out; showed that there are significant statistical differences between gender, presence of chronic disease, working status and compliance with the measures taken, trust in the healthcare system and coronavirus anxiety (p< 0.05). In Addition, the correlation analysis performed showed that there is a weak negative relationship between trust in the healthcare system and social coronavirus anxiety. Conclusion: The results showed that the Turkish society trusts their healthcare system. This makes think that the struggle given under the pandemic conditions is well managed by the Turkish healthcare system.
Assessment of cost-effectiveness of surgical clipping and endovascular coil methods in the treatment of unruptured cerebral aneurysms
(Dokuz Eylul Univ Inst Health Sciences, 2022) Kar, Ahmet; Şahin, İsmet; Şahin, Bayram
Purpose: The study aims to assess the cost-effectiveness of endovascular coiling and surgical clipping in the treatment of unruptured cerebral aneurysms. Material and methods: Patients with ICD 10 167.1 and treated with one of the two treatment methods performed at the Hacettepe University Hospitals between January 2013 and December 2015 were included in the study. The cost data in the study were obtained by analyzing patient invoices through the automation program of the university hospital. The effectiveness and treatment costs were assessed using the Markov model with the Social Security Institution's (SSI) perspective. To generate the cost input in the model, the lifetime costs obtained based on the expert's opinions were added to the amounts received from patient invoices. Results: The study results were presented as the incremental cost-effectiveness ratio (ICER). When 3% reduction rate was applied to the costs and effectiveness data, the Quality Adjusted Life Years (QALY) was calculated as 4.39 and 1.84 for the coiling and clipping methods, respectively. Lifetime costs were 66463.40$ and 7900.27$ for the coiling and clipping methods, respectively. The incremental cost-effectiveness rate of endovascular coiling method was 22965.93. Conclusion: The endovascular coiling method was found to be cost-effective because the ICER score of the process is below the threshold.
E-profesyonelizm Kavramı ve Sağlık Alanına Yansımaları
(2020) Öke, Pınar; Yılmaz, Necla
Etik kurallara uymak ve profesyonel davranmak her meslek için önemlidir. Bu sebeple her meslek kendine özgü etik kodlar ve profesyonel davranış kalıpları geliştirmiştir. Bu davranış kalıpları sayesinde kişilerin mesleki sınırlarını daha iyi bildiği ve oluşturulan standartlar sayesinde bu sınırlara uyum sağlamada zorlanmadığı söylenebilir. Dijital çağ olarak nitelenen günümüzde ise yeni etik sorunlar doğmuştur. Sağlık alanı, bu gibi sorunların en çok yaşandığı alanlardan biridir. Bu çalışmada dijitalleşme, çevrimiçi ortamlar, etik ilkeler ve etik ihlaller perspektifinden e-profesyonelizm kavramının sağlık alanına yansımalarını değerlendirmek, ayrıca sağlık sektörüne ilişkin İnternet’teki haberlerin e-profesyonelizm ile ilgili yönlerini ele almak hedeflenmiştir. Bu doğrultuda konu ile ilgili literatür taranmış, e-profesyonelizm ile ilişkilendirilebilecek etik ihlallere dair haberler derlenmiş ve yorumlanmıştır. E-profesyonelizm kavramının sağlık alanına yönelik önemine vurgu yapmak ve ilgili literatüre katkıda bulunmak amaçlanmıştır.
Emergency department visits following discharge: Implications for healthcare management
(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2020) Kaya, Sidika; Guven, Gulay Sain; Teles, Mesut; Aydan, Seda; Kar, Ahmet; Bahcecioglu, A. Begum; Senturk, Esra Firat
Objective: This study aimed to reveal the frequency of emergency department (ED) visits within 7 and 30 days after discharge and to identify the factors affecting these ED visits. Methods: A total of 1570 patients discharged from the internal medicine wards of a university hospital in Turkey within 1 year were included in this prospective cohort study. Multiple logistic regression analyses were used to identify the factors affecting ED visits. Results: Of the patients, 1.3% visited the ED within the first 7 days after discharge and 5.2% within 30 days. Multivariable analyses showed that the probability of an ED visit within 30 days was 1.83 (95% CI 1.09-3.08; p = 0.023) times higher for male patients and 2.15 (95% CI 1.00-4.60; p = 0.049) times higher for patients with intensive care unit (ICU) stay before discharge. The probability of an ED visit increased by 1.25 (95% CI 1.11-1.42, p < 0.001) times for every 1-point increase in the comorbidity score. The costs of ED visits within 0-7 days were lower than the costs within 8-30 days (p = 0.001). Conclusion: Innovative approaches targeting discharge planning and postdischarge care for patients with high comorbidity scores and ICU use during index hospitalization could reduce ED visits within 30 days after discharge.
