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    Bayram Sahin

    Purpose: The aim of the study was to examine the effects of socio-demographic characteristics, disease-related characteristics and health care use related-characteristics on the treatment effectiveness of rheumatoid arthritis patients,... more
    Purpose: The aim of the study was to examine the effects of socio-demographic characteristics, disease-related characteristics and health care use related-characteristics on the treatment effectiveness of rheumatoid arthritis patients, both separately and together. Methods: The sample of the study consisted of 440 rheumatoid arthritis patients for 99% confidence level, and this sample was reached based on the convenience sampling method. Patients who received at least one anti-TNF therapy were included in the study. Treatment effectiveness levels of rheumatoid arthritis patients were measured with a questionnaire. In the analysis of the study, four different regression models were established. In the first model, socio-demographic characteristics; in the second model, disease characteristics; in the third model, health care use characteristics: in the fourth model, the effect of all these variables on treatment effectiveness was examined. Results: In the study, smoking status, age (socio-demographic characteristics), drug regimen complexity, comorbidity status, education about the disease, disease duration (disease characteristics), and a number of admissions (health care use characteristics), were found to have a significant effect on treatment effectiveness. Conclusion: In the study, the factors affecting the treatment effectiveness were determined. Therefore, it is important to consider these factors revealed in this study in order to increase the treatment effectiveness in patients with rheumatoid arthritis.
    Background In Türkiye, as in other countries, the maldistribution of the health workforce is a serious concern. Although policymakers have developed various incentive packages, this problem has not been thoroughly addressed yet. Discrete... more
    Background In Türkiye, as in other countries, the maldistribution of the health workforce is a serious concern. Although policymakers have developed various incentive packages, this problem has not been thoroughly addressed yet. Discrete choice experiment (DCE) is a valuable method to provide evidence-based information for these incentive packages to attract healthcare staff for rural jobs. The main aim of this study is to investigate the stated preferences of physicians and nurses when choosing a job region. Methods A labelled DCE was conducted to assess job preferences of physicians and nurses from two hospitals one of which is urban, and the other is in a rural region in Türkiye Job attributes included wage, creche, infrastructure, workload, education opportunity, housing, and career opportunity. Mixed logit model was used to analyse the data. Results The strongest attribute associated with job preferences was region (coefficient − 3.06, [SE 0.18]) for physicians (n = 126) and wa...
    Bu calisma ile, Ankara’da bulunan ozel ve kamu hastanelerinde gorev yapmakta olan hastane yoneticilerinin ve bu hastanelere basvuran poliklinik hastalarinin kurumsal itibar ve imaj algilari arasinda fark olup olmadiginin belirlenmesi ve... more
    Bu calisma ile, Ankara’da bulunan ozel ve kamu hastanelerinde gorev yapmakta olan hastane yoneticilerinin ve bu hastanelere basvuran poliklinik hastalarinin kurumsal itibar ve imaj algilari arasinda fark olup olmadiginin belirlenmesi ve kurumsal itibar ve imaj algilarinin hastane performans gostergeleri ile iliskisinin incelenmesi amaclanmistir. Arastirmada, kurumsal itibar ve imaj algilarinin tespit edilmesi icin Ankara metropolitan alanda bulunan toplam yirmi hastaneye Ocak-Temmuz 2011 tarihleri arasinda basvuran 400 poliklinik hastasi ve bu hastanelerde gorev yapmakta olan 90 hastane ust duzey yoneticisine anket uygulanmistir. Hastane performans gostergelerinin elde edilmesinde ikincil verilerden yararlanilmistir. Arastirmada hastalar ve hastane yoneticilerinin kurumsal itibar ve imaj algilari arasinda farkliliklar oldugu (p<0,05) bulunmus ve kurumsal itibar ve imaj algisi ile personel memnuniyeti arasinda guclu bir iliski oldugu belirlenmistir. Arastirma sonuclari literaturde...
    ... durulacaktır. Bu çerçevede önce, tıbbi uygulamalarda değişkenliğin nasıl oluştuğuna bakmak ve konunun felsefi yönünü ortaya koymak açısından profesyonel belirsizlik ve arzın talep yaratması konuları üzerinde durulacaktır. Bunu ...
