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OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ

Year 2021, Volume: 24 Issue: 1, 127 - 138, 24.03.2021

Seda Aydan Cengiz Arıkan

Abstract

Bir hastanın hastaneye başvurması ile taburculuğu arasında geçen süre olarak ifade edilebilecek olan “hastanede yatış süresi” pek çok çalışmada kalite, performans ve verimlilik ile ilgili önemli bir sonuç ölçüsü olarak değerlendirilmektedir. Yatış süresinin kısa olması; hastanın kısa sürede etkin şekilde tedavi edilmiş olmasından kaynaklanabilir ve bu kalite göstergesi olarak kullanılabilir. Ancak hasta çeşitli nedenlerle gereken yeterli tedaviyi almadan çıkmış olabilir ve bunu değerlendirmek her zaman mümkün olmamaktadır. Hastanın yeterli tedaviyi almadan çıkması, sağlık çalışanı ve yatak sayısının yetersiz olması gibi kaynaklarla ilişkili ya da doğrudan sağlık statüsüne bağlı olarak da gelişmiş olabilir. Bu doğrultuda çalışmada, OECD ülkelerinde, yatak sayısı, sağlık çalışanı sayısı (doktor ve hemşire sayısı) ve bireylerin algıladıkları sağlık statüsünün (kötü sağlık statüsüne sahip olma oranı) yatış süresi üzerindeki etkisini incelemek amaçlanmıştır. Çalışma kapsamında seçilmiş OECD ülkelerinin 2005-2017 yıllarına ait yıllık verileri kullanılarak panel modeller tahmin edilmiştir. Spesifikasyon testleri neticesinde belirlenen en uygun model olan sabit etkiler modeline göre; seçilmiş OECD ülkelerinde ortalama hastane yatış süresi 5,55’tir. Yatış süresi üzerinde 1.000 kişiye düşen yatak sayısı ve algılanan sağlık statüsü pozitif, 1000 kişiye düşen sağlık hizmeti çalışanı sayısı ise negatif etki yaratmaktadır. Yatış süresini sadece verilen sağlık hizmetinin kalitesi belirlememektedir ve bazen kısa bazen ise uzun yatış süresi kaliteli hizmet sunumunun göstergesi olabilir. Bu nedenle, yatış süresi bir kalite göstergesi olarak kullanılırken; yatak sayısı, sağlık çalışanı sayısı gibi kaynaklara ilişkin ve doğrudan sağlık statüsüne ilişkin pek çok faktörle birlikte değerlendirilmelidir.

Keywords

Hastane Yatış Süresi Kalite Göstergesi Hastane Yatak Sayısı Algılanan Sağlık Statüsü Panel Veri

