Pandemide Geriatrik Nüfusun Sağlık Çalışanlarından Sağladığı Sosyal Faydada Yaşanan Artış

Amaç: Pandeminin ilk şok etkisini gösterdiği 2020 yılında, yaşlıların sağlık personelinin iller arası dağılımından kaynaklanan sosyal fayda kayıplarında 2019’a göre yaşanan değişimi ve buna dayalı olan diğer göstergeleri (sosyal fayda oranı, SHW, IHW, bin yaşlı başına düşen , SHW ve IHW) analiz etmek amaçlandı. Gereç ve Yöntem: Çalışmada kullanılan yöntem, Atkinson eşitsizlik endeksidir. Uygulamada kullanılan verileri İBBS-3 düzeyinde 2019 ve 2020 yılları içindir. Sağlık personeli verileri SGK’dan, yaşlı yaş gruplarındaki nüfus için veriler TÜİK’ten derlenmiştir. Bulgular: Atkinson eşitsizlik endeksi 2019’da 0,414 ile 0,302 arasında gerçekleşti. Endeks değeri 2020’deyse 0,292 ile 0,206 arasına geriledi. Endeks değerlerine bağlı olarak 2019’da sosyal fayda oranı 69,8% ile 58,6% arasındayken, 2020’de 79,4% ile 70,8% arasına yükseldi. Bu değişim rate of socail utility için yaklaşık ¼’lük artışa işaret eder. Sosyal fayda kaybıysa 2019’da 41,4% ile 30,2% arasındayken, 2020’de 20,6% ile 29,2% arasına geriledi. Bu değişim sosyal fayda kaybı oranında yaklaşık ortalama 1/3’lük gerilemeye işaret eder. Sonuç: Elde edilen bulgular, insan sağlığı hizmetlerinde çalışanlardan yaşlıların sağladığı sosyal faydada ciddi iyileşmenin olduğunu gösteriyor. Bu durum pandemi sürecinde uygulanan sağlık politikalarının, diğer pek çok ülkenin aksine yaşlıların sağlık hizmet erişimini destekleyici yönde olduğuna bir kanıt özelliğindedir.

Anahtar Kelimeler:

Pandemi, Türk sağlık politikası, geriatri, kamu sağlığı, sosyal politika, bölgelerarası eşitsizlik.

The Increase in the Social Utility of the Geriatric Population Gained from the Human Health Workers during the Pandemic

Objective: It was intended to analyze the change in social utility loss in 2020, when the pandemic showed its first shock, caused by the inter-provincial distribution of health personnel of the elderly compared to 2019 and other indicators based on this (rate of social utility, SHW, IHW, SHW/IHW per thousand elderly people). Method: The method used in the study is the Atkinson inequality index. The data used in the application are for 2019 and 2020 at the NUTS-3 level. Health personnel data were compiled from SSI and data for the elderly population were compiled from TSI. Results: The Atkinson inequality index varied between 0.414 and 0.302 in 2019. The index value fell between 0.292 and 0.206 in 2020. Depending on the index values, while the rate of social utility varied between 69.8% to 58.6% in 2019, it increased to vary between 79.4% to 70.8% in 2020. The rate of social utility loss, on the other hand, while being varied from 41.4% to 30.2% in 2019, decreased to being varied between 20.6% to 29.2% in 2020. Conclusions: The findings show that there is a significant improvement in the social utility of the elderly from the human health workers. This serves as evidence to the situation which shows that the health policies implemented during the pandemic period, unlike many other countries, supported the access of the elderly to health services.

Keywords:

Pandemic, Turkish health politics, geriatrics, public health, social politics, interregional inequality.,

