Background In Türkiye, as in other countries, the maldistribution of the health workforce is a serious concern. Although policymakers have developed various incentive packages, this problem has not been thoroughly addressed yet. Discrete choice experiment (DCE) is a valuable method to provide evidence-based information for these incentive packages to attract healthcare staff for rural jobs. The main aim of this study is to investigate the stated preferences of physicians and nurses when choosing a job region. Methods A labelled DCE was conducted to assess job preferences of physicians and nurses from two hospitals one of which is urban, and the other is in a rural region in Türkiye Job attributes included wage, creche, infrastructure, workload, education opportunity, housing, and career opportunity. Mixed logit model was used to analyse the data. Results The strongest attribute associated with job preferences was region (coefficient − 3.06, [SE 0.18]) for physicians (n = 126) and wages (coefficient 1.02, [SE 0.08]) for nurses (n = 218). According to the Willingness to Pay (WTP) calculations, while the physicians claimed 8627 TRY (1,813 $), the nurses claimed 1407 TRY (296 $) in addition to their monthly salaries to accept a rural job. Conclusion Both financial and non-financial factors did affect the preferences of physicians and nurses. These DCE results provide information for policymakers about what characteristics might increase the motivation of physicians and nurses to work in rural areas in Türkiye.
Objective To evaluate the effect of continuity of care on health outcomes (quality of life and functionality) in patients with rheumatoid arthritis and to reveal whether treatment adherence and disease activity have a serial multiple mediator role on this relationship. Methods The study was cross‐sectional on 440 rheumatoid arthritis patients who applied to a university hospital rheumatology outpatient clinic. Research data were obtained from both the questionnaire method, which is the primary data source, and the patient files, which are the secondary data source. Process analysis was used in the analysis of the data. Results It was found that the continuity of care has a direct effect on the quality of life and the functionality. In addition, it is seen that treatment adherence has a single partial mediator role on the relationship between continuity of care and quality of life; It has been determined that treatment adherence and disease activity have both partial single mediation and serial multiple mediation roles on the relationship between continuity of care and functionality. Conclusion It is thought that these findings will provide clinicians with important data and information in the management of rheumatoid arthritis.
Purpose: The aim of the study was to examine the effects of socio-demographic characteristics, disease-related characteristics and health care use related-characteristics on the treatment effectiveness of rheumatoid arthritis patients, both separately and together. Methods: The sample of the study consisted of 440 rheumatoid arthritis patients for 99% confidence level, and this sample was reached based on the convenience sampling method. Patients who received at least one anti-TNF therapy were included in the study. Treatment effectiveness levels of rheumatoid arthritis patients were measured with a questionnaire. In the analysis of the study, four different regression models were established. In the first model, socio-demographic characteristics; in the second model, disease characteristics; in the third model, health care use characteristics: in the fourth model, the effect of all these variables on treatment effectiveness was examined. Results: In the study, smoking status, age (socio-demographic characteristics), drug regimen complexity, comorbidity status, education about the disease, disease duration (disease characteristics), and a number of admissions (health care use characteristics), were found to have a significant effect on treatment effectiveness. Conclusion: In the study, the factors affecting the treatment effectiveness were determined. Therefore, it is important to consider these factors revealed in this study in order to increase the treatment effectiveness in patients with rheumatoid arthritis.
Along with the changes in the disease structure resulting from aging population, increased awareness of health and access to services have increased the need for effective selection and use of health policies. An important part of these health policies is pharmaceutical policy. Pharmaceutical pricing and reimbursement policies are expected to meet the needs of individuals on time, maintain the effective use of resources and support research and development activities. These expectations differ according to each stakeholder, and these differences directly affect the preferences of the stakeholder groups. With this study, it is aimed to reveal the differences in opinions and preferences of stakeholders regarding pharmaceutical policies. The analysis of the study data was made with Multi Criteria Decision Making tool ELECTRE III. According to the results, the most important policy objectives were access to pharmaceuticals, sustainability of healthcare system and control of pharmaceutical spending. Accelerated authorization and reimbursement processes had been found the most effective tools to achieve the stated objectives. This was followed by pharmacoeconomic evaluation and alternative reimbursement contracts, respectively. It is expected that the results of this research will guide the decision makers while evaluating existing policies and creating new ones.
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