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A Conceptual Investigation On The Internal Migration, Health Care Utilization and Health Status

Year 2020, Issue: 1, 1 - 7, 01.03.2020

Abstract

This study aims to examine the effect of internal migration on health care utilization and health status conceptually. Accessible academic publications, which examine the relationship between internal migration, health care utilization and health status in the world and Turkey, are included in the study. The studies on this subject in Turkey appear to be more conceptual and it is observed that empirical studies do not reflect the current situation. It can be said that there is a need for studies that reveal the effect of internal migration on health care utilization and health status with current data and macroscale

References

  • Ginsburg C, Bocquier P, Béguy D, Afolabi S, Augusto O, Derra K, et al. Healthy or Unhealthy Migrants? Identifying Internal Migration Effects on Mortality in Africa Using Health and Demographic Surveillance Systems of the INDEPTH Network. Soc Sci Med 2016;164:59–73. [CrossRef]
  • Hu X, Cook S, Salazar MA. Internal Migration and Health in China. Lancet 2008;372:1717–9. [CrossRef]
  • Bell M, Charles‐Edwards E, Ueffing P, Stillwell J, Kupiszewski M, Kupiszewska D. Internal Migration and Development: Comparing Migration Intensities Around the World. Population and Development Review 2015 41:33–58. [CrossRef]
  • Türkiye İstatistik Kurumu Göç İstatistikleri 2018. http://www.tuik. gov. tr/VeriBilgi.do?alt_id=1067
  • Bartram D, Poros MV, Monforte P. Göç Meselesinde Temel Kavramlar. (Ağabeyoğlu Tuncay I, Çev.) Ankara: Hece Yayınları; 2017.
  • Three. In: Barer ML, Stoddart GL, McGrail KM, McLeod CB, editors.
  • An Undisciplined Economist: Robert G. Evans on Health Economics
  • Health Care Policy, and Population Health. Canada: McGill-Queen’s Press-MQUP; 2016.
  • Portes A, Kyle D, Eaton, WW. Mental Illness and Help-Seeking Behavior among Mariel Cuban and Haitian Refugees in South Florida. J Health Soc Behav 1992;33:283–98. [CrossRef]
  • Andersen R, Newman JF. Societal and Individual Determinants of Medical Care Utilization in the United States. Milbank Q 2005;83:1– 28. [CrossRef]
  • Leclere FB, Jensen L, Biddlecom AE. Health Care Utilization, Family Context, and Adaptation among Immigrants to the United States. J Health Soc Behav 1994;35:370–84. [CrossRef]
  • Solorio MR, Milburn NG, Andersen RM, Trifskin S, Rodríguez MA. Emotional Distress and Mental Health Service Use among Urban Homeless Adolescents. J Behav Health Serv Res 2006;33:381–93. [CrossRef]
  • Gelberg L, Andersen RM, Leake BD. The Behavioral Model for Vulnerable Populations: Application to Medical Care Use and Outcomes for Homeless People. Health Serv Res 2000;34:1273–302. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1089079/pdf/ hsresearch00023-0019.pdf
  • Dünya Sağlık Örgütü (WHO). Health Service Delivery 2010. http:// www.who.int/healthinfo/systems/WHO_MBHSS_2010_section1_ web.pdf
  • Curtis JR, Patrick DL. The Assessment of Health Status among Patients with COPD. Eur Resp J 2003;21:36s–45s. [CrossRef]
  • Sengupta K. Determinants of health status in India. India: Springer; 2016. [CrossRef]
  • Kavuncubaşı Ş, Yıldırım S. Hastane ve Sağlık Kurumları Yönetimi. Ankara: Siyasal Kitabevi; 2012.
