Turkiye Klinikleri Journal of Medical Ethics-Law and History

.: RESEARCH
Kamu Hastane Birlikleri Yapılanması ve Hasta Hakları Kurul Yapısındaki Düzenlemenin Kamu Kararları Üzerine Etkisi
Public Hospital Union Construction and Changing Patient Rights Board Effects on Board Decisions
Sedat BOSTANa
aSağlık Kurumları Yöneticiliği Bölümü AD, Gümüşhane Üniversitesi Sağlık Bilimleri Fakültesi, Gümüşhane
Turkiye Klinikleri J Med Ethics. 2017;25(1):1-10
doi: 10.5336/mdethic.2016-54426
Article Language: TR
ÖZET
Hasta hakları kavramı literatüre 1980'li yıllarda girmiş, 1990 yıllarda gelişerek, bilimsel tartışma ve bildirilere konu olmuş, 2000'li yıllarda ise sağlık işletmelerinde/kurumlarında uygulanmaya başlanarak hukuki bir alt yapı kazanmış, 2010'lu yıllarda kurumsal bir yapı haline dönüşmüştür. Bu çalışmanın amacı, son dönemde gerçekleşen kamu hastane birlik yapılanması ve hasta hakları kurul yapılanmasındaki değişimin hasta hakları kurul kararları üzerine etkisini araştırmaktır. Araştırmada bir ildeki 2012-2015 yılları arasında hasta hakları kurullarının hasta şikayetlerine bağlı olarak aldığı kararlarının içerik analizi yapılmaktadır. Veriler çapraz tablo tekniği ile işlenmiş ve yıllar arasındaki farklılaşma Pearson Chi-Square testi ile izlenmeye çalışılmıştır. Hasta şikayetlerinin nedenleri incelendiğinde, yarısı hizmetten faydalanma hakkı ile ilgili olup, saygı görme, tıbbi özen ve bilgilendirme ile ilgili sorunlar bütün yıllarda ön plana çıkmaktadır. Şikayet edilen personelin yaklaşık yarısını istikrarlı bir şekilde hekimler ve onda birini ise hemşireler oluşturmaktadır. Son yılda diş hekimlerinin şikayet edilmesinde anlamlı bir artış gözlenirken, tıbbi sekreter, temizlikçi, güvenlikçi ve idari personel şikayetlerinde anlamlı bir azalma gözlenmektedir. Elde edilen bulgulara göre; kamu hastane birlik yapılanmasının hastaların yazılı şikayetlerini azaltmış ve yerinde çözüm uygulamalarını güçlendirmiştir. Hasta hakları kurullarının sağlık müdürlükleri bünyesinde birleştirilmesi ve üye yapısının değiştirilmesi de kararların daha profesyonelce ve objektif alınmasına katkı sağlamıştır. Sonuç olarak, sistem ve hastalar tarafından kanıksanmış olan mahremiyet ihlalleri insani değerleri, bilgilendirilme eksikliği tedavi etkinliğini, nöbet usulü çalışma düzeni çalışanlarında tükenmişliği, tıbbi bakımda ise 'özensizliği' tetiklemektedir. Sağlık yöneticileri ve eğitimciler bu sorunlarla yakından ilgilenmelidirler.

Anahtar Kelimeler: Hasta hakları; hasta hakları kurulları; kamu hastane birlikleri; hasta hakları ihlalleri
ABSTRACT
The concept of patient rights, 1980s went into the literature, developed in 1990, and began to be implemented in health institutions in the 2000s. Thus, a legal infrastructure has gained, institutionalized in 2010 years. The purpose of this study is to investigate patient rights violations through the decisions of the patient rights board, taking into account the change in board structure and public hospital union structuring. The survey was conducted on board decisions taken in 2012-2015. The data were processed with cross-table technique and the difference between the years was tried to be monitored by Pearson Chi-square test. Public hospital union structure has reduced written complaints of patients and strengthened on-site solutions. When the causes of patient complaints are examined, half is concerned with the right to benefit from the service, and issues of respect, medical care and information are at the forefront. Approximately half of the complaints are consisted of physicians and one in ten nurses. Significant reductions have been observed in complaints of medical secretaries, cleaners, security personnel and administrative staff when there has been a significant increase in complaints of dentists in the last year. According to findings; the integration of patient rights boards within the health directorates and the change of member structure contributed to making decisions more professionally and objectively. As a result, patient privacy violations that have been acknowledged by the system and the patients, is destroying human values. Lack of patient information reduces treatment effectiveness. Health worker's seizure-prone work are increasing their exhaustion and triggers insecurity in medical care. Health administrators and educators should be very interested in these issues.

Keywords: Patient rights; patient rights boards; public hospital unions; patient violations

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