References

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  • Bayın, G. (2016). Determination of factors affecting life expectancy at birth and at age 65. Türk Aile Hekimliği Dergisi,, 20(3), 93-103.
  • Brasel, K. J., Lim, H. J., Nirula, R., & Wigelt, J. A. (2007). Length of stay an appropriate quality measure? Archives of Surgery, 142(5), 461-466.
  • Bucheli, B., & Martina, B. (2004). Reduced length of stay in medical emergency department patients: A prospective controlled study on emergency physician staffing. European Journal of Emergency Medicine, 11(1), 29-34.
  • Cram, P. (2019). Hospital length of stay … a measure of what, exactly? Medical Care, 57(10), 751-752.
  • Culakova, E., Poniewierski, M. S., Crawford, J., Dale, D. C., & Lyman, G. H. (2014). Impact of comorbidities on length of stay and mortality in hospitalized patients with cancer and febrile neutropenia. Blood, 124(21), 2601.
  • Çınaroğlu, S. (2016). Relationships between effectiveness and outcome indicators in health: An application of path model. Hacettepe Sağlık İdaresi Dergisi, 19(4), 397-411.
  • Deniz, S., Çeldir Emre, J., Baysak, A., & Özdemir, Ö. (2015). KOAH alevlenme tanısıyla yatırılan ekonomik yükü ve maliyete etki eden faktörler. SDÜ Tıp Fakültesi Dergisi, 22(4), 126-130.
  • Englert, J., Davis, K. M., & Koch, K. E. (2001). Using clinical practice analysis to improve care. The Joint Commission journal on Quality Improvement, 27(6), 291-301.
  • Garg, S. K., Campbell, J. P., Anugwom, C., Wadhwa, V., Singh, R., Gupta, N., & Sanaka, M. R. (2018). Incidence and predictors of readmissions in acute pancreatitis: a nationwide analysis. Pancreas, 47(1), 46-54.
  • Gorman, J., Vellinga, A., Gilmartin, J. J., & O’Keeffe, S. T. (2010). Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals. Irish journal of medical science, 179(2), 255-258.
  • Guru, V., Anderson, G. M., Fremes, S. E., O'Connor, G. T., Grover, F. L., & Tu, J. V. (2005). Canadian CABG surgery quality indicator consensus panel. The identification and development of Canadian coronary artery bypass graft surgery quality indicators. The Journal of Thoracic and Cardiovascular Surgery, 130(5), 1257.
  • Heggested, T. (2002). Do hospital length of stay and staffing ratio affect elderly patients’ risk of readmission? A Nation-wide Study of Norwegian Hospitals. Health Services Research, 37(3), 647-665.
  • Hong, J., Leeb, W. K., Kimb, M. K., Leec, B. E., Shind, S. D., & Park, H. (2013). Effect of comorbidity on length of hospital stay and in-hospital mortality among unintentionally injured patients. Accident Analysis and Prevention, 52, 44-50.
  • Jimenez, R., Lopez, L., Dominguez, D., & Farinas, H. (1999). Difference between observed and predicted length of stay as an indicator of inpatient care inefficiency. International Journal for Quality in Healthcare, 2(5), 375-384.
  • Kaya, S., Sain Guven, G., Aydan, S., Kar, A., Teleş, M., Yıldız, A., ... & Toka, O. (2018). Patients’ readiness for discharge: Predictors and effects on unplanned readmissions, emergency department visits and death. Journal of Nursing Management, 26(6), 707-716.
  • Kossovsky, M. P., Perneger, T. V., Sarasin, F. P., Bolla, F., Borst, F., & Gaspoz, J. M. (1999). Comparison between planned and unplanned readmissions to a department of internal medicine. Journal of Clinical Epidemiology, 52(2), 151-156.
  • Krantz, M. J., Tanner, J., Horwich, T. B., Yancy, C., Albert, N. M., Hernandez, A., Dai, D., & Fonarow, G. C. (2008). Influence of hospital length of stay for heart failure on quality of care. The American Journal of Cardiology, 102, 1693-1697.
  • Lingsma, H. F., Bottle, A., Middleton, S., Kievit, J., Steyerberg, E. W., & Marang-Van De Mheen, P. J. (2018). Evaluation of hospital outcomes: The relation between length-of-stay, readmission, and mortality in a large international administrative database. BMC Health Services Research, 18(1), 1-10.
  • Moisoglou, I., Galanis, P., Meimeti, E., Dreliozi, A., Kolovos, P., & Prezerakos, P. (2019). Nursing staff and patients’ length of stay. International Journal of Health Care Quality Assurance, 32(6), 1004-1012. Mozes, B. (1989). Unnecessary hospitalization days. Israel Journal of Medical Sciences, 25(7), 360-361.
  • Numanoğlu Tekin, R., Yılmaz, F., İlter, H. K., & Malhan, S. (2016). Determination of factors affecting length of stay with multinomial logistic regression in Turkey. Sosyal Güvence Dergisi, 5(10), 74-94.
  • O’Keefe, G. E., Jurkovich, G. J., & Maier, R. V. (1999). Defining excess resource utilization and identifying associated factors for trauma victims. Journal of Trauma and Acute Care Surgery, 46(3), 473-478.
  • OECD Data (2020, March 10). Health. https://data.oecd.org/health.htm
  • OECD Stat (2020, March 10). Perceived health status. https://stats.oecd.org/index.aspx?queryid=58315 OECD/World Health Organization. (2012). Health at a glance: Asia/Pacific 2012, OECD Publishing.
  • Rapoport, J., Teres, D., Zhao, Y., & Lemeshow, S. (2003). Length of stay data as a guide to hospital economic performance for ICU patients. Medical Care, 41(3), 386.
  • Rushton, J., Evans, I., Carr, S., Mathews, C., Morgan, W., Dean, S., Chisambara, C., Mustfa, N., Stone, H., & Hussain, I. (2016). Impact of disease severity and comorbidities on length of stay (LOS) in COPD. European Respiratory Journal, 48, PA4157.
  • Selker, H. P., Beshanky, J. R., Pauker, S. G., & Kassirer, J. P. (1989). The epidemiology of delays in a teaching hospital. Medical Care, 27(2), 112-129.
  • Shah, R, Haydek, C., Mulki, R., & Qayed, E. (2018). Incidence and predictors of 30-day readmissions in patients hospitalized with chronic pancreatitis: A nationwide analysis. Pancreatology, 18(4), 386-393.
  • Shu, C. C., Lin, Y. F., Hsu, N. C., & Ko, W. J. (2012). Risk factors for 30‐day readmission in general medical patients admitted from the emergency department: A single centre study. Internal Medicine Journal, 42(6), 677-682.
  • Svendsen, M. L., Ehlers, L. H., Andersen, G., & Johnsen, S. P. (2009). Quality of care and length of hospital stay among patients with stroke. Medical Care, 47(5), 575-582.
  • Tatoğlu, F. Y. (2018). Panel veri ekonometrisi stata uygulamalı. İstanbul: Beta Basım Yayım.
  • Thomas, J. W., Guire, K. E., & Horvat, G. G. (1997). Is patient length of stay related to quality of care. Hospital Health Service Administration, 42(4), 489-507.
  • Todai, M. (2016). Nurses' role in reducing length of stay at the hospitals. Hospital Case Management. https://www.hospitalcasemanagement.net/en/?p=840
  • Weiss, M. E., Piacentine, L. B., Lokken, L., Ancona, J., Archer, J., Gresser, S., & Vega‐Stromberg, T. (2007). Perceived readiness for hospital discharge in adult medical‐surgical patients. Clinical Nurse Specialist, 21(1), 31–42.
  • Yiğit, V., Ağırbaş, İ. (2004). Effect of capacity use ratio on costs in hospitals: An application in the Ministry of Health Tokat Maternity and Child Care Hospital. Hacettepe Sağlık İdaresi Dergisi, 7(2), 141-162.

