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.

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