Quality of Work Life and Burnout in Healthcare Workers in Turkey
(SAGE PUBLICATIONS INDIA PVT LTD, 2020) Saygılı, Meltem; Avcı, Keziban; Sönmez, Seda
Quality of work life (QWL) is important to healthcare organisations that aim to increase patient and employee satisfaction and produce quality healthcare services. The literature lacks research investigating the relationship between QWL and burnout among in healthcare professionals. The purpose of this study is to determine healthcare workers' QWL and burnout levels and to investigate whether there is a correlation them. The research population consisted of all healthcare workers serving in a public hospital in Ankara. The study did not make a sample selection but tried to access the entire population; a total of 328 usable surveys were obtained. 'Quality of Work Life Scale' and 'Maslach Burnout Inventory' scales were used for this research. A correlation analysis was performed to determine the correlation between healthcare workers' QWL and burnout levels. The analysis results showed that healthcare workers had 'good' perceived QWL and 'moderate' level of burnout. Additionally, there was a statistically significant but weak correlation between healthcare workers' levels of QWL and burnout (rho = 0.184; p = 0.0008). Results can be used by healthcare managers to implement appropriate initiatives to improve QWL and reduce burnout of healthcare workers.
The Effect of COVID-19 Pandemic on the Turkish Society
(MODESTUM LTD, 2020) Bostan, Sedat; Erdem, Ramazan; Ozturk, Yunus Emre; Kilic, Taskin; Yilmaz, Ali
Pandemics leave significant marks on the memories of societies with their permanent impacts. Going beyond a cause of disease or death, they can have consequences in many aspects, psychological, social and economic ones being in the first place. The Covid-19 outbreak, which first emerged in China and has spread to the whole world as of the first months of 2020, has the potential to constitute a breaking the course of history, as well. Turkey is located on the transit point between Asia and Europe with its geographical position, and thus, received its share from the outbreak of Covid-19, which spreads through social contact. The first official case was recorded on 11 March 2020, and then the virus spread rapidly. This study aims to assess the attitude of the public towards Covid19 at times when the impact of the disease reached maximum. To this end, data were collected from 1586 people with different socio-demographic features through Covid-19 Pandemic Community Scale. The impact of the pandemic on the society was measured in three dimensions as Sensitivity to Pandemic, Protection against Pandemic and Social Trust. The research results showed that the people had high levels of sensitivity to the pandemic, exerted the maximum effort for protection and social trust was above the average although it fell behind the other dimensions. As a consequence, it can be concluded that Covid-19 has had a significant impact on the Turkish people.
The impact of work alienation on organizational health: A field study in health sector
(Routledge Journals, Taylor & Francis Ltd, 2019) Ozer, Ozlem; Ugurluoglu, Ozgur; Saygili, Meltem; Songur, Cuma
This study aims to examine the impact of work alienation on organizational health. The implementation of the research is conducted on the nurses and physicians working in a public hospital and the data collected from 388 people are evaluated. As a result of the analyses carried out, work alienation's subdimensions and correlations with organizational health are moderate in the negative direction and the subdimensions of perception of work alienation explain the 21.5% of total variance on organizational health. When the test results of regression coefficient significance in the regression model are analyzed, increasing levels of powerlessness and self-estrangement of the participants decrease the perception of organizational health statistics. Order of relative importance predictor variables on the organizational health level is such as powerlessness, self-estrangement, and meaninglessness.
An evaluation of the cost-effectiveness of the different palliative care models available to cancer patients in Turkey
(Wiley, 2019) Saygili, Meltem; Celik, Yusuf
Background Three different models are commonly used to provide palliative care services to cancer patients in Turkey: comprehensive palliative care center (CPCC), hospital inpatient services (HIS) and home healthcare (HHC). Objectives The purpose of this study was to evaluate the cost-effectiveness of three alternative palliative care models for cancer patients. Methods The study included a total of 160 patients diagnosed with cancer (CPCC:60, HIS:59, HHC:41). The patients' quality of life and their levels of satisfaction were used as the indicators of effectiveness, while direct and indirect costs incurred by service providers, patients and relatives were considered in estimating the costs of alternative models. The cost and effectiveness of the alternatives compared the "patient perspective" and "societal perspective" separately. Results From a societal perspective, palliative care services provided the HIS model was found to be more cost-effective than the CPCC model. From a patient perspective, HHC was found to be more cost-effective compared to the other two models. Conclusions This study has the potential to provide substantial evidence to health managers and decision-makers with respect to health planning and the formulation of social security policies in Turkey.
