Turkiye Klinikleri Journal of Biostatistics

.: REVIEW
Unlocking the Potential of National Healthcare Data in Türkiye: A Journey Through Challenges and Opportunities: Traditional Review
Türkiye'nin Ulusal Sağlık Verilerinin Potansiyelini Açığa Çıkarma Yolundaki Zorluklar ve Fırsatlar: Geleneksel Derleme
Mehmet KOÇAKa , Zeynep KÖMBE ELAZABb,c
aİstanbul Medipol University International Faculty of Medicine, Department of Biostatistics and Medical Informatics, İstanbul, Türkiye
bBoğaziçi University Institute of Social Sciences, Masters Program of Psychological Sciences, İstanbul, Türkiye
cBoston University, PhD Program of Psychological and Brain Sciences, Boston, USA
Turkiye Klinikleri J Biostat. 2024;16(2):118-28
doi: 10.5336/biostatic.2024-102184
Article Language: EN
Full Text
ABSTRACT
 In this paper, we share our experience between 2020- 2023 through our TÜBİTAK BIDEB-2232 International Fellowship for Outstanding Researchers (Award No: 118C306) project titled ''Feasibility Assessment and Utility of Combining Streaming National Healthcare Data with Environmental and Food Intake Data to Improve Health Policy and Outcomes''. In our feasibility assessment, national data sources covering health and disease outcomes, behavioral data e.g., smoking and environmental factors (e.g., air quality these primary data dimensions are the minimum of what would be needed to initiate any academic pursuits or health policy development efforts. In this regard, we discuss our experiences with data availability depth, quality, and accessibility, along with providing alternative surrogates necessary. If access to such data is possible, we assess challenges regarding the preparatory steps to bring such data from multiple domains into a form that is clean and analysis-ready. We also discuss the importance of the selection of correct modeling framework when dealing with spatially-structured outcome variables such as province level disease prevalence or behavioral data. We conclude that even though there are present sources of health and environmental data, there are limitations at various stages of data availability, accessibility, integration, and utilization, making analyses that would adequately address important epidemiological research questions for developing relevant public health policies in Türkiye challenging.

Keywords: Turkish national healthcare data; data access; spatial modeling
ÖZET
 Bu makalede, TÜBİTAK BIDEB-2232 Uluslararası Lider Araştırmacılar Programı (Ödül No: 118C306) kapsamında ''Sağlık Politikalarının ve Sağlık Çıktılarının İyileştirilmesinde Ulusal Akışkan Sağlık Verilerini (Streaming Healthcare Data) Çevresel ve Gıda Tüketim Verileri ile Birleştirmenin Fizibilitesinin ve Faydasının Değerlendirilmesi'' başlıklı projemizdeki 2020-2023 yılları arasında gerçekleşen deneyimlerimizi paylaşıyoruz. Fizibilite değerlendirmesinin bir parçası olarak, tanı sıklığı ve mortalite gibi sağlık çıktısı verilerini, özellikle sigara ve alkol tüketimi gibi zararlı alışkanlıkları kapsayan davranışsal verileri ve hava kalitesi, meteoroloji, su kalitesi ve toprak kalitesini temsil eden çevresel belirteçleri de içerecek şekilde çok boyutlu ulusal veri kaynaklarını tartışıyoruz. Bu temel veri alanları, herhangi bir akademik çalışmanın başlatılmasında veya sağlık politikalarının geliştirilmesinde ihtiyaç duyulacak verilerinin en azını temsil etmektedir. Bu bağlamda, bu tür verilerin mevcudiyetini, derinlik ve genişliğini, bu tür verilere erişim varlığını ya da erişimin kısıtlamalarının seviyesini ve veri talep sürecini tartışıyoruz. Gerekli veriler mevcut değilse veya erişimleri son derece kısıtlanmışsa, bu tür verilere alternatif teşkil edebilecek verileri (surrogate markers) değerlendiriyoruz. Bu veri alanlarına erişim mümkünse, bu verilerin birden çok kaynaktan alınmaları, veri temizliği aşamaları, verilerin birleştirilmiş veriler olarak analize hazır hâle getirilmesi sürecinin adımlarıyla ilgili zorlukları tartışıyoruz. Ayrıca il sağlık prevalansı veya davranışsal veriler gibi mekânsal olarak yapılandırılmış çıktı değişkenleriyle çalışıldığında, doğru modelleme çerçevesinin seçiminin önemini de tartışıyoruz. Sonuç olarak, sağlık ve çevresel veri kaynaklarının mevcut olduğunu gözlemliyoruz, ancak Türkiye'de önemli epidemiyolojik araştırma sorularını uygun bir şekilde ele alacak analizler için veri erişilebilirliği, erişilebilirlik, entegrasyon ve kullanım aşamalarında çeşitli kısıtlamalar bulunmaktadır. Bu da ilgili kamu sağlığı politikalarının geliştirilmesini zorlaştırmaktadır.

Anahtar Kelimeler: Türkiye ulusal sağlık verisi; veri erişimi; mekansal modelleme
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30.03.2014

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