Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Kamu Hastaneleri Birliği Yapılanmasının Değiştirilmesinde Hasta Görüşlerinin Etkisi Var mı?
Does the Patient's Opinion Have Any Effect on the Change of Public Hospital Association's Structure?
Sedat BOSTANa, Gökhan AĞAÇa
aSağlık Yönetimi Bölümü, Gümüşhane Üniversitesi, Sağlık Bilimleri Fakültesi, Gümüşhane, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2019;27(1):1-10
doi: 10.5336/mdethic.2018-60590
Article Language: TR
Full Text
ÖZET
 Bu çalışma, Kamu Hastaneleri Birliği (KHB) yönetim tarzı ve uygulamalarının sağlık hizmeti sunum paydaşları tarafından nasıl değerlendirildiği ve hastane çıktılarına nasıl yansıdığını araştıran bir projenin parçasıdır. Çalışmanın yayına hazırlanma sürecinde sağlık politika yapıcıları, mevcut KHB sistemini 694 sayılı kanun hükmünde kararname ile Ağustos 2017 tarihinde önemli ölçüde değiştirmiş ve KHB yapılanmasını tamamen ortadan kaldırmıştır. Yeni yapısal değişiklikle çalışmanın amacı, KHB hakkında hasta görüşlerini saptayarak, hastalar açısından sistem değişikliğini gerektiren bir durumun olup olmadığının anlaşılması olarak geliştirilmiştir. Nicel araştırma olan bu çalışmada, verilerin toplanmasında dörtlü likert anket tekniği kullanılmıştır. Çalışmaya katılan hastalardan 210'undan geçerli geri dönüşüm sağlanmıştır. İstatistikî hesaplamalar için IBM SPSS Statistics 21 paket programı kullanılmıştır. Ölçeğin güvenirlik analizi için Cronbach's alfa katsayısına bakılmış ve bu değerin 0,87 olduğu görülmüştür. Ölçeğin yapı geçerliliğini sağlamak için faktör analizi yapılmış ve yapısal geçerliliği saptanmıştır. Araştırma neticesinde, KHB yapılanmasının hastanelerdeki uygulamalarının, hastalara olumlu yansıdığı ve kamuoyu görüşlerinin olumlu olduğu söylenebilmektedir. Uygulamalardan hastaların kazançlı çıktığı, hastanın öneminin arttığı ve bekleme sürelerinin azaldığı ifade edilmiştir. Buna karşın, hastaların çok kısa sürede muayene edildiği konusu hasta bakım kalitesine yönelik soruna işaret etmesi açısından önemlidir. Genel olarak bu sonuçlar, KHB sisteminin temel yaklaşımı olan özerk ve profesyonel tedavi hizmetleri yönetimi anlayışının, hasta görüşleri açısından değiştirilmesini gerektirecek bir durumun söz konusu olmadığına işaret etmektedir.

Anahtar Kelimeler: Sağlık sistemleri; Kamu Hastane Birliği (KHB); hasta; hasta görüşleri; sağlık hizmeti sunumu
ABSTRACT
 This study is part of a project that investigates how the management style and practices of Public Hospitals Association (PHA) is assessed by healthcare delivery stakeholders and reflected in hospital outcomes. During the preparation of the study, health policy makers changed the existing PHA system with Decree Law no. 694 in August 2017 and completely removed PHA structure. In the emerging case, the purpose of the study was to identify patients' opinions about PHA, and to understand whether there is a condition that requires system change in terms of patients. In this quantitative study, a four-point Likert-type survey was used to collect data. Valid recycling was provided from 210 patients participating in the study. IBM SPSS Statistics 21 package program is used for statistical calculations. For the reliability analysis of the scale, Cronbach?s alpha coefficient was found to be 0.87. Factor analysis was performed to determine the structural validity of the scale and its structural validity was determined. As a result of the research, it can be said that the practices of PHA in hospitals are positive and the opinions of the public are positive. It has been stated that the patients benefited, the increase in importance of the patients, and the waiting times have decreased from the practice. On the other hand, the issue that patients are treated in a very short period of time is important in terms of pointing out the problem of quality of care. In general, these conclusions do not indicate that there is a need to change the management approach of autonomous and professional treatment services, which is the basic approach of the PHA system, in terms of patient views.

Keywords: Health systems; Public Hospital Association (PHA); patient; patient opinions; health service delivery
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