Research Outputs
Permanent URI for this communityhttps://hdl.handle.net/20.500.14288/2
Browse
5 results
Search Results
Publication Metadata only Cost-of-disease in heart failure in Turkey: a Delphi panel based analysis of direct costs(ELSEVIER, 2022) Cavusoglu, Y.; Altay, H.; Aras, D.; Celik, A.; Dinc, M.; Aktas, F. S.; Kilicaslan, B.; Nalbantgil, S.; Ozdemir, O.; Ozsoy, A.; Temizhan, A.; Yildirimturk, O.; Yilmaz, M. B.; Ural, Dilek; Faculty Member; N/A; School of Medicine; N/A; 1057N/APublication Metadata only Desires vs. conditions: a qualitative study exploring the factors affecting the place of death of child with cancer in Turkey(Wiley, 2022) Bingöl, Hülya; Aydın, Ayfer; Kebudi, Rejin; Koç, Başak; Yıldırım, Ülkü Miray; Zülfikar, Bülent; Umaç, Eyşan Hanzade; PhD Student; Graduate School of Health Sciences; N/AObjective: The purpose of this study was to describe factors affecting the place of death of children with cancer at the end of life. Methods: The descriptive phenomenological approach was used. Eighteen mothers who lost their children to cancer participated in in-depth interviews. Data were analysed using MAXQDA software version. Codes and categories were developed inductively from participants' narratives. Results: The factors affecting the place of death of children were categorised into two main themes: (1) desires and (2) conditions. Most of the mothers reported that their deceased children wanted to be with their families at the end of life and they wanted to go home. The conditions related to health services were defined as the barriers to the death of their children in the places of death preferred by the mothers. Conclusion: The desire to be close to the child was the main factor affecting the parents' decisions. The findings revealed the prevailing circumstances in the death place decision beyond parental desires. These were the child's health conditions, physical conditions of hospitals, and the lack of home care and paediatric palliative care services, which were factors related to the system, and the lack of other options for parents.Publication Metadata only Health-related quality of life and perceived health status of Turkish population(Springer, 2019) Horasan, Gönül Dinç; Selçuk, Kevser Tarı; Sözmen, Kaan; Ergör, Gül; Yardım, Nazan; Sarıoğlu, Gülay; Soylu, Meltem; Keskinkılıç, Bekir; Buzgan, Turan; Hülür, Ünal; Ekinci, Halil; Ekinci, Banu; Ünal, Belgin; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Purpose: This study was conducted to assess the health-related quality of life (HRQOL) and perceived health status of the Turkish population. Methods: The data came from a nationwide survey, which was conducted by Ministry of Health on prevalence and risk factors for chronic diseases in Turkey, with a representative random sample of 18,477 people aged >= 15 years from Turkey. Each family physician invited two individuals selected from their registered population to the Family Health Center, conducted the survey by face to face interviews using an electronic form. HRQOL was determined using EQ-5D-3L scale. Results: In Turkish population, each four women out of 10, two men out of 10 have problems in pain/discomfort and anxiety/depression dimensions of the scale; three women out of 10, one man out of 10 have some or severe problems in mobility. Proportion of people without health problems (health state 11,111) were 64,1% in men, 40,7% in women. The mean VAS score for males was 71.50.2 (95% CI 70.9-72.1), 66.4 +/- 0.2 (95% CI 65.8-66.9) for females (p < 0.05).The most important determinants of having a problem in any of the five dimensions are age, gender, education, diabetes mellitus, coronary heart disease, stroke, alzheimer, cancer, renal failure. The OR of having some or severe problems in any dimensions was 4.6 (95% CI 38-5.4) for over 65-74 and 7.5 (95% CI 5.8-9.6) for over 75 compared to 15-24 age group. Conclusions: The perceived health level and HRQOL is worse in women, in older age groups, in people from lower socioeconomical status.Publication Metadata only Impact of health policies on catastrophic health expenditures in Turkey(Elsevier Science Inc, 2017) Koçkaya, Güvenç; Aygün, Abidin; Yıldırım, Jülide; Department of Economics; Alpanda, Berna Tuncay; Teaching Faculty; Department of Economics; College of Administrative Sciences and Economics; 258769Objectives: Turkish Health Transformation Program has been launched in 2003, to improve the availability, quality, and the use of primary health care services. The program aimed to rebuild Turkish health system and establish a national based health insurance coverage. According to TURKSTAT figures, the proportion of households with catastrophic health expenditure decreased from 0.81 in 2002 to 0.14 in 2012. However, the ratio increased to 0.31 in 2014. The aim of the study is to investigate the determinants of catastrophic health expenditure and investigate the impact of health policies and factors on catastrophic health expenditure in Turkey. Methods: Catastrophic health expenditure is calculated from a national representative data derived from TURKSTAT, Household Budget Survey, belonging to the time period 2010 - 2015. Proportion of households facing catastrophic health expenditure are calculated by using the methodology proposed by Ke Xu (Xu 2005). Results: The average spending values of household with positive health expenditure have been decreased on pharmacy-related products(-36%), medical services (doctors)(-71%), hospital services(-84%), dentistry, and laboratory services. However, there was an increase in the average spending value on other medical products(+76%), medical aids(+79%) and other services. The average spending values of household with catastrophic health expenditure have been decreased on pharmacy-related products(-64%), medical services (doctors)(-57%), dentistry, and laboratory services. However, there was an increase in the average spending value on other medical products(+79%), medical aids(+193%) and hospital services(+93%). Conclusions: As a result, the increase in the number of households with catastrophic health expenditure could be the result of changes in health policy may impact on medical products, tools and equipment for treatment, other medicinal products, medical aids, other services and hospital services. Further studies should be done to investigate this effect.Publication Metadata only Screening for preclinical alzheimer's disease: deriving optimal policies using a partially observable Markov model(Springer) Gürvit, İbrahim Hakan; Department of Business Administration; N/A; Sayın, Serpil; Dumlu, Zehra Önen; Faculty Member; PhD Student; Department of Business Administration; College of Administrative Sciences and Economics; Graduate School of Sciences and Engineering; 6755; N/AAlzheimer's Disease (AD) is believed to be the most common type of dementia. Even though screening for AD has been discussed widely, there is no screening program implemented as part of a policy in any country. Current medical research motivates focusing on the preclinical stages of the disease in a modeling initiative. We develop a partially observable Markov decision process model to determine optimal screening programs. The model contains disease free and preclinical AD partially observable states and the screening decision is taken while an individual is in one of those states. An observable diagnosed preclinical AD state is integrated along with observable mild cognitive impairment, AD and death states. Transition probabilities among states are estimated using data from Knight Alzheimer's Disease Research Center (KADRC) and relevant literature. With an objective of maximizing expected total quality-adjusted life years (QALYs), the output of the model is an optimal screening program that specifies at what points in time an individual over 50 years of age with a given risk of AD will be directed to undergo screening. The screening test used to diagnose preclinical AD has a positive disutility, is imperfect and its sensitivity and specificity are estimated using the KADRC data set. We study the impact of a potential intervention with a parameterized effectiveness and disutility on model outcomes for three different risk profiles (low, medium and high). When intervention effectiveness and disutility are at their best, the optimal screening policy is to screen every year between ages 50 and 95, with an overall QALY gain of 0.94, 1.9 and 2.9 for low, medium and high risk profiles, respectively. As intervention effectiveness diminishes and/or its disutility increases, the optimal policy changes to sporadic screening and then to never screening. Under several scenarios, some screening within the time horizon is optimal from a QALY perspective. Moreover, an in-depth analysis of costs reveals that implementing these policies are either cost-saving or cost-effective.