Trakya Üniversitesi Hastanesi ile Edirne Devlet Hastanesine başvuran hastaların sosyo-demografik özellikleri ve hizmet talepleriyle ilgili etmenler /
Yazar: NİHAT TURAN
Danışman: DOÇ.DR. AHMET SALTIK
Trakya Üniversitesi / Sağlık Bilimleri Enstitüsü / Halk Sağlığı Ana Bilim Dalı
Derece: Yüksek Lisans, 1993
Konu: Halk Sağlığı = Public Health
Dizin: Hastalar = Patients ; Hastaneler-devlet = Hospitals-public ; Hastaneler-üniversite = Hospitals-university ; Sağlık hizmetleri = Health services ; Sosyodemografik özellikler = Socio-demographic characteristics ; Sosyoekonomik faktörler = Socio-economic factors

Özet:
As a conclusion, it should be underlined that above mentioned mat ter constitutes a social problem as it is directly related to the socioeconomic status of the society and the resultant choice and usage of health administration has a very great responsibility in the solution of this problem. Consequently we suggest that the primary health care services should be presented in their own health units other than the University Hos pitals should urgently take their place primarily in scientific re searches and educational programs. Furthermore, the efforts to impro ve the socioeconomic status of the society should be executed in or der to make use of a more balanced service of health among the so ciety and the epidemiological researches should be carried out to define the target population and to make a through plan of the fu ture health sevices. We also suggest that the efforts should be encouraged to introduce the health service levels of the hospitals and the results should cautiously be interpreted. 71secondary health care. None of the participants used the State Hos pital as a tertiary health care service institution. 78.3 % of the patients admitted to the University Hospital stated that they were satisfied from the level of the health services while the satisfac tion rate was 69 % among those admitted to ESH. No significant difference could be demonstrated among the partici pants of both groups in respect to the parameters regarding sex, age, number of households, presence of social security, annual he alth expenditure and the place of residence in urban or rural/area Educational status of those patients admitted to the University Hospital proved to be superior to the ESH group. On the other hand, unmarried patient population was greater in the University Hospital group compared to the ESH group. Of the patients who have a social security, those who are the members of Emekli Sandığı admit 1 in a g- reater percent to the University Hospital and majority of those from Bag-Kur apply to ESH primarily. The average level of income is higher among the University Hospital group compared with the pati ents admitted to ESH. As it was mentioned before, the socioeconomic status uf the University Hospital participants are superior to the ESH group. Overall, TUH attracts a greater portion from the hinterland in E- dirne. The majority of the patients who preferred the University Hospital showed the higher level of health service as the predomi nant cause of their choise while the majority of these in the ESH group stated that they have used to State Hospital because they we re referred to this hospital. 70As a conclusion, it should be underlined that above mentioned mat ter constitutes a social problem as it is directly related to the socioeconomic status of the society and the resultant choice and usage of health administration has a very great responsibility in the solution of this problem. Consequently we suggest that the primary health care services should be presented in their own health units other than the University Hos pitals should urgently take their place primarily in scientific re searches and educational programs. Furthermore, the efforts to impro ve the socioeconomic status of the society should be executed in or der to make use of a more balanced service of health among the so ciety and the epidemiological researches should be carried out to define the target population and to make a through plan of the fu ture health sevices. We also suggest that the efforts should be encouraged to introduce the health service levels of the hospitals and the results should cautiously be interpreted. 71

Abstract:
S U M M A R Y This study was designed and performed to investigate, comperatively the socioeconomic status status of patients admitted to outpatient clinics of TUH (Trakya University Hospital) and ESH (Edirne State Hospital) and also to define the hospital-target population relati- onships and to determine the usefulness and the utility of the he- alth services presented through referral chain in the University Hospital. The outpatient visit numbers recorded in both hospitals for every month were used for sampling. The total number of outpatients in TUH for April. July, October and December 1990 constituted the stu-. dy universe. The sample size was determined to be the 5 % of the s- tudy universe which amounted to 1250 of total 25 000 patients admit¬ ted to outpatient clinics of the University Hospital during these 4 months. With a simi lar method, the control group sample was consti¬ tuted by randomly assigning 350 patients from ESH with a sample ratio of l %. The subjects in the sample groups were applied a qu- estionnaire in order to gather the required data. The 79.4 % (n= 1185) of the participants were belonging to those admitted to TUH and patients from ESH comprised the remaining 20.6 % (n=» 307). The distribution among sexes was 48.8 % male, 51.2 % female and 45.3 % male, 54.7 % female for TUH and ESH respectively. 