Year 2021, Volume: 24 Issue: 1, 127 - 138, 24.03.2021

Seda Aydan Cengiz Arıkan

Abstract

References

  • American College of Surgeons Committee on Trauma (1999). Resources for optimal care of the injured patient. Chicago: American College of Surgeons.
  • Bayın, G. (2016). Determination of factors affecting life expectancy at birth and at age 65. Türk Aile Hekimliği Dergisi,, 20(3), 93-103.
  • Brasel, K. J., Lim, H. J., Nirula, R., & Wigelt, J. A. (2007). Length of stay an appropriate quality measure? Archives of Surgery, 142(5), 461-466.
  • Bucheli, B., & Martina, B. (2004). Reduced length of stay in medical emergency department patients: A prospective controlled study on emergency physician staffing. European Journal of Emergency Medicine, 11(1), 29-34.
  • Cram, P. (2019). Hospital length of stay … a measure of what, exactly? Medical Care, 57(10), 751-752.
  • Culakova, E., Poniewierski, M. S., Crawford, J., Dale, D. C., & Lyman, G. H. (2014). Impact of comorbidities on length of stay and mortality in hospitalized patients with cancer and febrile neutropenia. Blood, 124(21), 2601.
  • Çınaroğlu, S. (2016). Relationships between effectiveness and outcome indicators in health: An application of path model. Hacettepe Sağlık İdaresi Dergisi, 19(4), 397-411.
  • Deniz, S., Çeldir Emre, J., Baysak, A., & Özdemir, Ö. (2015). KOAH alevlenme tanısıyla yatırılan ekonomik yükü ve maliyete etki eden faktörler. SDÜ Tıp Fakültesi Dergisi, 22(4), 126-130.
  • Englert, J., Davis, K. M., & Koch, K. E. (2001). Using clinical practice analysis to improve care. The Joint Commission journal on Quality Improvement, 27(6), 291-301.
  • Garg, S. K., Campbell, J. P., Anugwom, C., Wadhwa, V., Singh, R., Gupta, N., & Sanaka, M. R. (2018). Incidence and predictors of readmissions in acute pancreatitis: a nationwide analysis. Pancreas, 47(1), 46-54.
  • Gorman, J., Vellinga, A., Gilmartin, J. J., & O’Keeffe, S. T. (2010). Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals. Irish journal of medical science, 179(2), 255-258.
  • Guru, V., Anderson, G. M., Fremes, S. E., O'Connor, G. T., Grover, F. L., & Tu, J. V. (2005). Canadian CABG surgery quality indicator consensus panel. The identification and development of Canadian coronary artery bypass graft surgery quality indicators. The Journal of Thoracic and Cardiovascular Surgery, 130(5), 1257.
  • Heggested, T. (2002). Do hospital length of stay and staffing ratio affect elderly patients’ risk of readmission? A Nation-wide Study of Norwegian Hospitals. Health Services Research, 37(3), 647-665.
  • Hong, J., Leeb, W. K., Kimb, M. K., Leec, B. E., Shind, S. D., & Park, H. (2013). Effect of comorbidity on length of hospital stay and in-hospital mortality among unintentionally injured patients. Accident Analysis and Prevention, 52, 44-50.
  • Jimenez, R., Lopez, L., Dominguez, D., & Farinas, H. (1999). Difference between observed and predicted length of stay as an indicator of inpatient care inefficiency. International Journal for Quality in Healthcare, 2(5), 375-384.
  • Kaya, S., Sain Guven, G., Aydan, S., Kar, A., Teleş, M., Yıldız, A., ... & Toka, O. (2018). Patients’ readiness for discharge: Predictors and effects on unplanned readmissions, emergency department visits and death. Journal of Nursing Management, 26(6), 707-716.
  • Kossovsky, M. P., Perneger, T. V., Sarasin, F. P., Bolla, F., Borst, F., & Gaspoz, J. M. (1999). Comparison between planned and unplanned readmissions to a department of internal medicine. Journal of Clinical Epidemiology, 52(2), 151-156.
