Analysis of Publications on Health Information Management Using the Science Mapping Method: A Holistic Perspective.

OBJECTIVE: In the age of digital transformation, there is a need for a sustainable information management vision in health. Understanding the accumulation of health information management (HIM) knowledge from the past to the present and building a new vision to meet this need reveals the importance of understanding the available scientific knowledge. With this research, it is aimed to examine the scientific documents of the last 40 years of HIM literature with a holistic approach using science mapping techniques and to guide future research. METHODS: This study used a bibliometric analysis method for science mapping. Co-citation and co-occurrence document analyses were performed on 630 academic publications selected from the Web of Science core collection (WoSCC) database using the keyword "Health Information Management" and inclusion criteria. The analyses were performed using the R-based software Bibliometrix (Version 4.0; K-Synth Srl), Python (Version 3.12.1; The Python Software Foundation), and Microsoft® Excel® 2016. RESULTS: Co-occurrence analyses revealed the themes of personal health records, clinical coding and data quality, and health information management. The HIM theme consisted of five subthemes: "electronic records", "medical informatics", "e-health and telemedicine", "health education and awareness", and "health information systems (HISs)". As a result of the co-citation analysis, the prominent themes were technology acceptance, standardized clinical coding, the success of HISs, types of electronic records, people with HIM, health informatics used by consumers, e-health, e-mobile health technologies, and countries' frameworks and standards for HISs. CONCLUSIONS: This comprehensive bibliometric study shows that structured information can be helpful in understanding research trends in HIM. This study identified critical issues in HIM, identified meaningful themes, and explained the topic from a holistic perspective for all health system actors and stakeholders who want to work in the field of HIM.

The mediating role of FoMO and the moderating role of narcissism in the impact of social exclusion on compulsive buying: a cross-cultural study.

BACKGROUND: There is an interrelationship between the concepts of social exclusion, compulsive buying behavior, fear of missing out (FoMO), and narcissism. Nevertheless, the extent to which these concepts mediate or moderate their relationships with each other has not been efficiently investigated. OBJECTIVE: This research aims to investigate how FoMO mediates and narcissism moderates the correlation between social exclusion and compulsive buying behavior. In addition, the research aims to test a conceptual model and highlight the differences that may occur in the conceptual model proposed in two different countries. METHODS: This model was analyzed among 1007 university students (Turkey = 506, Denmark = 501). The study used scales to measure social exclusion, compulsive buying behavior, FoMO, and narcissism. The study employed PROCESS Model 4 to analyze direct and indirect (mediation) effects and PROCESS Model 59 to assess conditional (moderation) effects. Furthermore, the Johnson-Neyman technique was utilized to investigate interaction terms. RESULTS: The findings indicate that those who face social exclusion tend to participate more in compulsive buying, and this connection is partly explained by FoMO. This suggests that individuals who encounter social exclusion may have an increased likelihood of experiencing FoMO, which may subsequently contribute to compulsive buying behavior. Furthermore, the moderating effect of narcissism differed between the Turkey and Danish samples. Specifically, in the Turkey sample, narcissism only modified the connection between social exclusion and FoMO, while in the Danish sample, it impacted both the connection between social exclusion and FoMO and the connection between FoMO and compulsive buying. CONCLUSION: The obtained results show that the regulating role of narcissism is different in Turkey and Denmark within the conceptual model we studied.

Evaluating the Financial Performances of the Publicly Held Healthcare Companies in Crisis Periods in Türkiye.

The purpose of this study was to evaluate the financial performances of the publicly held healthcare companies in crisis periods in Türkiye. The 2018 economic crisis and the COVID-19 pandemic crisis were included in the study as the crisis periods. We collected the financial data of the publicly held healthcare companies and calculated three liquidity, three turnover, three leverage and three profitability ratios through ratio analysis to use as financial performance indicators. We then conducted Wilcoxon signed-rank tests and we performed separate analyses for the 2018 economic crisis and the COVID-19 pandemic crisis. The results of the analyses showed that there were no statistically significant differences between the publicly held healthcare companies' liquidity, turnover, leverage, profitability ratios and thus their financial performances before the crises and after the crises. While the results are reassuring and give valuable insights to managers and policy makers to determine the areas that needs to be strengthened to be better prepared for possible future crises, our sample was limited. Therefore, this study presents an exploratory foundation for future studies which are needed to make a case for financial stability for the publicly held healthcare companies before and after the crisis periods.

Convergence of economic growth and health expenditures in OECD countries: Evidence from non-linear unit root tests.