63.1 % of patients from TUH group were married, 32.4 % were unmar- ried and 4.5 % were widows while the respective values for those from ESH were 69 %f 24.5 % and 6.5 %. When the family structure was questioned, it was found that 84.7 % of those from TUH had smali 68families, 13.1 % had large families and 2 % had separated families; the same figures för the subjects from ESH were 79.2 %, 18.9 % and 2 % respectively. The average room number för each resident was 3.5 for the University Hospital group and 3.2 för the State Hospital g- roup. The mean number of residents for each house was 3.89 ± 1.29 among the participants from TUH and 3.96 ± 1.25 in the ESH group. 69.8 % of the patients from TUH and 73 % of the sample from ESH declared that they had a social security. The average per capita expenditure for outpatient visit, medication and transportation was l 807 768 TL annually for the TUH group and l 599 582 TL for the ESH group. The figures reflecting the socioeconomic status were fo- und to be good in 30 %, medium in 58.3 % and poor in 11.7 % for the participants from TUH and 21.8 %, 66.2 % and 16 % for the ESH group respectively. 83.3 % of the patients applied to the University Hos¬ pital proved to l ive in urban regions and 16.7 % in rural areas, w- hile 84.4 % of those from ESH were living in urban areas and 15.6 % in rural areas. Evaluation of the distance from the residence to the hospital showed that 47.9 % of those applied to TUH and 60.3 % of those frorn ESH had to travel 0-9 km and the percentage of the patients who had to travel more than 9 km was 52.8 % in TUH group and 39.7 % in ESH group. it was also understood from the questionnaire results that the U- niversity Hospital had being utilized as the primary health çare services by 39.9 % of the patients, as the secondary health çare by 42.6 % and as the tertiary heith çare by 17.5 %.> the relavent figures for ESH were 64.1 % for primary health çare, 39.9 % for the 69secondary health care. None of the participants used the State Hos pital as a tertiary health care service institution. 78.3 % of the patients admitted to the University Hospital stated that they were satisfied from the level of the health services while the satisfac tion rate was 69 % among those admitted to ESH. No significant difference could be demonstrated among the partici pants of both groups in respect to the parameters regarding sex, age, number of households, presence of social security, annual he alth expenditure and the place of residence in urban or rural/area Educational status of those patients admitted to the University Hospital proved to be superior to the ESH group. On the other hand, unmarried patient population was greater in the University Hospital group compared to the ESH group. Of the patients who have a social security, those who are the members of Emekli Sandığı admit 1 in a g- reater percent to the University Hospital and majority of those from Bag-Kur apply to ESH primarily. The average level of income is higher among the University Hospital group compared with the pati ents admitted to ESH. As it was mentioned before, the socioeconomic status uf the University Hospital participants are superior to the ESH group. Overall, TUH attracts a greater portion from the hinterland in E- dirne. The majority of the patients who preferred the University Hospital showed the higher level of health service as the predomi nant cause of their choise while the majority of these in the ESH group stated that they have used to State Hospital because they we re referred to this hospital. 70As a conclusion, it should be underlined that above mentioned mat ter constitutes a social problem as it is directly related to the socioeconomic status of the society and the resultant choice and usage of health administration has a very great responsibility in the solution of this problem. Consequently we suggest that the primary health care services should be presented in their own health units other than the University Hos pitals should urgently take their place primarily in scientific re searches and educational programs. Furthermore, the efforts to impro ve the socioeconomic status of the society should be executed in or der to make use of a more balanced service of health among the so ciety and the epidemiological researches should be carried out to define the target population and to make a through plan of the fu ture health sevices. We also suggest that the efforts should be encouraged to introduce the health service levels of the hospitals and the results should cautiously be interpreted. 71