    Turkey has accomplished remarkable improvements in terms of health status in the last three decades, particularly after the implementation of the Health Transformation Program (HTP (Saglikta Donus, um Programi)). Average life expectancy... more
    Turkey has accomplished remarkable improvements in terms of health status in the last three decades, particularly after the implementation of the Health Transformation Program (HTP (Saglikta Donus, um Programi)). Average life expectancy reached 71.8 for men and 76.8 for women in 2010. The infant mortality rate (IMR) decreased to 10.1 per 1000 live births in 2010, down from 117.5 in 1980. Despite these achievements, there are still discrepancies in terms of infant mortality between rural and urban areas and different parts of the country, although these have been diminishing over the years. The higher infant mortality rates in rural areas can be attributed to low socioeconomic conditions, low female education levels and the prevalence of infectious diseases. The main causes of death are diseases of the circulatory system followed by malignant neoplasms. Turkeys health care system has been undergoing a far-reaching reform process (HTP) since 2003 and radical changes have occurred both...
    Background: Hospital manager have crucial responsibilities wit h regard to the monitoring of mobbing for the establishment of safe and peaceful work environment , and taking necessary measures accordingly. Objective: The aim of this study... more
    Background: Hospital manager have crucial responsibilities wit h regard to the monitoring of mobbing for the establishment of safe and peaceful work environment , and taking necessary measures accordingly. Objective: The aim of this study is to identify the factors t hat affect the mobbing levels of medical secretarie s, who are the officers that patients meet the first. Methodology: The population of this research is a total number o f 282 employees working as medical secretaries at a university hospital in Ankara, Tur key. The sample size is calculated as 163 people, a nd a random stratified sampling method was performed in the sel ection of samples. Mobbing levels of employees were measured by the Leymann Inventory of Psychological Terrorization (LIPT) scale. Results: According to the logistic regression, the marital st tus and age of medical secretaries were identifi d as statistically significant on the mobbing level (p<0 .05). Hence, the single medical secretaries have th e...
    Kurumsal baglilik calisanlarin bir kuruma karsi hissettigi baglilik derecesini ifade eden bir kavramdir. Bu arastirmada hekimlerin kurumsal baglilik duzeylerini etkileyen faktorlerin belirlenmesi amaclamistir. Arastirma evrenini Samsun... more
    Kurumsal baglilik calisanlarin bir kuruma karsi hissettigi baglilik derecesini ifade eden bir kavramdir. Bu arastirmada hekimlerin kurumsal baglilik duzeylerini etkileyen faktorlerin belirlenmesi amaclamistir. Arastirma evrenini Samsun Sahra Sihhiye Okulu ve Egitim Merkez Komutanliginda yedek subaylik temel egitimi alan hekimler olusturmustur. Veri toplama yontemi olarak anket yontemi kullanlmistir. Toplam 298 anket dagitilmis ve geri donus orani %79 (n=235) olarak gerceklesmistir. Arastirma sonuclarina gore; hekimlerin duygusal baglilik duzeylerinin pratisyen ve uzman hekim olup olmamalarina (t=3,19, p
    This study aimed to reflect the efficiency of hospitals under the Ministry of Health (MoH) before and after the implementation of Public Hospital Associations (PHAs). This study covered 3 years before (2010-2012) and 3 years after... more
    This study aimed to reflect the efficiency of hospitals under the Ministry of Health (MoH) before and after the implementation of Public Hospital Associations (PHAs). This study covered 3 years before (2010-2012) and 3 years after (2013-2015) the implementation. The population of the study included 865 hospitals under the MoH providing health care services in 81 provinces. No sample was selected; all hospitals were included under the scope of study. The provinces were chosen as the decision-making unit. Changes in the efficiency values of hospitals were analyzed with the Malmquist Total Factor Efficiency Index. The results showed that, for the pre-PHAs period, 24 provinces in 2010, 27 provinces from 2010 to 2011, and 32 provinces from 2011 to 2012 were assessed as efficient. From 2012, the year of implementation, to 2013, the number of efficient provinces dropped to 16. However, 20 provinces were subsequently found to be efficient from 2013 to 2014, and 26 from 2014 to 2015. The efficiency scores average of all provinces were found to be 0.89, 0.92, 0.92, 0.82, 0.88, and 0.90, respectively. Further, the efficiency score average of the 3 years before PHAs (0.91 ± 0.09) was significantly higher than the score obtained 3 years after PHAs (0.86 ± 0.11; p < 0.05). In consideration of such finding, the PHAs established at the provinces were identified as hampering increased efficiency.