  • Blum HL. Planning For Health: Development and Application of Social Change Theory. New York: Human Sciences Press; 1974.
  • Vlahov D, Freudenberg N, Proietti F, Ompad D, Quinn A, Nandi V, Galea S. Urban as a Determinant of Health. J Urban Health 2007;84:16–26. [CrossRef]
  • Marmot MG, Wilkinson RG. Sağlığın Sosyal Belirleyicileri. Kayı İ, Yasin Y, Çev. İstanbul: İnsev Yayınları; 2009.
  • Carballo M, Mboup M. International Migration and Health; 2005. https://www.iom.int/jahia/webdav/site/myjahiasite/shared/shared/ mainsite/policy_and_research/gcim/tp/TP13.pdf
  • Green MA, Subramanian SV, Vickers D, Dorling D. Internal Migration, Area Effects and Health: Does Where You Move to Impact upon Your Health? Soc Sci Med 2015;136:27–34. [CrossRef]
  • Zhou JF, Mantell JE, Ru XM. Reproductive and Sexual Health of Chinese Migrants. J Reprod Contracept 2009;20:169–82. [CrossRef]
  • Babu BV, Swain BK, Mishra S, Kar SK. Primary Healthcare Services among a Migrant Indigenous Population Living in an Eastern Indian City. J Immigr Minor Health 2010;12:53–9. [CrossRef]
  • Wang H, Zhang D, Hou Z, Yan F, Hou Z. Association Between Social Health Insurance and Choice of Hospitals among Internal Migrants in China: A National Cross-Sectional Study. BMJ Open 2018;8:e018440. [CrossRef]
  • Sengupta P, Benjamin AI, Babu BV. Status of Maternal and Child Health Services Amongst Migrants in Ludhiana Slums - How Far from the MDG Targets? Int J Commun Med Pub Health 2017;4:1188– 94. [CrossRef]
  • Zhang J, Lin S, Liang D, Qian Y, Zhang D, Hou Z. Public Health Services Utilization and its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey. Int J Environ Res Pub Health 2017;14:1002. [CrossRef]
  • Gu H, You H, Ning W, Zhou H, Wang J, Lu Y, et al. Internal Migration and Maternal Health Service Utilisation in Jiangsu, China. Tropic Med Int Health 2017;22:124–32. [CrossRef]
  • Taşçı-Duran E. Göç Eden Gebe Kadınların Planlı Davranış Kuramına Göre Doğum Öncesi Bakım Almaya Yönelik Niyet Ve Tutumlarını Etkileyen Etmenler. Hacettepe Üniversitesi Hemşirelik Fakültesi Derg 2016;3:1–15. https://dergipark.org.tr/tr/download/ article-file/225594
  • Liang Y. Guo M. Utilization of Health Services and Health-Related Quality of Life Research of Rural-to-Urban Migrants in China: A Cross- Sectional Analysis. Soc Indicat Res 2015;120:277–95. [CrossRef]
  • Le AT, Vu LH, Schelling E. Utilization of Health Care Services among Internal Migrants in Hanoi and its Correlation with Health Insurance: A Cross-Sectional Study. Tap Chi Y Te Cong Cong 2015;3:44–56. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228634/
  • Kusuma YS, Kumari R, Kaushal S. Migration and Access to Maternal Healthcare: Determinants of Adequate Antenatal Care and Institutional Delivery among Socio‐Economically Disadvantaged Migrants in Delhi, India. Tropic Med Int Health 2013;18:1202–10. [CrossRef]
  • Mou J, Griffiths SM, Fong H, Dawes MG. Health of China’s Rural- Urban Migrants and Their Families: A Review of Literature from 2000 to 2012. Br Med Bull 2013;106:19–43. [CrossRef]
  • Aksu H, Sevil Ü. Göç ve Kadın Sağlığı. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Derg 2010;2:133–8.
  • Deniz O, Etlan E. Kırdan Kente Göç ve Göçmenlerin Uyum Süreci Üzerine Bir Çalışma: Van Örneği. Uluslararası İnsan Bilimleri Derg 2009;6:472–98.
