Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Birinci Basamak Sağlık Kuruluşları ve Hastaneler Tarafından Sunulan Evde Sağlık Hizmetlerinin Karşılaştırması: Kesitsel Bir Çalışma
Comparison of Home Health Care Services Provided by Primary Health Care Organizations and Hospitals: A Cross-Sectional Study
Yavuz Selim KÜÇÜKa, Bayram ŞAHİNb
aEskişehir İl Sağlık Müdürlüğü, Eskişehir, Türkiye
bHacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi, Sağlık Yönetimi Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(2):508-15
doi: 10.5336/healthsci.2021-83271
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada, 1. basamak sağlık kuruluşlarıyla hastaneler tarafından evde sağlık hizmetleri kapsamında sunulan hizmetlerin miktarını ve giderini karşılaştırmak ve hizmet miktarı ve gideriyle hastaların özellikleri arasında anlamlı bir ilişki olup olmadığını tespit etmek amaçlanmıştır. Gereç ve Yöntemler: Araştırma, Eskişehir ilinde hem 1. basamak sağlık kuruluşlarından hem de hastanelerden evde sağlık hizmeti alan 304 hastanın verilerine dayandırılmıştır. Çalışmada, evde sağlık hizmetleri verilerini karşılaştırmak için t-testi, değişkenler arasındaki ilişkiyi incelemek için ise çok değişkenli regresyon analizi kullanılmıştır. Bulgular: Hastaneler tarafından yapılan ziyaret sayısının (OrtHst=3,64 karşı OrtBB=2,98), işlem sayısının (OrtHst=4,74 karşı OrtBB=3,80), tedavi giderinin (OrtHst=48,49 karşı OrtBB=25,39) ve ziyaret başı tedavi giderinin (OrtHst=13,71 karşı OrtBB=10,14) 1. Basamak sağlık kuruluşlarına göre daha fazla ve istatistiksel olarak anlamlı olduğu görülmüştür (p<0,05). Ayrıca evde sağlık hizmetleriyle ilgili toplam ve ziyaret başı tedavi giderlerinin hastaların yaşı, cinsiyeti ve hastalıklarına göre değiştiği, toplam ziyaret sıklığı ve işlem sayısının ise sadece hastalıklarından etkilendiği bulunmuştur (p<0,05). Sonuç: Hastaneler tarafından sunulan evde sağlık hizmetleri miktarının ve giderlerinin, 1. basamak sağlık kuruluşlarına göre daha fazla olduğu görülmüştür. Bu araştırmaya ait bulguların evde sağlık hizmetlerinin geliştirilmesiyle ilgili karar vericiler için önemli veri ve bilgi sağlayacağı düşünülmektedir.

Anahtar Kelimeler: Evde sağlık hizmetleri; birinci basamak sağlık kuruluşları; hastaneler; ziyaret başı tedavi gideri; ziyaret sayısı
ABSTRACT
 Objective: In this study, it was aimed to compare the amount and expense of services provided by primary health care institutions and hospitals within the scope of home health services and to determine whether there is a significant relationship between the amount and cost of services and the characteristics of the patients. Material and Methods: The research was based on the data of 304 patients who received home health services from both primary health care institutions and hospitals in Eskişehir. In the study, t-test was used to compare home health services data, and multivariate regression analysis was used to examine the relationship between variables. Results: The number of hospital visits (AvgHsptl=3.64 versus AvgPC=2.98), the number of procedures (AvgHsptl=4.74 versus AvgPC=3.80), the treatment expense (AvgHsptl=48.49 versus AvgPC=25.39) and treatment expense per visit (AvgHsptl=13.71 versus AvgPC=10.14) was found to be higher and statistically significant compared to primary health care institutions (p<0.05). In addition, it was found that the total and per-visit treatment expenses related to home healthcare services vary according to the age, gender and diseases of the patients, and the total frequency of visits and the number of procedures were only affected by their diseases (p<0.05). Conclusion: It has been observed that the amount and expenses of home healthcare services provided by hospitals are higher than primary health care institutions. It is thought that the findings of this study will provide important data and information for decision makers regarding the development of home healthcare services.

Keywords: Home healthcare services; primary health care institutions; hospitals; treatment expense per visit; number of visits
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