    Calismada; hekimlerin orgutsel adalet hakkindaki algilarinin sosyo-demografik ozelliklerine gore degiskenlik gosterip gostermedigini incelemek amaclanmistir. Bu calisma, Turkiye’nin degisik bolgelerinde bulunan 39 kamu hastanesinde... more
    Calismada; hekimlerin orgutsel adalet hakkindaki algilarinin sosyo-demografik ozelliklerine gore degiskenlik gosterip gostermedigini incelemek amaclanmistir. Bu calisma, Turkiye’nin degisik bolgelerinde bulunan 39 kamu hastanesinde gorevli toplam 900 hekim uzerinde yapilmistir. Arastirmada veri toplama araci olarak anket yontemi kullanilmistir. Elde edilen verilerin degerlendirilmesinde; varimax rotasyonlu faktor analizi, t testi, tek yonlu varyans analizi ve LSD testi kullanilmistir. Arastirma kapsamindaki hekimlerin; %91.8’inin erkek, %88’inin evli, %39’unun 36-40 yas grubunda, %91’inin uzman tabip oldugu, %92’sinin yonetici gorevi olmadigi gorulmustur. Arastirmaya katilan hekimlerin %86’si kurumlarinin ucretlendirme politikasini adil bulmadigini ifade etmistir. Hekimlerin %71’i kurumlarinin mesleki gelisim ve kariyer imkanlarinin adil olmadigini belirtmislerdir. Hekimlerin %72,2’sinin dagitimsal adalet boyutuna iliskin olumsuz degerlendirmeler yapmislardir. Hekimlerin %63,9’u islemsel adaletle ilgili olumsuz gorusler ifade etmislerdir. Kisiler arasi iliskide adalet boyutu icin hekimlerin %47,8’inin olumlu gorusler ifade ettigi gorulmustur. Bilgisel adalet boyutuna iliskin olarak ise %46,5’inin olumsuz degerlendirmeler yaptiklari belirlenmistir. Hekimlerin orgutsel adalet algilarinin cinsiyet, yas ve gorev turlerine gore farkliliklar gosterdigi, uzmanlik statuleri ve medeni durumlarina gore farklilik gostermedigi bulunmustur.
    Son yillarda tibbi uygulamalardaki hizli degisimlerin de etkisiyle, saglik sektorunde calisanlarin algilarini, isleriyle ilgili tutumlarini ve davranislarini olcmeye yonelik arastirmalarin yapilmasi giderek hiz kazanmaktadir. Bu calisma... more
    Son yillarda tibbi uygulamalardaki hizli degisimlerin de etkisiyle, saglik sektorunde calisanlarin algilarini, isleriyle ilgili tutumlarini ve davranislarini olcmeye yonelik arastirmalarin yapilmasi giderek hiz kazanmaktadir. Bu calisma da, saglik calisanlarinin is tutumlari arasinda yer alan is tatmin duzeylerini etkileyen faktorleri belirlemek amaciyla yapilmistir. Calisma evrenini Adana ilinde faaliyet gosteren bir kamu hastanesi calisanlari olusturmaktadir ve veri toplama yontemi olarak anket kullanilmistir. Hastanede gorev yapanlarin is tatminleri Minnesota Is Tatmini Anketi ile belirlenmeye calisilmistir. Anket toplam 838 saglik calisanina dagitilmis ve geri donus orani %57 (n=477) olarak gerceklesmistir. Is doyumunu etkileyen faktorlerin incelendigi yapisal esitlik modeli sonuclari; saglik calisanlarinin is doyum duzeylerinin orgutsel adalet algilari (t=3.465;p
    ... George's Respiratory Questionnaire (SGRQ) (Jones et al., 1992), the Asthma Quality of Life Questionnaire (AQLQ) (Juniper et al., 1992 ... Likelihood (ML), unweighted least squares, generalised least squares or asymptotic... more
    ... George's Respiratory Questionnaire (SGRQ) (Jones et al., 1992), the Asthma Quality of Life Questionnaire (AQLQ) (Juniper et al., 1992 ... Likelihood (ML), unweighted least squares, generalised least squares or asymptotic distribution free estimators (Joreskog and Sorborn, 1983). ...