  • Krantz, M. J., Tanner, J., Horwich, T. B., Yancy, C., Albert, N. M., Hernandez, A., Dai, D., & Fonarow, G. C. (2008). Influence of hospital length of stay for heart failure on quality of care. The American Journal of Cardiology, 102, 1693-1697.
  • Lingsma, H. F., Bottle, A., Middleton, S., Kievit, J., Steyerberg, E. W., & Marang-Van De Mheen, P. J. (2018). Evaluation of hospital outcomes: The relation between length-of-stay, readmission, and mortality in a large international administrative database. BMC Health Services Research, 18(1), 1-10.
  • Moisoglou, I., Galanis, P., Meimeti, E., Dreliozi, A., Kolovos, P., & Prezerakos, P. (2019). Nursing staff and patients’ length of stay. International Journal of Health Care Quality Assurance, 32(6), 1004-1012. Mozes, B. (1989). Unnecessary hospitalization days. Israel Journal of Medical Sciences, 25(7), 360-361.
  • Numanoğlu Tekin, R., Yılmaz, F., İlter, H. K., & Malhan, S. (2016). Determination of factors affecting length of stay with multinomial logistic regression in Turkey. Sosyal Güvence Dergisi, 5(10), 74-94.
  • O’Keefe, G. E., Jurkovich, G. J., & Maier, R. V. (1999). Defining excess resource utilization and identifying associated factors for trauma victims. Journal of Trauma and Acute Care Surgery, 46(3), 473-478.
  • OECD Data (2020, March 10). Health. https://data.oecd.org/health.htm
  • OECD Stat (2020, March 10). Perceived health status. https://stats.oecd.org/index.aspx?queryid=58315 OECD/World Health Organization. (2012). Health at a glance: Asia/Pacific 2012, OECD Publishing.
  • Rapoport, J., Teres, D., Zhao, Y., & Lemeshow, S. (2003). Length of stay data as a guide to hospital economic performance for ICU patients. Medical Care, 41(3), 386.
  • Rushton, J., Evans, I., Carr, S., Mathews, C., Morgan, W., Dean, S., Chisambara, C., Mustfa, N., Stone, H., & Hussain, I. (2016). Impact of disease severity and comorbidities on length of stay (LOS) in COPD. European Respiratory Journal, 48, PA4157.
  • Selker, H. P., Beshanky, J. R., Pauker, S. G., & Kassirer, J. P. (1989). The epidemiology of delays in a teaching hospital. Medical Care, 27(2), 112-129.
  • Shah, R, Haydek, C., Mulki, R., & Qayed, E. (2018). Incidence and predictors of 30-day readmissions in patients hospitalized with chronic pancreatitis: A nationwide analysis. Pancreatology, 18(4), 386-393.
  • Shu, C. C., Lin, Y. F., Hsu, N. C., & Ko, W. J. (2012). Risk factors for 30‐day readmission in general medical patients admitted from the emergency department: A single centre study. Internal Medicine Journal, 42(6), 677-682.
  • Svendsen, M. L., Ehlers, L. H., Andersen, G., & Johnsen, S. P. (2009). Quality of care and length of hospital stay among patients with stroke. Medical Care, 47(5), 575-582.
  • Tatoğlu, F. Y. (2018). Panel veri ekonometrisi stata uygulamalı. İstanbul: Beta Basım Yayım.
  • Thomas, J. W., Guire, K. E., & Horvat, G. G. (1997). Is patient length of stay related to quality of care. Hospital Health Service Administration, 42(4), 489-507.
  • Todai, M. (2016). Nurses' role in reducing length of stay at the hospitals. Hospital Case Management. https://www.hospitalcasemanagement.net/en/?p=840
  • Weiss, M. E., Piacentine, L. B., Lokken, L., Ancona, J., Archer, J., Gresser, S., & Vega‐Stromberg, T. (2007). Perceived readiness for hospital discharge in adult medical‐surgical patients. Clinical Nurse Specialist, 21(1), 31–42.
  • Yiğit, V., Ağırbaş, İ. (2004). Effect of capacity use ratio on costs in hospitals: An application in the Ministry of Health Tokat Maternity and Child Care Hospital. Hacettepe Sağlık İdaresi Dergisi, 7(2), 141-162.
There are 35 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Makaleler
Authors

