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Sağlık Bakanlığı Genel Hastaneleri ve Sağlık Bakanlığına Devredilen SSK Genel Hastanelerinin Teknik Verimliliklerinin Karşılaştırmalı Analizi

Comparative Technical Efficiency Analysis of the Ministry of Health General Hospitals and the Former SSK General Hospitals Transferred to the MoH

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Abstract (2. Language): 
The objective of this study was to estimate the relative technical efficiency of SSK Hospitals and the Ministry of Health General Hospitals following the transfer taken place within the context of Health Transformation Program using the Data Envelopment Analysis (DEA) technique. Data were from the 2006 Statistical Yearbook on Inpatient Health Care Institutions and the MoH Department Performance and Quality. The efficiency model was composed of three outputs (the number of outpatient visits, inpatients and the number of operations) and five inputs (the numbers of staffed beds, FTE staff of physicians, nurses, and other employees, and operating expenses). According to the DEA results which are descriptive in nature, the CRS and VRS models found 12% and 23% of hospitals in 2006 technically efficient, respectively. The average efficiency of formerly SSK-owned hospitals was found to be lower (0.82) than that of the MoH General Hospitals (0.83). Potential contribution of the variables studied here to technical inefficiency was found to be staffed beds by 14%, physicians by 11.8%, nurses by 16.8%, other personnel by 16.8%, operating expenses by 13%, operations by 18.9%, inpatients by 6.8%, and outpatient visits by 1.5%. As a result, the findings suggest variation in efficiency across MoH general hospitals and provide useful insights on where to start improving efficiency.
Abstract (Original Language): 
Bu çalışmanın amacı, Veri Zarflama Analizi tekniğini (VZA) kullanarak Sağlıkta Dönüşüm Programı bağlamında Sağlık Bakanlığına (SB) devredilen SSK hastanelerinin ve SB genel hastanelerinin teknik verimliliklerini değerlendirmektir. Araştırmanın veri kaynağı 2006 Yılı Yataklı Tedavi Kurumları İstatistik Yıllığı ve Sağlık Bakanlığı Performans ve Kalite Daire Başkanlığıdır. Araştırmaya toplam 48’i eski SSK hastanesi dâhil olmak üzere 50 yatak ve üzeri toplam 352 SB genel hastanesi alınmıştır. Teknik verimlilik ölçüm modeli üç çıktıdan (ayakta hasta, yatan hasta ve ameliyat sayısı) ve beş girdiden (fiili yatak, hekim, hemşire ve diğer personel sayısı ile hizmet üretim giderleri) oluşmuştur. Tanımlayıcı analiz niteliğindeki ölçeğe sabit getiri modeli VZA sonuçlarına göre, 2006 yılında SB genel hastanelerinin %12’si, ölçeğe değişken getiri modeli sonuçlarına göre ise %23’ü verimli bulunmuştur. Eski SSK hastanelerinin ortalama verimlilik (0,82) düzeyi, SB genel hastanelerin ortalama verimlilik (0,83) düzeyinden biraz daha düşüktür. Gözlem kümesindeki değişkenlerin toplam verimsizlik artışına potansiyel katkısı; fiili yatak %14, doktor %11,8, hemşire %16,8, diğer personel %16,8, hizmet üretim giderleri %13, ameliyat %18,9, yatan hasta %6,8 ve ayakta hasta %1,5 kadardır. Sonuç olarak, bu araştırmanın bulguları, SB genel hastaneleri arasında teknik verimlilik bakımından farklılık olduğuna işaret etmektedir ve hastanelerin verimliliği geliştirmelerinde ne yapabilecekleri konusunda ışık tutmaktadır.
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