Background
Turkish public hospitals have been subjected to health care reform because of increasing cost pressure, inequities in access to health care, poor quality of care and limited patient responsiveness in the last three decades. This study investigates the impact of recent hospital reforms on the efficiency of public hospitals.
Methods
The study provides a comprehensive evaluation of the efficiency of Turkish hospitals by using Data Envelopment Analysis (DEA). The estimation of efficiency of 669 public hospitals of Turkey is performed by an output-oriented model of DEA under the assumption of variable return-to-scale by using data collected from the Ministry of Health (MoH) over the period 2013–17.
Results
The average efficiency score is equal to 0.83 for all MoH hospitals. Considering the hospital type, the efficiency scores of training and research hospitals are higher than those of the general and branch hospitals. In addition, considering the hospital size, huge-scale hospitals have the highest efficiency score in all years. Moreover, overcrowded regions such as Marmara and South-eastern Anatolia regions had higher efficiency scores than other geographical regions.
Conclusions
The results indicate that recent health reforms did not significantly enhance hospital efficiency. Thus, policymakers and managers should take the necessary precautions to increase hospital efficiency.
SummaryThe distribution of plant-feeding and free-living nematodes in large scale onion production areas in five geographical regions in Turkey was investigated in 2016 and 2017. Ditylenchus spp. and Tylenchus spp. were widely distributed. The stem and bulb nematode, Ditylenchus dipsaci, was found in 48 locations from 13 provinces. Other plant-feeding nematode genera were Pratylenchus, Paratylenchus and Pratylenchoides. Pratylenchus thornei was the most widely distributed root-lesion nematode species in onion fields in 11 locations from seven provinces. Pratylenchus neglectus was present in three locations and P. vulnus was in four locations. Aphelenchus spp. and Aphelenchoides spp. were the principal fungal-feeding nematodes in onion-growing areas. The most abundant bacterial-feeding nematode genera were Acrobeloides, Cephalobus, Eucephalobus and Rhabditis. Acrobeles and Wilsonema genera were low in occurrence and abundance. Nematodes from Dorylaimida and predator nematodes, Mononchus spp., were also found. The numbers of Ditylenchus from plant samples were significantly correlated positively to silt content, and significantly correlated negatively to organic matter and calcium content.
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