Sağlık Sistemine Duyulan Güven: Türkiye'deki Kardiyoloji Hastaları Örneği
Bu çalışma Mersin ilinde yer alan
üç devlet hastanesinden hizmet alan 231 kardiyoloji hastasına uygulanan anket
verisi üzerine kuruludur. Makale, çıkarım ve test için çeşitli istatistiksel
yöntemleri kullanmaktadır. Bunlar faktör analizi, kümeleme teknikleri ve Markov
geçiş olasılık matrislerini içerir. Makalenin dört ana sonucu şu şekildedir:
İlk olarak, yaş, cinsiyet, medeni durum, eğitim ve ekonomik durum gibi
demografik ve sosyo-ekonomik faktörler, sağlık sistemine duyulan güven ile
ilişkili değildir. İkincisi, daha yüksek düzeyde genel kişilerarası güven ve
sağlık hizmetlerinden daha yüksek düzeyde memnuniyet duyan hastalar, sağlık
sistemine daha yüksek güven düzeylerine sahiptir. Üçüncüsü, hemşireler ve
hekimlere duyulan kişilerarası güven, hastanelere ve Sağlık Bakanlığına duyulan
kişisel olmayan güven ile güçlü ve pozitif bir ilişki içerisindedir. Son
olarak, sağlık sistemine duyulan güven ve güvensizlik hem kişilerarası hem de
kişisel olmayan bir şekilde geçmişten günümüze kayda değer bir süreklilik gösterir.
Bu sonuçlar, geçtiğimiz on yılda sistemli bir dönüşüm yaşayan, gelişmekte olan
bir ülke bağlamında sağlık sistemine güven oluşturma ve erozyon anlayışımıza
katkıda bulunmaktadır.
Trust in the Health System: The Case of Cardiology Patients in Turkey
This paper studies trust in the
health system via survey data collected for a sample of 231 cardiology patients
residing in three public hospitals in the Mersin province, Turkey. The paper
uses a diversity of statistical methods for inference and testing. These
include factor analysis, clustering techniques, and Markov transition
probability matrices. Four central results of the paper are the following:
First, demographic and socioeconomic factors, i.e., age, sex, marital status,
education, and economic status, are not related with trust in the health
system. Second, patients exhibiting higher levels of general interpersonal
trust and higher levels of satisfaction from healthcare services have higher
levels of trust in the health system. Third, interpersonal trust in nurses and
physicians is strongly and positively related with impersonal trust in
hospitals and the Ministry of Health. Finally, trust and distrust in the health
system exhibit remarkable persistence from past to present in both
interpersonally and impersonally. These results contribute to our understanding
of trust building and erosion in the health system in the context of a
developing country that has experienced a systemic transformation in the recent
decade.
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