Fikriye YILMAZ, Halil Kemal İLTER, Simten MALHAN, Rukiye NUMANOGLU TEKİN

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DETERMINATION OF FACTORS AFFECTING LENGTH OF STAY WITH MULTINOMIAL LOGISTIC REGRESSION IN TURKEY

Birçok faktöre bağlı olarak değişiklik gösteren hasta yatış süresinin sağlık hizmetleri üzerinde önemli etkileri bulunmaktadır. Bu çalışmanın amacı, Türkiye'de hasta yatış süresini etkileyen faktörlerin belirlenmesidir. Bu amaçla 1 Ocak-31 Aralık 2010 dönemi arasında Türkiye genelinde Sosyal Güvenlik Kurumu ile anlaşmalı olan üniversite hastanesi, özel hastane, vakıf üniversitesi hastanesi ve diğer hastanelerde (belediye, dernek ve yabancı/azınlık) yatarak tedavi görmüş 2.255.836 hasta çalışma kapsamına alınmıştır. Hasta verileri MEDULA Sistemi'nden elde edilmiş ve istatistiksel analizler SPSS 18.0 paket programı kullanılarak gerçekleştirilmiştir. Hasta yatış süresini etkileyen faktörlerin belirlenmesinde t-testi, tek yönlü varyans analizi ve multinomial lojistik regresyon yöntemleri kullanılmıştır. Ortalama hasta yatış süresi 3.93 gün (SS = 5.882) olarak belirlenmiştir. Çalışmada kullanılan tüm bağımsız değişkenlere göre (yaş, cinsiyet, hastalık türü, hasta yatış türü, eşlik eden hastalık olup olmama durumu, uygulanan ameliyat türü ve ameliyat sayısı, yatış yapılan mevsim, hastane mülkiyet durumu/yatak kapasitesi/yerleşim yeri/hizmet türü, hastanenin faaliyet gösterdiği coğrafik bölge) ortalama hasta yatış süresinin istatistiksel açıdan anlamlı bir farklılık gösterdiği belirlenmiştir. Çalışmadan elde edilen sonuçlara göre, hasta yatış süresinin cinsiyet, eşlik eden hastalık olup olmama durumu ve hastanenin bulunduğu coğrafik bölge açısından negatif yönde, yaş, hastane yatak kapasitesi, hastane mülkiyet durumu, yatış yapılan mevsim, hastane hizmet türü ve hastane yerleşim yeri açısından pozitif yönde etkilendiği ortaya konulmuştur.

TÜRKİYE'DE HASTA YATIŞ SÜRESİNİ ETKİLEYEN FAKTÖRLERİN MULTİNOMİAL LOJİSTİK REGRESYON İLE BELİRLENMESİ

Length of stay (LOS) has important implications in various aspects of health services, can vary according to a wide range of factors. It is noticed that LOS has been neglected mostly in both theoratical studies and practice of health care management in Turkey. The main purpose of this study is to identify factors related to LOS in Turkey. A retrospective analysis of 2.255.836 patients hospitalized to private, university, foundation university and other (municipality, association and foreigners/minority hospitals) hospitals which have an agreement with Social Security Institution (SSI) in Turkey, from January 1, 2010, until the December 31, 2010, was examined. Patient's data were taken from MEDULA (National Electronic Invoice System) and SPSS 18.0 was used to perform statistical analysis. In this study t-test, one way anova and multinomial logistic regression are used to determine variables that may affect to LOS. The average LOS of patients was 3,93 days (SD = 5,882). LOS showed a statistically significant difference according to all independent variables used in the study (age, gender, disease class, type of hospitalization, presence of comorbidity, type and number of surgery, season of hospitalization, hospital ownership/bed capacity/ geographical region/residential area/type of service). According to the results of the multinomial lojistic regression analysis, LOS was negatively affected in terms of gender, presence of comorbidity, geographical region of hospital and was positively affected in terms of age, season of hospitalization, hospital bed capacity/ownership/type of service/residential area.
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Sosyal Güvence-Cover
  • ISSN: 2146-5649
  • Yayın Aralığı: Yılda 2 Sayı
  • Başlangıç: 2011
  • Yayıncı: Sosyal Güvenlik Uzmanları Derneği
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DETERMINATION OF FACTORS AFFECTING LENGTH OF STAY WITH MULTINOMIAL LOGISTIC REGRESSION IN TURKEY

Fikriye YILMAZ, Halil Kemal İLTER, Simten MALHAN, Rukiye NUMANOGLU TEKİN