SAĞLIK SİSTEMLERİNDE CEVAP VEREBİLİRLİK ÜZERİNE SİSTEMATİK BİR DERLEME

Bu çalışmada, sağlık sistemlerinde cevap verebilirlik üzerine yapılan uluslararası çalışmaların sistematik derleme yöntemi ile analiz edilmesi amaçlanmıştır. Çalışmada, sistematik incelemeler ve meta analizleri için geliştirilen “PRISMA” yönergesi kullanılmış, belirlenen dahil edilme kriterleri doğrultusunda ulaşılan 27 çalışma araştırma kapsamına alınmıştır. İnceleme sonucunda sağlık sistemlerinde cevap verebilirlik üzerine yapılmış çalışmaların en fazla 2017 yılında gerçekleştirildiği (n=5) ve en fazla çalışma yapılan ülkenin İran (%25.9) olduğu belirlenmiştir. İncelenen çalışmaların büyük kısmında ayakta ve yatan hastalar (%29.6) birlikte değerlendirilmiştir. Cevap verebilirlik alt boyutlarından en yüksek puanı alan alt boyutlar, saygılı tedavi (%25.9), gizlilik (%22.2) ve sosyal destek (%18.5); en düşük puanı alan boyutlar, seçim (%37.04) ve otonomi (%25.9)’dir. Ayrıca cevap verebilirliğinin cinsiyet, yaş, eğitim seviyesi, yerleşim yeri ve hizmet türü gibi değişkenlerden etkilendiği saptanmıştır. Cevap verebilirliğin ölçümü, hem genel sağlık sistemi hem de belirli sağlık hizmetlerinin performans değerlendirmesinde kullanılmaktadır. Cevap verebilirlik çalışmaları üzerinde yapılan bu araştırmada elde edilen bulgular, bütüncül ve derinlemesine bir perspektif sunarak, ulusal düzeyde sağlık sisteminin değerlendirilmesinde yapılacak çalışmalara rehber olabilir, çalışmaların gündeme gelmesini sağlayabilir.

Anahtar Kelimeler:

sağlık politikası, Cevap verebilirlik, kalite, performans, sağlık hizmeti

A SYSTEMATIC REVIEW ON RESPONSIVENESS IN HEALTH SYSTEMS

The present study aims to analyze international studies on responsiveness in health systems by systematic review method. In the study, the "PRISMA" directive developed for systematic reviews and meta-analyses was used, and 27 studies meeting the inclusion criteria were included in the study. As a result of the analysis, it was determined that the greatest number of studies on responsiveness in health systems were carried out in 2017 (n=5) and the country with the most studies was Iran (25.9%). In most of the studies reviewed, outpatients and inpatients (29.6%) were evaluated together. Respectful treatment (25.9%), confidentiality (22.2%) and social support (18.5%) get the highest scores from the responsiveness sub-dimensions; the lowest scoring dimensions are choice (37.04%) and autonomy (25.9%). In addition, it was determined that its responsiveness was affected by variables such as gender, age, education level, place of residence and service type. The measurement of responsiveness is used in the performance evaluation of both the general health system and specific health services. The findings obtained from this study on responsiveness studies, by presenting a holistic and in-depth perspective, can guide the studies to be carried out in the evaluation of the health system at the national level and bring the studies to the agenda.

Keywords:

Health policy, health services, performance, quality, responsiveness.,

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