  • Hesketh T, Jun YX, Lu L, Mei WH. Health Status and Access to Health Care of Migrant Workers in China. Pub Health Rep 2008;123:189–97. [CrossRef]
  • Subaiya L. Internal migration and use of reproductive and child health services in Peru 2007. https://dhsprogram.com/pubs/pdf/ wp38/wp38.pdf
  • Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Türkiye Göç ve Yerinden Olmuş Nüfus Araştırması 2006. http://www.hips. hacettepe.edu.tr/TGYONA-AnaRapor.pdf
  • Topçu S, Beşer A. Göç ve Sağlık. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Derg 2006;10(3):37–42. http://eskidergi.cumhuriyet. edu.tr/makale/1479.pdf
  • Tezcan S, Eryurt MA. Türkiye’de İç Göç ve Çocuk sağlığı. Nüfusbilim Derg 2006;28-29:15–28. http://www.hips.hacettepe.edu.tr/nbd_ cilt28_29/tezcan-eryurt.pdf
  • Stephenson R, Matthews Z. Maternal Health-Care Service Use among Rural-Urban Migrants in Mumbai, India. Asia-Pacific Populat J 2004;19:39–60. [CrossRef]
  • Nauman E, Van Landingham M, Anglewicz P, Patthavanit U, Punpuing S. Rural-to-Urban Migration and Changes in Health among Young Adults in Thailand. Demography 2015;52:233–57. [CrossRef]
  • Song Y, Sun W. Health Consequences of Rural‐to‐Urban Migration: Evidence from Panel Data in China. Health Econ 2016;25:1252–67. [CrossRef]
  • Gerritsen A, Bocquier P, White M, Mbacke C, Alam N, Beguy D, et al. Health and Demographic Surveillance Systems: Contributing to an Understanding of the Dynamics in Migration and Health. Glob Health Action 2013;6:1–6. [CrossRef]
  • Dodd W, Humphries S, Patel K, Majowicz S, Little M, Dewey C. Determinants of Internal Migrant Health and the Healthy Migrant Effect in South India: A Mixed Methods Study. BMC Int Health Hum Rights 2017;17:1–12. [CrossRef]
  • Arabacı Z, Hasgül E, Serpen A. Türkiye’de Kadın Göçmenlik ve Göçün Kadın Sağlığı Üzerine Etkisi. Sosyal Politika Çalışmaları Derg 2016;16:129–44. [CrossRef]
  • Anil KP, Reshmi Rs, Hemalatha N. Effect of Women’s Migration on Urban Children’s Health in India. International Journal of Migration. Health Soc Care 2016;12:133–45. [CrossRef]
  • Tuzcu A, Bademli K. Göçün Psikososyal Boyutu. Psikiyatride Güncel Yaklaşımlar 2014;6:56–66. [CrossRef]
  • Demir G, Arıöz A. Göç Eden Kadınların Sağlıklı Yaşam Biçimi Davranışları ve Etkileyen Faktörler. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Derg 2014;4:1–8. https://dergipark.org.tr/tr/download/ article-file/56569
  • Faetanini M, Subrahmanian R. For a Better Inclusion of Internal Migrants in India. New Delhi: United Nations Educational, Scientific and Cultural Organization and United Nations Children’s Fund; (2012). 22 p. Policy Briefs. https://unesdoc.unesco.org/ark:/48223/ pf0000219173
  • Eryurt MA, Koç İ. Internal Migration and Fertility in Turkey: Kaplan- Meier Survival Analysis. Int J Populat Res 2012;2012:1–11. [CrossRef]
  • Chen J. Internal Migration and Health: Re-Examining the Healthy Migrant Phenomenon in China. Soc Sci Med 2011;72:1294–301. [CrossRef]
  • Şirin A, Kavlak O, Şen E, Yağcan H. The Effects of Internal Migration on Women’s Health in Turkey. J Hum Sci 2011;8:1019–27. https://www.j- humansciences.com/ojs/index.php/IJHS/article/view/1061/695
  • Shaokang Z, Zhenwei S, Blas E. Economic Transition and Maternal Health Care for Internal Migrants in Shanghai, China. Health Policy Plan 2002;17:47–55. [CrossRef]

Yozgat Bozok Üniversitesi, İktisadi ve İdari Bilimler Fakültesi, Sağlık Yönetimi, Yozgat, Türkiye

Year 2020, Issue: 1, 1 - 7, 01.03.2020

Abstract

Bu çalışmanın amacı iç göçün sağlık hizmetleri kullanımı ve sağlık statüsüne etkisinin kavramsal olarak incelenmesidir. Çalışmada dünyada ve Türkiye’de iç göç, sağlık hizmetleri kullanımı ve sağlık statüsü ilişkisini inceleyen ve erişimi sağlanabilen akademik yayınlara yer verilmiştir. Türkiye’de bu konuda yapılan çalışmaların daha çok kavramsal olduğu, ampirik çalışmaların mevcut durumu yansıtmadığı görülmektedir. İç göçün sağlık hizmetleri kullanımı ve sağlık statüsü üzerindeki etkisini güncel verilerle ve makro ölçekte ortaya koyan çalışmalara ihtiyaç duyulduğu söylenebilir

References

  • Ginsburg C, Bocquier P, Béguy D, Afolabi S, Augusto O, Derra K, et al. Healthy or Unhealthy Migrants? Identifying Internal Migration Effects on Mortality in Africa Using Health and Demographic Surveillance Systems of the INDEPTH Network. Soc Sci Med 2016;164:59–73. [CrossRef]
  • Hu X, Cook S, Salazar MA. Internal Migration and Health in China. Lancet 2008;372:1717–9. [CrossRef]
  • Bell M, Charles‐Edwards E, Ueffing P, Stillwell J, Kupiszewski M, Kupiszewska D. Internal Migration and Development: Comparing Migration Intensities Around the World. Population and Development Review 2015 41:33–58. [CrossRef]
  • Türkiye İstatistik Kurumu Göç İstatistikleri 2018. http://www.tuik. gov. tr/VeriBilgi.do?alt_id=1067
  • Bartram D, Poros MV, Monforte P. Göç Meselesinde Temel Kavramlar. (Ağabeyoğlu Tuncay I, Çev.) Ankara: Hece Yayınları; 2017.
  • Three. In: Barer ML, Stoddart GL, McGrail KM, McLeod CB, editors.
  • An Undisciplined Economist: Robert G. Evans on Health Economics
  • Health Care Policy, and Population Health. Canada: McGill-Queen’s Press-MQUP; 2016.
  • Portes A, Kyle D, Eaton, WW. Mental Illness and Help-Seeking Behavior among Mariel Cuban and Haitian Refugees in South Florida. J Health Soc Behav 1992;33:283–98. [CrossRef]
  • Andersen R, Newman JF. Societal and Individual Determinants of Medical Care Utilization in the United States. Milbank Q 2005;83:1– 28. [CrossRef]
  • Leclere FB, Jensen L, Biddlecom AE. Health Care Utilization, Family Context, and Adaptation among Immigrants to the United States. J Health Soc Behav 1994;35:370–84. [CrossRef]
  • Solorio MR, Milburn NG, Andersen RM, Trifskin S, Rodríguez MA. Emotional Distress and Mental Health Service Use among Urban Homeless Adolescents. J Behav Health Serv Res 2006;33:381–93. [CrossRef]
  • Gelberg L, Andersen RM, Leake BD. The Behavioral Model for Vulnerable Populations: Application to Medical Care Use and Outcomes for Homeless People. Health Serv Res 2000;34:1273–302. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1089079/pdf/ hsresearch00023-0019.pdf
  • Dünya Sağlık Örgütü (WHO). Health Service Delivery 2010. http:// www.who.int/healthinfo/systems/WHO_MBHSS_2010_section1_ web.pdf
  • Curtis JR, Patrick DL. The Assessment of Health Status among Patients with COPD. Eur Resp J 2003;21:36s–45s. [CrossRef]
  • Sengupta K. Determinants of health status in India. India: Springer; 2016. [CrossRef]
  • Kavuncubaşı Ş, Yıldırım S. Hastane ve Sağlık Kurumları Yönetimi. Ankara: Siyasal Kitabevi; 2012.
  • Blum HL. Planning For Health: Development and Application of Social Change Theory. New York: Human Sciences Press; 1974.