Seda Aydan This is me 0000-0003-1221-6768

Cengiz Arıkan 0000-0001-8926-5707

Publication Date March 24, 2021
Published in Issue Year 2021 Volume: 24 Issue: 1

Cite

APA Aydan, S., & Arıkan, C. (2021). OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ. Hacettepe Sağlık İdaresi Dergisi, 24(1), 127-138.
AMA Aydan S, Arıkan C. OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ. HSİD. March 2021;24(1):127-138.
Chicago Aydan, Seda, and Cengiz Arıkan. “OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ”. Hacettepe Sağlık İdaresi Dergisi 24, no. 1 (March 2021): 127-38.
EndNote Aydan S, Arıkan C (March 1, 2021) OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ. Hacettepe Sağlık İdaresi Dergisi 24 1 127–138.
IEEE S. Aydan and C. Arıkan, “OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ”, HSİD, vol. 24, no. 1, pp. 127–138, 2021.
ISNAD Aydan, Seda - Arıkan, Cengiz. “OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ”. Hacettepe Sağlık İdaresi Dergisi 24/1 (March 2021), 127-138.
JAMA Aydan S, Arıkan C. OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ. HSİD. 2021;24:127–138.
MLA Aydan, Seda and Cengiz Arıkan. “OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ”. Hacettepe Sağlık İdaresi Dergisi, vol. 24, no. 1, 2021, pp. 127-38.
Vancouver Aydan S, Arıkan C. OECD ÜLKELERİNDE HASTANE YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN İNCELENMESİ. HSİD. 2021;24(1):127-38.
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