Determining Breast Cancer Treatment Costs Using the Top Down Cost Approach
(Aves, 2019) Tekin, Rukiye Numanoglu; Saygili, Meltem
Objective: Breast cancer is the most common type of cancer among women in Turkey, with approximately 15.000 breast cancer diagnoses each year. In this study, our goal was to determine annual direct medical costs of all breast cancer patients in Turkey with top down cost approach. Materials and Methods: Data regarding patients who have been diagnosed with breast cancer and received health services from any hospital in Turkey in 2014 were used for the purpose of the study. Data were obtained from the MEDULA System for a total of 126.664 patient. Treatment of costs of patients were calculated based on types of patient admissions (inpatient/outpatient/intensive care) and costs of drugs and medical equipment. Indirect costs and out of pocket costs were not included. Results: Total medical costs of 126,664 patients was calculated as $116.792.107,9, with an average treatment cost per patient of $922,1. Based on types of patient admission, intensive care treatment had the highest average cost with $2.916.5. In metastatic breast cancer patients, average annual treatment cost per patient is $2.326,6, which is 2.8 times higher compared to non-metastatic breast cancer patients. Conclusion: In order to ensure effective resource allocation at micro and macro level, healthcare administrators have to learn costs of diseases with high incidence such as breast cancer. Results obtained from studies on disease costs calculated using the top down cost approach provide data on actual health services use and therefore are seen as important tools for healthcare administrators in terms of effective resource allocation.
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, Huseyin
Purpose 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.
An Evaluation Of Abuse And Neglect In Elderly With The Hwalek-Sengstock Elder Abuse Screening Test
(Gunes Kitabevi Ltd Sti, 2018) Sahin, Hande; Erkal, Sibel
Introduction: The participants in this study, which was conducted to evaluate abuse and neglect in the elderly using the Hwalek-Sengstock Elder Abuse Screening Test, comprised older adults aged 65 and over, residing in Etimesgut, Ankara. Materials and Method: The study employed the Hwalek-Sengstock Elder Abuse Screening Test as the data collection instrument. In addition to standard deviation and arithmetic mean, the t-test was used for data comparisons between two groups, and analysis of variance was conducted when analyzing more than two groups. Results: The abuse and neglect status of the participants displayed significant differences with respect to educational attainment, monthly income, number of children, other household members, ownership of residence, and social security (p < 0.05). Conclusion: The elderly experience serious health problems because of physical, psychological, sexual, and economic violence and neglect.
Parent expectations towards participation to extracurricular sport activity of high school students
(Kharkiv State Acad Design & Arts, 2018) Yilmaz, A.
Purpose: Extracurricular activities are the activities that are carried out inside and outside of the school after the class depending upon a plan and program, and that contain the traits designed for the various purposes. This activities are important for adolescents in terms of discovery the skills, interests and strengths, and creating a chance to get to know themselves. Besides, the activities provide to strengthen the relationships with persons in school, and to build up academic success and moral life factors. This study aims to determine the expectations of parents from the extracurricular sportive activities. Material: In research, interwoven single case study design, one of the qualitative research approaches, was used. Easy accessible sample was benefited for the selection of study group. Parents of 14 students studying in different high schools in the city center of Kirikkale in 2014-2015 academic years were included in the research. Data were obtained from the semi-structured interview form and applied a content analysis. Results: As a result of the obtained findings, it was figured out that expectations of parents from the extracurricular sportive activities are generally the contributions of activities on children to spend a quality leisure time. 5 categories were obtained as a result of analysis. These categories are "being a healthy individual", "keeping away from the harmful habits", "socializing", "keeping away from the bad circle of friends", "providing skill development" and "providing being an intellectual individual". Conclusions: As a result, parental opinions revealed that extracurricular sportive activities are important in terms of children spending a quality leisure time. Parents' expectations from these activities are also in this direction.
