EFFECTS OF RECONSTRUCTION OF HEALTH CARE ON SERVICE DELIVERY PERFORMANCE IN TURKEY: THE PUBLIC HOSPITAL UNIONS

Abstract

Objectives: In this study, the performance of 555 public hospitals was evaluated to research the impact of the Public Hospital Unions (PHU) practice applied in Turkey. Materials and Methods: Performance has two dimensions: efficiency and effectiveness. The scores obtained as a result of Data Envelopment Analysis (DEA) and Malmquist Index (MI) methods were taken as efficiency indicators. The degree of achievement of the targets was taken as effectiveness indicators, and the evaluation of effectiveness was performed by examining to what extent it has gotten closer to the targeted values on the Strategic Plans prepared by Turkey Public Hospitals Authority (TPHA). Results: According to the results of the DEA-VRS model, the percentage of efficient hospitals; was 69% in 2012, 74% in 2013, 70% in 2014, 70% in 2015, and 71% in 2016. According to the results of the DEA-CRS model, the percentage of efficient hospitals; was 55% in 2012, 60% in 2013, 56% in 2014, 55% in 2015, and 53% in 2016. The efficiency changes of all hospitals between the period of 2012-2016 were analyzed by the MI method, and the Technical Efficiency Change (TEC), Technological Change (TC), and Total Factor Productivity (TFP) values of the hospitals were found to decrease by 45%, 87%, and 72%, respectively. Conclusion: The public hospital unions (PHU) model, which was created to use resources effectively and efficiently in the field of health, did not significantly enhance hospitals' performance.