    Artan rekabet, degisen piyasa kosullari, gelisen teknoloji, yeni yonetim anlayislari, egitim seviyesinin yukselmesi gibi faktorler, kurumlarin yapilarini iyice karmasiklastirmakta, bunun sonucunda da calisanlar hem kendilerine hem de... more
    Artan rekabet, degisen piyasa kosullari, gelisen teknoloji, yeni yonetim anlayislari, egitim seviyesinin yukselmesi gibi faktorler, kurumlarin yapilarini iyice karmasiklastirmakta, bunun sonucunda da calisanlar hem kendilerine hem de islerine yabancilasmakta, orgute, orgut yoneticilerine ve calisma arkadaslarina olan bagliliklari azalmaktadir. Bu yabancilasma sonucunda, calisanlarin azimsanmayacak bir bolumunun, ilk bir-iki yil icerisinde kurumlarindan ayrildiklari ya da ayrilmasalar bile dusuk performans sergiledikleri, islerini sabote ettikleri hatta saldirgan davranislar icine girdikleri gozlenmektedir. Beklentilerinin karsilanmadigini goren organizasyon yonetimleri de, calisanlar ile ilgili cesitli arayislar icine girerek, orgutsel bagliligi temin etmeye yonelmektedirler. Iste bu noktada; sozlu ve yazili olmayan ancak sozlu ve yazili sozlesmeler uzerinde olumlu ya da olumsuz ciddi etkileri olabilen bir sozlesme turu ortaya cikmaktadir: Psikolojik Sozlesme. Kisi ve icinde bulundugu orgut arasinda sozle ifade edilmeyen, kapali, taraflarin is iliskileri icerisinde birbirlerine vermeyi ve birbirlerinden almayi bekledikleri psikolojik yonu bulunan anlasma olarak tanimlanan psikolojik sozlesme, orgutler icin onemli bir fenomen haline gelmistir.
    Bu calisma hastanede gorev yapan saglik calisanlarinin kisisel ozellikleri ile orgutsel adalet algilarinin orgute baglilik duzeyleri uzerine etkisini belirlemek amaciyla yapilmistir. Calisma evrenini Adana ilinde faaliyet gosteren bir... more
    Bu calisma hastanede gorev yapan saglik calisanlarinin kisisel ozellikleri ile orgutsel adalet algilarinin orgute baglilik duzeyleri uzerine etkisini belirlemek amaciyla yapilmistir. Calisma evrenini Adana ilinde faaliyet gosteren bir kamu hastanesi calisanlari olusturmaktadir ve veri toplama yontemi olarak anket kullanilmistir. Anket toplam 838 saglik calisanina dagitilmis ve geri donus orani %57 (n=477) olarak gerceklesmistir. Hastane calisanlarinin bagliliklarini etkileyen faktorlerin incelendigi yapisal esitlik modeli sonuclari; saglik calisanlarinin calistiklari hastanelere baglilik duzeylerinin kisisel ozelliklerden meslek gruplarina (t=5,258; p 0,05). Ayrica hastane calisanlarinin orgutsel adalet algilarinin orgute bagliliklarini onemli olcude etkiledigi (t=9,146; p<0.001) sonucuna ulasilmistir.
    Turkey has accomplished remarkable improvements in terms of health status in the last three decades, particularly after the implementation of the Health Transformation Program (HTP (Saglikta Donus, um Programi)). Average life expectancy... more
    Turkey has accomplished remarkable improvements in terms of health status in the last three decades, particularly after the implementation of the Health Transformation Program (HTP (Saglikta Donus, um Programi)). Average life expectancy reached 71.8 for men and 76.8 for women in 2010. The infant mortality rate (IMR) decreased to 10.1 per 1000 live births in 2010, down from 117.5 in 1980. Despite these achievements, there are still discrepancies in terms of infant mortality between rural and urban areas and different parts of the country, although these have been diminishing over the years. The higher infant mortality rates in rural areas can be attributed to low socioeconomic conditions, low female education levels and the prevalence of infectious diseases. The main causes of death are diseases of the circulatory system followed by malignant neoplasms. Turkeys health care system has been undergoing a far-reaching reform process (HTP) since 2003 and radical changes have occurred both...