Patients' readiness for discharge: Predictors and effects on unplanned readmissions, emergency department visits and death
(Wiley, 2018) Kaya, Sidika; Guven, Gulay Sain; Aydan, Seda; Kar, Ahmet; Teles, Mesut; Yildiz, Ahmet; Toka, Onur
AimTo determine the variables that affect patients' perceptions about their readiness for discharge and to elucidate the effects of these perceptions on patient outcomes such as unplanned readmission to the hospital, emergency department visits and death within 30days after discharge. BackgroundIn recent years, it has become even more important to assess patients' readiness for discharge as patients tend to be discharged more quickly. MethodsFor the determination of patients' self-assessment, the Readiness for Hospital Discharge Scale/Short Form was utilized. This 1-year prospective cohort study included 1,601 patients. Data were analysed using a chi-square test, Mann-Whitney U test, univariate logistic regression analysis and multiple logistic regression analysis. ResultsThe results of multiple logistic regression analysis revealed that age, sex, marital status, educational status, presence of someone to help at home after discharge and length of stay were predictors of patients' readiness for hospital discharge. Furthermore, being unready for discharge increased the risk of 30day unplanned readmission and 30day death. ConclusionsConsidering these predictors, patients' perceptions of readiness for discharge must be assessed before deciding to discharge them. Implications for Nursing ManagementNurse managers can consider the predictors of patients' readiness for discharge, thus the risk of unplanned readmission and death may be reduced.
Determining the level and cost of sickness presenteeism among hospital staff in Turkey
(Taylor & Francis Ltd, 2017) Aysun, Kandemir; Bayram, Sahin
Objective. This study aimed to determine the associations between sickness presenteeism and socio-demographic factors, perceived health status and health complaints among hospital staff and to calculate the cost burdens and productivity losses attributed to presenteeism. Methods. A cross-sectional study was conducted using 951 hospital staff, including physicians, nurses, midwives, other health personnel and administrative staff working in two hospitals located in Kirikkale province in Turkey. The health and work performance questionnaire developed by Kessler et al. was revised to measure sickness presenteeism. Results. After performing Student's t test and a one-way analysis of variance, presenteeism was mostly observed in women, nurse-midwives, young employees, university health staff and health workers with low health status. Average productivity loss and cost of lost productivity per staff member were calculated as 19.92 h/TRY 315.57 for 2 weeks and 478.08 h/TRY 7573.68 for 1 year. Conclusions. The problem of sickness presenteeism is mostly observed in women and nurses. It causes both financial burdens and productivity losses for hospitals. These survey results are thus expected to provide critically important information on presenteeism for decision-makers and healthcare managers.
Effect of Organizational justice on Work Engagement in Healthcare Sector of Turkey
(Sage Publications India Pvt Ltd, 2017) Ozer, Ozlem; Ugurluoglu, Ozgur; Saygili, Meltem
Work engagement is a concept that reflects a positive way of thinking that relates to commitment and involvement to one's organization, his/her enthusiasm and energy. In relevant literature there is a wide range of studies focusing on the relation between work engagement and a set of variables. Thus this study was executed to analyze the effect of organizational justice on work engagement. Implementation stage of the research was conducted on healthcare personnel working in a state hospital in Turkey and data were collected from 414 healthcare employees. Conducted analyses revealed that the correlations between subdimensions of organizational justice and work engagement were positive and in medium level. In the regression analysis which was implemented to measure the effect of subdimensions of organizational justice on work engagement it was identified that subdimensions of organizational justice perception in tandem explained 33 per cent of total variance. It can thus be claimed that climbing organizational justice perception increases in turn in a statistically significant way the work engagement level of the personnel. As regards work engagement, the most significant effect was created by procedural justice subsequently followed by distributive and interactional justice.
Evaluation of intensive care performance in hospitals
(Derman Medical Publ, 2017) Saygılı, Meltem; Özkan, Şirin; Kar, Ahmet; Özer, Özlem
Aim: The purpose of this study is to evaluate and compare the performances of intensive care units in public hospitals located in Kocaeli province (its central district and other districts). Material and Method: To this end, the intensive care data of nine hospitals from the year 2016 were evaluated through grey relational analysis method. Results: At end of the analysis, Hospital A was found to have the intensive care with the highest grey relational degree (0.77): the lowest intensive care mortality rate, the biggest number of; patient dependent on each ventilator, days with a patient dependent on each ventilator, days with a patient hospitalized per intensive care bed, patients discharged per intensive care bed, patients discharged from intensive care per nurse, and the highest occupancy rate. Discussion: It was revealed that grey analysis method applied in the present study can be used for comparing the intensive care units of different hospitals as well.

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