PDF

___

Atkinson AB. On the measurement of inequality. Journal of Economic Theory 1970;2(3), 244-263.
Banerjee A, Chen S, Pasea L, Lai, AG, Katsoulis M, et al. Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic. European Journal of Preventive Cardiology. 2021;28(14), 1599-1609.
Barnett-Howell Z, Watson OJ, Mobarak AM. The benefits and costs of social distancing in high-and low-income countries. Transactions of the Royal Society of Tropical Medicine and Hygiene.2021; doi: 10.1093/trstmh/traa140
Borah P, Mirgh S, Sharma SK, Bansal S, Dixit A, et al. Effect of age, comorbidity and remission status on outcome of COVID-19 in patients with hematological malignancies. Blood Cells, Molecules, and Diseases. 2021;87, 102525.
Burlacu A, Mavrichi I, Crisan-Dabija R, Jugrin D, Buju S, et al. “Celebrating old age”: An obsolete expression during the COVID-19 pandemic? Medical, social, psychological, and religious consequences of home isolation and loneliness among the elderly. Archives of Medical Science: AMS. 2021;17(2), 285-295.
Centers for Disease Control and Prevention, Risk for COVID-19 Infection, Hospitalization, and Death By Age Group, URL: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html, 07.01.2022.
Chakrawarty A, Ranjan P, Klanidhi KB, Kaur D, Sarkar S, et al. Psycho-social and behavioral impact of COVID-19 on middle-aged and elderly individuals: a qualitative study. Journal of Education and Health Promotion. 2021;10.
Coccia M. High health expenditures and low exposure of population to air pollution as critical factors that can reduce fatality rate in COVID-19 pandemic crisis: a global analysis. Environmental Research. 2021;199, 111339.
Çalışkan Z. Main Determinants of the Unequal Distribution of Physicians in Turkey: An Empirical Analysis. International Journal of Arts and Commerce. 2013;2(4), 47-61.
Çiftçi M. Türkiye'de 60 yaş ve üstü nüfusun sağlık hizmetlerinin bölgesel dağılımından sağladıkları sosyal fayda düzeyleri. Turkish Journal of Geriatrics. 2010;13(4), 252-260.
Çiftçi M. Sosyal politika perspektifiyle geriatrik nüfusun aile hekimlerinden sağladığı sosyal fayda. Avrasya Aile Hekimliği Dergisi. 2018;7(1 Ek), 9.
D’ascanio M, Innammorato M, Pasquariello L, Pizzirusso D, Guerrieri G, et al. Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes. BMC Geriatrics. 2021;21(1), 1-10.
Dai SP, Zhao X, Wu JH. Effects of comorbidities on the elderly patients with COVID-19: clinical characteristics of elderly patients infected with COVID-19 from sichuan, China. The journal of nutrition, health & aging. 2021;25(1), 18-24.
Diderichsen F. How did Sweden fail the pandemic?. International Journal of Health Services.2021;5(4), 417-422.
García I, Molina JA. The effects of region on the welfare and monetary ıncome of Spanish Families, Urban Studies. 2001;38(13), 2415‐2424.
Garcia MA, Homan PA, García C, Brown TH. The color of COVID-19: Structural racism and the disproportionate impact of the pandemic on older Black and Latinx adults. The Journals of Gerontology: Series B. 2021;76(3), e75-e80.
Goudarzi R, Meshkani Z, Barooni M, Jahanmehr N, Moalemi S. Distribution of general practitioners in the health system of iran using equity indices (gini, atkinson). Health and Development Journal. 2015;4(3), 247-258.
Gravelle H, Sutton M. (2001). Inequality in the geographical distribution of general practitioners in England and Wales 1974-1995. Journal of health services research & policy, 6(1), 6-13.
Grund S, Gordon AL, Bauer JM, Achterberg WP, Schols JM. The COVID rehabilitation paradox: why we need to protect and develop geriatric rehabilitation services in the face of the pandemic. Age and Ageing. 2021;50(3), 605-607.
Haklai Z, Aburbeh M, Goldberger N, Gordon ES. Excess mortality during the COVID-19 pandemic in Israel, March–November 2020: when, where, and for whom?. Israel Journal of Health Policy Research. 2021;10(1), 1-7.
Hann M, Gravelle H. The maldistribution of general practitioners in England and Wales: 1974–2003. British Journal of General Practice. 2004;54(509), 894-898.