  • Vlahov D, Freudenberg N, Proietti F, Ompad D, Quinn A, Nandi V, Galea S. Urban as a Determinant of Health. J Urban Health 2007;84:16–26. [CrossRef]
  • Marmot MG, Wilkinson RG. Sağlığın Sosyal Belirleyicileri. Kayı İ, Yasin Y, Çev. İstanbul: İnsev Yayınları; 2009.
  • Carballo M, Mboup M. International Migration and Health; 2005. https://www.iom.int/jahia/webdav/site/myjahiasite/shared/shared/ mainsite/policy_and_research/gcim/tp/TP13.pdf
  • Green MA, Subramanian SV, Vickers D, Dorling D. Internal Migration, Area Effects and Health: Does Where You Move to Impact upon Your Health? Soc Sci Med 2015;136:27–34. [CrossRef]
  • Zhou JF, Mantell JE, Ru XM. Reproductive and Sexual Health of Chinese Migrants. J Reprod Contracept 2009;20:169–82. [CrossRef]
  • Babu BV, Swain BK, Mishra S, Kar SK. Primary Healthcare Services among a Migrant Indigenous Population Living in an Eastern Indian City. J Immigr Minor Health 2010;12:53–9. [CrossRef]
  • Wang H, Zhang D, Hou Z, Yan F, Hou Z. Association Between Social Health Insurance and Choice of Hospitals among Internal Migrants in China: A National Cross-Sectional Study. BMJ Open 2018;8:e018440. [CrossRef]
  • Sengupta P, Benjamin AI, Babu BV. Status of Maternal and Child Health Services Amongst Migrants in Ludhiana Slums - How Far from the MDG Targets? Int J Commun Med Pub Health 2017;4:1188– 94. [CrossRef]
  • Zhang J, Lin S, Liang D, Qian Y, Zhang D, Hou Z. Public Health Services Utilization and its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey. Int J Environ Res Pub Health 2017;14:1002. [CrossRef]
  • Gu H, You H, Ning W, Zhou H, Wang J, Lu Y, et al. Internal Migration and Maternal Health Service Utilisation in Jiangsu, China. Tropic Med Int Health 2017;22:124–32. [CrossRef]
  • Taşçı-Duran E. Göç Eden Gebe Kadınların Planlı Davranış Kuramına Göre Doğum Öncesi Bakım Almaya Yönelik Niyet Ve Tutumlarını Etkileyen Etmenler. Hacettepe Üniversitesi Hemşirelik Fakültesi Derg 2016;3:1–15. https://dergipark.org.tr/tr/download/ article-file/225594
  • Liang Y. Guo M. Utilization of Health Services and Health-Related Quality of Life Research of Rural-to-Urban Migrants in China: A Cross- Sectional Analysis. Soc Indicat Res 2015;120:277–95. [CrossRef]
  • Le AT, Vu LH, Schelling E. Utilization of Health Care Services among Internal Migrants in Hanoi and its Correlation with Health Insurance: A Cross-Sectional Study. Tap Chi Y Te Cong Cong 2015;3:44–56. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228634/
  • Kusuma YS, Kumari R, Kaushal S. Migration and Access to Maternal Healthcare: Determinants of Adequate Antenatal Care and Institutional Delivery among Socio‐Economically Disadvantaged Migrants in Delhi, India. Tropic Med Int Health 2013;18:1202–10. [CrossRef]
  • Mou J, Griffiths SM, Fong H, Dawes MG. Health of China’s Rural- Urban Migrants and Their Families: A Review of Literature from 2000 to 2012. Br Med Bull 2013;106:19–43. [CrossRef]
  • Aksu H, Sevil Ü. Göç ve Kadın Sağlığı. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Derg 2010;2:133–8.
  • Deniz O, Etlan E. Kırdan Kente Göç ve Göçmenlerin Uyum Süreci Üzerine Bir Çalışma: Van Örneği. Uluslararası İnsan Bilimleri Derg 2009;6:472–98.
  • Hesketh T, Jun YX, Lu L, Mei WH. Health Status and Access to Health Care of Migrant Workers in China. Pub Health Rep 2008;123:189–97. [CrossRef]
  • Subaiya L. Internal migration and use of reproductive and child health services in Peru 2007. https://dhsprogram.com/pubs/pdf/ wp38/wp38.pdf
  • Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Türkiye Göç ve Yerinden Olmuş Nüfus Araştırması 2006. http://www.hips. hacettepe.edu.tr/TGYONA-AnaRapor.pdf
  • Topçu S, Beşer A. Göç ve Sağlık. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Derg 2006;10(3):37–42. http://eskidergi.cumhuriyet. edu.tr/makale/1479.pdf
  • Tezcan S, Eryurt MA. Türkiye’de İç Göç ve Çocuk sağlığı. Nüfusbilim Derg 2006;28-29:15–28. http://www.hips.hacettepe.edu.tr/nbd_ cilt28_29/tezcan-eryurt.pdf
  • Stephenson R, Matthews Z. Maternal Health-Care Service Use among Rural-Urban Migrants in Mumbai, India. Asia-Pacific Populat J 2004;19:39–60. [CrossRef]
  • Nauman E, Van Landingham M, Anglewicz P, Patthavanit U, Punpuing S. Rural-to-Urban Migration and Changes in Health among Young Adults in Thailand. Demography 2015;52:233–57. [CrossRef]
  • Song Y, Sun W. Health Consequences of Rural‐to‐Urban Migration: Evidence from Panel Data in China. Health Econ 2016;25:1252–67. [CrossRef]
  • Gerritsen A, Bocquier P, White M, Mbacke C, Alam N, Beguy D, et al. Health and Demographic Surveillance Systems: Contributing to an Understanding of the Dynamics in Migration and Health. Glob Health Action 2013;6:1–6. [CrossRef]
  • Dodd W, Humphries S, Patel K, Majowicz S, Little M, Dewey C. Determinants of Internal Migrant Health and the Healthy Migrant Effect in South India: A Mixed Methods Study. BMC Int Health Hum Rights 2017;17:1–12. [CrossRef]
  • Arabacı Z, Hasgül E, Serpen A. Türkiye’de Kadın Göçmenlik ve Göçün Kadın Sağlığı Üzerine Etkisi. Sosyal Politika Çalışmaları Derg 2016;16:129–44. [CrossRef]
  • Anil KP, Reshmi Rs, Hemalatha N. Effect of Women’s Migration on Urban Children’s Health in India. International Journal of Migration. Health Soc Care 2016;12:133–45. [CrossRef]
  • Tuzcu A, Bademli K. Göçün Psikososyal Boyutu. Psikiyatride Güncel Yaklaşımlar 2014;6:56–66. [CrossRef]
  • Demir G, Arıöz A. Göç Eden Kadınların Sağlıklı Yaşam Biçimi Davranışları ve Etkileyen Faktörler. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Derg 2014;4:1–8. https://dergipark.org.tr/tr/download/ article-file/56569
  • Faetanini M, Subrahmanian R. For a Better Inclusion of Internal Migrants in India. New Delhi: United Nations Educational, Scientific and Cultural Organization and United Nations Children’s Fund; (2012). 22 p. Policy Briefs. https://unesdoc.unesco.org/ark:/48223/ pf0000219173
  • Eryurt MA, Koç İ. Internal Migration and Fertility in Turkey: Kaplan- Meier Survival Analysis. Int J Populat Res 2012;2012:1–11. [CrossRef]
  • Chen J. Internal Migration and Health: Re-Examining the Healthy Migrant Phenomenon in China. Soc Sci Med 2011;72:1294–301. [CrossRef]
  • Şirin A, Kavlak O, Şen E, Yağcan H. The Effects of Internal Migration on Women’s Health in Turkey. J Hum Sci 2011;8:1019–27. https://www.j- humansciences.com/ojs/index.php/IJHS/article/view/1061/695
  • Shaokang Z, Zhenwei S, Blas E. Economic Transition and Maternal Health Care for Internal Migrants in Shanghai, China. Health Policy Plan 2002;17:47–55. [CrossRef]
There are 54 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

Gülcan Şantaş

Publication Date March 1, 2020
Published in Issue Year 2020Issue: 1

Cite

EndNote Şantaş G (March 1, 2020) Yozgat Bozok Üniversitesi, İktisadi ve İdari Bilimler Fakültesi, Sağlık Yönetimi, Yozgat, Türkiye. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 1 1–7.