Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
COVID-19 Pandemisinin Hastanelerin Vaka Karma İndeksine Etkisinin Değerlendirilmesi: Tanımlayıcı Bir Araştırma
Evaluation of the Impact of the COVID-19 Pandemic on the Case Mixed Index of Hospitals: A Descriptive Study
Emine ÇETİN ASLANa, Mustafa ORHANa
aİzmir Bakırçay Üniversitesi Sağlık Bilimleri Fakültesi, Sağlık Yönetimi Bölümü, İzmir, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(3):888-98
doi: 10.5336/healthsci.2021-87432
Article Language: TR
Full Text
ÖZET
 Amaç: Araştırmanın amacı, koronavirüs hastalığı 2019 [coronavirus disease 2019 (COVID-19)] pandemisi döneminde, sağlık kurumlarının sunmuş oldukları sağlık hizmet üretim hacminin değişip değişmediğini araştırmaktır. Ayrıca COVID-19 hastalarının vaka karma indeksinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışma, retrospektif, kesitsel ve tanımlayıcı bir araştırmadır. Araştırma, Sağlık Bakanlığına bağlı bir B grubu hastanede yapılmış olup, veriler 2019 ve 2020 yıllarını kapsamaktadır. Sağlık hizmeti üretimindeki değişim tedavi edilen hasta sayısı, üretilen toplam teşhis ilişkili gruplar bağıl değeri ve vaka karma indeksi ile ölçülmüştür. Vaka karma indeksi, belli bir dönemdeki toplam bağıl değerlerin aynı dönemdeki toplam hasta sayısına bölünmesiyle hesaplanmıştır. Bulgular: Hastanede, 2019 yılında 15.944, ve 2020 yılında, 1.343'ü COVID-19 olmak üzere, toplam 10.697 hasta tedavi görmüştür. Dolayısıyla hasta başvurularında yaklaşık 1/3'lük bir azalış gerçekleşmiştir. Pandemi döneminde hastanede bakılan hasta sayısı ve üretilen toplam bağıl değer düşmüş, buna karşın vaka karma indeksi yükselmiştir. Hastanenin vaka karma indeksi 2019 yılında 0,90, 2020 yılında 0,97 ve COVID-19 hastalarında 0,99 bulunmuştur. COVID-19 hastalarının vaka karma indeksi dönemlere göre farklılık göstermiştir. Sonuç: Pandemi süreci hastanede üretilen sağlık hizmeti miktarının azalmasına neden olmuştur. Ancak vaka karma indeksi artmıştır. Vaka karma indeksindeki artışta, COVID-19 hastalarının teşhis ilişkili gruplar bağıl değerlerinin pandemi öncesi dönemde bakılan hastalarının bağıl değerlerinden yüksek olmasının yanında, düşük bağıl değerli vaka başvurularındaki azalışın ortak etkisinden kaynaklandığı sonucuna varılmıştır.

Anahtar Kelimeler: COVID-19; pandemi; teşhis ilişkili gruplar; vaka karma indeksi
ABSTRACT
 Objective: The aim of the research is to investigate whether the volume of health care production offered by health institutions has changed during the coronavirus disease 2019 [coronavirus disease 2019 (COVID-19)] pandemic. In addition, it was aimed to determine the case mix index of COVID-19 patients. Material and Methods: The study is a retrospective, cross-sectional and descriptive study. The research was conducted in a group B hospital affiliated to the Ministry of Health, and the data cover the years 2019 and 2020. Change in healthcare production was measured by the number of patients treated, the relative value of total diagnosis-related groups produced, and the case mix index. The case mix index was calculated by dividing the total relative values in a given period by the total number of patients in the same period. Results: 15,944 patients were treated at the hospital in 2019, and a total of 10,697 patients in 2020 were treated, of which 1,343 were COVID-19. Therefore, there has been a decrease of approximately 1/3 in patient admissions. During the pandemic period, the number of patients cared for in the hospital and the total relative value produced decreased, but the case mix index increased. The hospital's case mix index was 0.90 in 2019, 0.97 in 2020, and 0.99 for COVID-19 patients. The case mix index of COVID-19 patients differed according to the periods. Conclusion: The pandemic process has led to a decrease in the amount of healthcare services produced in the hospital. However, the case mix index increased. It has been concluded that the increase in the case mix index is due to the common effect of the decrease in case admissions with low relative values, as well as the relative values of the diagnosisrelated groups of COVID-19 patients being higher than the relative values of the patients cared for in the pre-pandemic period.

Keywords: COVID-19; pandemic; diagnosis-related groups; case mix index
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