Harvey J. A Note on the ‘natural rate of subjective ınequality’ hypothesis and the approximate relationship between the Gini Coefficient and the Atkinson index. Journal of Public Economics. 2005;89, 1021– 1025.
Heid, AR, Cartwright F, Wilson-Genderson M, Pruchno R. Challenges experienced by older people during the initial months of the COVID-19 Pandemic, The Gerontologist. 2021;61(1), 48–58.
Khammarnia M, Ghiasvand H, Javadi F, Safdari Adimi F. Equity in the Distribution of health resources: A Case Study in Southeast Iran. Shiraz E-Medical Journal. 2021;22(8):e106392.
Li, G, Liu, Y, Jing X, Wang Y, Miao M, et.al. Mortality risk of COVID-19 in elderly males with comorbidities: A multi-country study. Aging (Albany NY). 2021;13(1), 27-60.
Li P, Wang, Y, Peppelenbosch MP, Ma Z, Pan, Q. Systematically comparing COVID-19 with the 2009 influenza pandemic for hospitalized patients. International Journal of Infectious Diseases. 2021;102, 375-380.
Matsumoto, K, Seto, K, Hayata, E, Fujita, S, Hatakeyama, Y, et. al. The geographical maldistribution of obstetricians and gynecologists in Japan. Plos One. 2021;16(1), e0245385.
Rój J, (2020). Inequality in the distribution of healthcare human resources in Poland. Sustainability, 12(5), 2043.
Romeyke T, Noehammer E, Stummer H. COVID-19 patient with severe comorbidity in multimodal acute care setting with non-invasive medical ventilation: A clinical outcome report. Clinics and Practice. 2021;11(1), 81-91.
Russo LX. Effect of More Doctors (Mais Médicos) Program on geographic distribution of primary care physicians. Ciência & Saúde Coletiva. 2021;26, 1585-1594.
Salas R. Welfare‐consistent inequality ındices in changing populations: The marginal population replication axiom a note. Journal of Public Economics. 1997;67, 145–150.
Seligman, B, Ferranna M, Bloom D E. Social determinants of mortality from COVID-19: A simulation study using NHANES. PLoS Medicine. 2021;18(1), e1003490.
SGK, 2020 İstatistik Yıllığı, 2021. URL. http://www.sgk.gov.tr/wps/portal/sgk/tr/kurumsal/istatistik/sgk_istatistik_yilliklari
Shiels MS, Almeida JS, García-Closas M, Albert PS, Freedman ND, et. al. Impact of population growth and aging on estimates of excess US deaths during the COVID-19 pandemic, March to August 2020. Annals of Internal Medicine. 2021; 174(4), 437-443.
Sotodeh Manesh S, Hedayati Zafarghandi M, Merati Z, Ebrahimzadeh J, Delpasand M. Inequality trends in the distribution of healthcare human resources in eastern Iran. Proceedings of Singapore Healthcare. 2021; 20101058211041177.
Theodorakis PN, Mantzavinis GD, Rrumbullaku L, Lionis C, Trell, E. Measuring health inequalities in Albania: a focus on the distribution of general practitioners. Human Resources for Health. 2006;4(1), 1-9.
Toyabe SI. Trend in geographic distribution of physicians in Japan. International Journal for Equity in Health. 2009;8(1), 1-8.
TÜİK. Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları; 2021. URL. https://biruni.tuik.gov.tr/medas/
Valent F. Age, comorbidities, nursing home stay and outcomes of SARS-CoV-2 infection in a Northern Italian cohort. Journal of Gerontology and Geriatrics. 2021;69(2), 114-119.
Woldemichael A, Takian A, Akbari Sari A, Olyaeemanesh A. Availability and inequality in accessibility of health centre-based primary healthcare in Ethiopia. PloS One. 2019;14(3), e0213896.
Wu J, Mafham M, Mamas MA, Rashid M, Kontopantelis E, Deanfield JE, et. al. Place and underlying cause of death during the COVID-19 pandemic: retrospective cohort study of 3.5 million deaths in England and Wales, 2014 to 2020. In Mayo Clinic Proceedings. 2021;96(4), 952-963.
Zehnati A. Dynamics of the geographical distribution of private physicians in Algeria. Cybergeo: European Journal of Geography. 2021;978.
Zhan XY, Li L, Hu Y, Li Q, Kong H, et. al. Elderly male with cardiovascular-related comorbidities has a higher rate of fatal outcomes: a retrospective study in 602 patients with coronavirus disease 2019. Frontiers in Cardiovascular Medicine. 2021;8.

ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez