Aims: The aim of this study was to evaluate the incidence and prevalence of chronic obstructive pulmonary disease (COPD) and COPD-related deaths by gender in Turkey. Methods: The data used in the study, covering the years 1990-2019, were taken from the estimation data prepared for Turkey within the global burden of disease study by the Institute for Health Metrics and Evaluation (IHME). Mann-Whitney test was applied to compare the variables according to gender. Non-parametric Spearman rank correlation coefficient was calculated to determine the relationships between variables. Results: The difference between the mean ranks of the total number of prevalences, the total number of incidences, and the total number of deaths by gender were statistically significant. A strong and linear association was found between the risk factors and deaths due to COPD. Conclusion: Policies are needed to decrease the risk factors that lead to the development of COPD. The more risk factors can be controlled, the more lives can be saved.

Aims: The aim of this study was to evaluate the incidence and prevalence of asthma, asthma-related DALYs and deaths, and risk factors for asthma by genders and age groups during the study years in Turkey. Methods: The data used in the study were obtained from the estimation data prepared by the Institute for Health Metrics and Evaluation on asthma for Turkey by the global burden of disease study covering the years 1990-2019. During the study years period, death from asthma and Disability-Adjusted Life Years (DALYs) were used as dependent variables. In addition, the effects of Occupational Asthmagens (OA), Smoking (SM), and High Body Mass Index (HBMI), which are known as risk factors for asthma-related deaths and DALYs, were investigated. Comparisons of the variables according to gender and age groups were made with the Mann-Whitney test. The relationships between the variables were examined with the Spearman rank correlation coefficient (Rho). Results: A statistically significant difference was found between the mean rank of total prevalence number, total incidence number, total number of deaths and DALYs scores by gender. Asthma-related deaths due to risk factors (OA, HBMI, SM) were found to be correlated with DALYs and the total number of asthma deaths. Total asthma deaths, and asthma-related deaths because of HBMI and DALYs because of HBMI-induced asthma in women; deaths from asthma because of OA, SM, and DALYs from asthma because of OA and SM were found to be higher in males. Conclusion: HBMI in women and SM and OA in men stand out as risk factors. Therefore, as a result of a detailed investigation of the risk factors leading to the development of asthma, policies should be developed for gender and age groups, and necessary precautions should be taken.

ANALYSIS OF THE SOCIAL SECURITY INSTITUTION’S HEALTH SPENDING: AN ARDL BOUNDS TEST APPROACH Yunus Emre KARATAŞ, Metin DİNÇER With the health transformation program, universal health insurance was introduced. Thus, it became the most significant health service purchaser social security institution. The services provided by hospitals began to occupy an important place in the expenditures of the social security institution. Thus, the study aims to predict and model the effect of functional characteristics of health facilities on Social Security Institution (SSI) health expenditures in Turkey. While collecting the data used in the study, the hospital’s service levels as functional characteristics were considered, and the data between 01/2009 and 05/2020 were analyzed. Auto-Regressive Distributed Lag Model (ARDL) bounds test was used to analyze the presence of cointegration between variables in the short and long run. Long-run predictions show that while the secondary-level state hospitals reduce the health expenditure of the SSI, the tertiary-level state, university, and secondary-level private hospitals increase the SSI health expenditure. Measuring the services provided by hospitals and the benefits they provide to patients according to objective criteria will be the most significant indicator of the appropriateness of health expenditures. Keywords: ARDL Bounds Test, Reimbursement, Health Spending, Health Insurance, Social Security Institution Jel Codes: C32, G22, G28, H51, I13