Author :
Abstract
Bu araştırmanın amacı; OECD (Organisation for Economic Co-operation and Development) ülkelerinde toplam sağlık harcamaları içerisinde cepten yapılan sağlık harcamalarının düzeyini etkileyen faktörleri karar ağacı yöntemini kullanarak belirlemek ve ülkeleri bu değişkenlere göre sınıflandırmaktır. OECD’ye üye olan 36 ülkenin 2015 yılına ait verileri araştırmanın evrenini oluşturmaktadır. Araştırmada bağımlı değişken olarak ülkelerin toplam sağlık harcamaları içerisindeki cepten sağlık harcamalarının oranı ve bağımsız değişken olarak ise kişi başı gayrisafi yurtiçi hâsıla, sağlık sigortası kapsamında olan nüfus oranı, kırsal bölgede yaşayan nüfus oranı, 0-14 yaş ve 65 yaş ve üzeri nüfus oranı, en az üniversite mezunu olan nüfus oranı, kalp hastalıkları, kanser, diyabet ya da solunum hastalıklarından kaynaklı ölüm oranı, sağlık statüsünü kötü olarak algılayan nüfus oranı, yurtiçi kamu harcamaları içerisindeki sağlık harcaması oranı ve işgücü sayısı kullanılmıştır. Karar ağacı modeli CART algoritması kullanılarak Orange veri madenciliği programı aracılığıyla kurulmuştur. Yapılan analizler sonucunda; cepten sağlık harcamalarını etkileyen en önemli faktörün, kamu harcamaları içerisindeki sağlık harcamalarının oranı olduğu ve diğer faktörlerin ise kırsal bölgede yaşayan nüfus oranı, 65 yaş ve üzeri nüfus oranı, en az üniversite mezunu olan nüfus oranı ve işgücü sayısı olduğu bulunmuş ve kurulan karar ağacı modeline göre ülkelerin 9 sınıfta toplandığı görülmüştür. Araştırmadan elde edilen sonuçların, sağlık politikacıları ve planlayıcılarına sağlık harcamalarının düzeyinin belirlenmesine ilişkin alınacak kararlarda önemli kanıta dayalı bilgiler sağlayacağı düşünülmektedir.
Keywords
Abstract
The aim of this research is to determine the factors affecting the level of out-of-pocket health expenditures as a proportion of total health expenditure in OECD countries by using decision tree method and to classify countries according to these variables. The research population comprised the 2015 data of 36 OECD member countries. In the research, the proportion of out-of-pocket health expenditures in total health expenditures of the countries as a dependent variable and the per capita gross domestic product, the ratio of the population covered by the health insurance, the ratio of the population living in the rural area, the ratio of the population of 0-14 years and 65 years of age, the proportion of the population with at least bachelor degree, the mortality rate due to cardiovascular disease, cancer, diabetes or respiratory diseases, the ratio of the population that perceives the health status as bad, domestic government health expenditure as a proportion of the total expenditure and the number of labor force as independent variables are used. The decision tree model was built using the Orange data mining program using the CART algorithm. As a result of the analyzes, it was found that the most important factor affecting the out-of-pocket health expenditures was the domestic government health expenditure as a proportion of the total expenditure and the other factors were the ratio of the population living in the rural areas, the ratio of the population 65 years and older, the proportion of the population with at least bachelor degree and the number of labor force. According to the model, it was found that the countries gathered in 9 classes. It is thought that the results obtained from the research will provide health policy makers and planners with important evidence-based information in the decisions to be taken regarding the determination of the level of health expenditures.
Keywords
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