Research Outputs
Permanent URI for this communityhttps://hdl.handle.net/20.500.14288/2
Browse
10 results
Search Results
Publication Restricted An empirical analysis for test ordering behavior of physicians at outpatient units under the influence of workload(Koç University, 2019) Ergün Şahin, Büşra; Güneş, Evrim Didem; 0000-0002-9924-3744; Koç University Graduate School of Business; Business Administration; 51391
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 Durinng COVID-19 outbreak situation of refugees in Turkey(Sağlık ve Sosyal Yardım Vakfı, 2020) Mardin, Deniz; Özvarış, Şevkat Bahar; Gürsoy, Gül; Yukarıkır, Neslihan; Başpınar, Anıl; Sakarya, Sibel; Kayı, İlker; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 172028; 168599Turkey is hosting sum of 5.5 million refugees and international migrants and has become the number one refugee hosting country in the world. Their right to health and access to health condition varies based on their legal status. During the pandemic both their access to health care and their living conditions are changed. After the declaration of the first COVID-19 case in Turkey on 10th of March 2020, has been published different regulations for accessing the health care of these population. However non-governmental organizations’ reports on access to health care conditions of refugees have declared that there are still barriers encountered by refugees. As an example, refugees do not have the necessary information about COVID-19, they do not have information about which hospital they can apply to, there are some problems about the registration process of undocumented migrants and language barriers are encountered during the filiation. In addition, refugees have lost their jobs during the epidemic which affects their conditions for access to shelter, nutrition and health services. In addition, it is an important problem that they do not have enough information about where to apply when there are any health problems other than COVID-19 In conclusion, in Turkey there is a need to make further efforts to provide public supports to the refugees coming from various countries either for health or for other socio economic issues by the supports of the international organizations and with the collaboration of the NGOs / Dünyada en fazla zorunlu göçmene ev sahipliği yapan Türkiye’de toplam 5,5 milyon geçici koruma altında Suriyeli, mülteci ve uluslararası göçmen bulunmaktadır. Bu kişilerin sağlık hizmetlerine erişimi ve sağlık hakkı hukuki statülerine göre farklılık göstermektedir. Salgın sürecinde ise hem sağlık hizmetlerine erişimin hem de kişilerin yaşam koşullarının değiştiği gözlemlenmektedir. Türkiye’de 10 Mart 2020 itibari ile ilk COVID-19 vakasının açıklanmasından sonra bu grupların da sağlık hizmetlerine erişimi konusunda farklı düzenlemeler yapılmıştır. Ancak, mültecilerle çalışan sivil toplum kuruluşlarının tespitlerine göre hala bazı sorunların devam ettiği görülmektedir. Mültecilerin COVID-19 konusunda gerekli bilgilendirmeye erişemedikleri, hangi hastaneye başvurabilecekleri konusunda bilgiye sahip olmadıkları, kayıtsız göçmenlerin kayıt süreçlerinde sorun yaşadıkları, filyasyon sürecinde dil bariyeri ile karşılaşıldığı belirtilmektedir. Ayrıca, mültecilerin salgın sürecinde işlerini kaybetmeleri, barınma, beslenme ve sağlık hizmetlerine erişim koşullarını da etkilemektedir. Bunların yanı sıra, COVID-19 dışında herhangi bir sağlık sorunları olduğunda nereye başvurulması gerektiği ile ilgili bilgiye sahip olmamaları da önemli bir sorundur. Sonuç olarak, Türkiye’de farklı ülkelerden gelen mültecilere yönelik, uluslararası kuruluşların desteği ve sivil toplum kuruluşların işbirliği ile kamusal olarak hem sağlık hem de sosyal ve ekonomik konularda çalışmaların yapılmasına ihtiyaç duyulmaktadırPublication Restricted Gebelikte algılanan sosyal destek düzeyinin sağlıklı yaşam biçimi davranışlarına etkisi(Koç University, 2016) Coşkun, Merve; Eroğlu, Kafiye; 0000-0002-8177-7211; Koç University Graduate School of Health Sciences; 6061Publication 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 Restricted Modeling time allocation in family practice in Turkey(Koç University, 2011) Avcı, Gökçen; Güneş, Evrim Didem; 0000-0002-9924-3744; Koç University Graduate School of Sciences and Engineering; Industrial Engineering; 51391Publication Metadata only Sağlıkta şiddetin önlenmesine yönelik yapılan Nisan 2020 tarihli yasal düzenlemenin incelenmesi(Galenos Yayınevi, 2022) Taşdemir, S. Yazgülü; Akay, Arda; Balcı, Işılay; Yorulmaz, Abdullah Coşkun; Faculty Member; School of Medicine; 3961Şiddet, 2002 yılı itibariyle Dünya Sağlık Örgütü (DSÖ) tarafından da önemli bir halk sağlığı sorunu olarak kabul edilmiştir. Her disiplinde olduğu gibi sağlık çalışanlarına yönelik şiddetin ele alındığı çalışmalarda da şiddet kavramı farklı şekillerde tanımlanmıştır. DSÖ’ye göre şiddet; kişinin bir başka kişiye, bir gruba ya da topluluğa yönelik iktidarın sağladığı güç veya fiziksel güç kullanması neticesinde bu eylemlere maruz kalan kişide yaralanmaya, ölüme, psikolojik zarara, gelişim bozukluğuna veya yoksunluğa yol açması ya da yol açma olasılığının yüksek olması olarak tanımlanmaktadır. Tüm dünyada olduğu gibi ülkemizde de sağlık çalışanlarına yönelik şiddet olayları görülmekte, bu konuyla ilgili olarak hem akademik düzeyde hem de sosyal politikalar bakımından araştırmalar ve düzenlemeler yapılmaktadır. Bu çalışmada, ülkemizde sağlık çalışanlarına yönelik şiddetin önlenmesi için 17.04.2020 tarihinde yürürlüğe giren düzenleme incelenecektir. / Violence has been accepted as an important public health problem by the World Health Organization (WHO) as of 2002. As in every discipline, the concept of violence has been defined in different ways in studies dealing with violence against healthcare workers. According to the WHO, violence is defined as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.” As in the rest of the world, there are incidents of violence against healthcare workers in our country and researches and arrangements are made on this subject both in academic level and in terms of social policies. In this study, the regulation that came into force on 17.04.2020 for the prevention of violence against healthcare workers in our country will be examined.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.