    This study examined the self-reported health status of 90 patients who had undergone Coronary Artery Bypass Grafting (CABG). Data were collected by the Short Form-36 (SF-36) instrument, administered twice at preoperative and postoperative... more
    This study examined the self-reported health status of 90 patients who had undergone Coronary Artery Bypass Grafting (CABG). Data were collected by the Short Form-36 (SF-36) instrument, administered twice at preoperative and postoperative periods. The reliability of the SF-36 ranged from 0.68 to 0.93 in the analysis of preoperative and postoperative measures of health status. The CABG patients reported markedly lower health status on all eight SF-36 dimensions at the preoperative period and considerable improvements on all dimensions at the postoperative period. The assessment of CABG patients' outcomes showed that perceived usefulness of the procedure contributed positively to their perceived health status when the effect of preoperative health status was controlled. Patients who perceived the CABG procedure as useful appeared to have more improved postoperative health status after the procedure.
    Our study aimed to identify factors affecting patient satisfaction. The study was conducted at a training hospital in Turkey. The final sample consisted of 302 inpatients. In this study, patient satisfaction was examined using a survey... more
    Our study aimed to identify factors affecting patient satisfaction. The study was conducted at a training hospital in Turkey. The final sample consisted of 302 inpatients. In this study, patient satisfaction was examined using a survey questionnaire with 22 questions collected under five dimensions. Factor analysis was used to group 22 questions measuring patients' satisfaction questions into certain dimensions. Then, structural equation model (SEM) was performed to determine the influence of patient characteristics on patient satisfaction. Our analysis showed the questionnaire has an appropriate reliability and validity. The structural equation model (SEM) was used to determine those factors which could affect patient satisfaction. The results of SEM analysis showed that 15% of the total variance in patients' satisfaction was explained by the model. The SEM analysis found that variables of education and type of clinic (surgical vs. non-surgical) were significant on patient satisfaction. Persons with a higher level of education were less satisfied when compared to those with a lower level of education. Surgical patients are more satisfied with the care they received when compared to non-surgical patients. The education level of patients and the type of clinics had a significant influence on patient satisfaction.
    To determine the factors affecting general satisfaction level of patients with the food services in a military hospital in Turkey. The study was carried out in a military hospital providing tertiary health care services with the capacity... more
    To determine the factors affecting general satisfaction level of patients with the food services in a military hospital in Turkey. The study was carried out in a military hospital providing tertiary health care services with the capacity of 1000 hospital bed. A questionnaire was used as data collection tool on measuring satisfaction of the patients with the food services. The results showed that of 374 patients 51.3% evaluated food service quality adequate, 32.4% said that the food quality was inadequate, and 16.3% stated that they were uncertain. A logistic regression model was estimated in determining the most important and statistically significant factors affecting patient satisfaction with hospital foods and food services. The results showed that patient-specific demographic characteristics were insignificant in explaining satisfaction level with food services, but the variables of taste (OR = 9.853, p = 0.000) and appearance (OR = 2.687, p = 0.014) of the food were statistically significant and important determinants of patient satisfaction with the foods served at the hospital. The results of this study would be helpful in making decision on increasing the level of satisfaction of patients with the food services for hospital managers and the food (nutrition) departments. On the other hand, the results can also be used in benchmarking the hospital's food services quality with other hospitals, and in monitoring improvements in food services quality in the future.
    ... George's Respiratory Questionnaire (SGRQ) (Jones et al., 1992), the Asthma Quality of Life Questionnaire (AQLQ) (Juniper et al., 1992 ... Likelihood (ML), unweighted least squares, generalised least squares or asymptotic... more
    ... George's Respiratory Questionnaire (SGRQ) (Jones et al., 1992), the Asthma Quality of Life Questionnaire (AQLQ) (Juniper et al., 1992 ... Likelihood (ML), unweighted least squares, generalised least squares or asymptotic distribution free estimators (Joreskog and Sorborn, 1983). ...

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