Introduction: The relationship between human capital, health spending, and economic growth is frequently neglected in the literature. However, one of the main determinants of human capital is health expenditures, where human capital is one of the driving forces of growth. Consequently, health expenditures affect growth through this link. Methods: In the study, these findings have been attempted to be empirically tested. Along this axis, health expenditure per qualified worker was chosen as an indicator of health expenditure, and output per qualified worker was chosen as an indicator of economic growth. The variables were treated with the convergence hypothesis. Due to the non-linear nature of the variables, the convergence hypothesis was carried out with non-linear unit root tests. Results: The analysis of 22 OECD countries from 1976 to 2020 showed that health expenditure converged for all countries, and there was a significant degree of growth convergence (except for two countries). These findings show that health expenditure convergence has significantly contributed to growth convergence. Discussion: Policymakers should consider the inclusiveness and effectiveness of health policies while making their economic policies, as health expenditure convergence can significantly impact growth convergence. Further research is needed to understand the mechanisms behind this relationship and identify specific health policies most effective in promoting economic growth.

The Problems Experienced by Employees with Chronic Disease during the COVID-19 Pandemic.

Chronic diseases served as a silent global epidemic before the pandemic, and individuals living with chronic disease now form one of the groups most affected by COVID-19. This study aims to determine the problems that employees with chronic disease face during the COVID-19 pandemic. As part of the study, data were collected from 952 individuals who live with chronic disease in Turkey. Of these, 76.6% of respondents worked for the public sector, a large majority of whom (67.7%) have worked full time during the COVID-19 pandemic. It was found that the COVID-19 fear level of employees living with chronic disease was higher than moderate (21.061 ± 7.607). When the variables affecting the COVID-19 fear level are listed in order of relative significance, eating problems, residing in the Mediterranean region, having asthma, and working as a female employee made the greatest impact, respectively. Necessary conditions of work should be provided to those living with chronic disease who could adapt themselves to working flexibly or working from home, so that they would not feel isolated from business life. This group should be provided with essential protective equipment, their working conditions must be reviewed and vaccination priority could be given to them.

An Examination of the Relationships between Nurses' Team Work Attitudes, Conflicts with College and Job Satisfaction: An Example of a Public Hospital.

Nurses are one of the most important elements of the health system. In this study, it was aimed to determine the teamwork attitudes of nurses, their conflicts with their colleagues, their job satisfaction, to determine whether these variables differ according to the socio-demographic characteristics of the nurses, and to reveal the relationships between these variables. The data in the study were obtained from 253 nurses working in the Children's Hospital of Ankara City Hospital using a questionnaire method. A significant relationship was found between the teamwork attitudes of the nurses, their colleagues, and their level of conflict and job satisfaction.

Evaluating the Factors (Stress, Anxiety and Depression) Affecting the Mental Health Condition of Nurses During the COVID-19 Pandemic.

This study aimed to determine the depression, anxiety and stress levels that have negatively impacted nurses' mental health during the COVID-19 pandemic. A sample group of 826 nurses working in Turkey were asked to fill in an online questionnaire in order to evaluate their psychological responses and the related factors that have adversely affected their mental health during the COVID-19 pandemic. In total, 696 nurses (84.3%) showed symptoms of depression, 644 (78%) reported anxiety and 543 (65.74%) reported stress. This study also highlighted that the most concerning factor for the nurses was the risk of transmitting the COVID-19 infection to their household members (89.2%). The most important problems faced by the nurses during COVID-19 included equipment shortages (50.7%), administrative problems (38.5%) and issues such as accommodation and nutrition (27.4%). These were found to have a statistically significant correlation with the nurses' levels of depression, anxiety and stress. The fear of losing a household member, the inability to their household's social needs and the fear of death were among the factors that concerned nurses during the COVID-19 pandemic, significantly affecting their levels of depression, anxiety and stress. Taking the necessary measures to deal with the aforementioned problems and fears is important to protect the health, productivity and efficiency of nurses during the pandemic period.

Refugees' Opinions about Healthcare Services: A Case of Turkey.

BACKGROUND: Migration is one of the most important social events in human history. In recent years, Turkey hosted a high number of asylum seekers and refugees, primarily because of continuing wars and radical social changes in the Middle East. METHODS: Using a random sampling method, Syrian refugees aged 18 and over, who can communicate in Turkish, were reached via personal contact and a total of 714 refugees participated in the study voluntarily. RESULTS: Turkey has mounted with some success and to point out that even though participating refugees in both provinces are young and healthy, almost 50% have bad or worse health status, 61% have chronic diseases, and 55% need regular medication. Participating refugees living in Sanliurfa stated that 'Hospitals are very clean and tidy.' (3.80 ± 0.80). The answers given to the following statements had the highest mean for the participating refugees living in Kilis; 'Hospitals are clean and tidy.' (3.22 ± 1.25). CONCLUSION: Due to financial and human resource deficiencies, there are problems in providing preventive and therapeutic health services, especially to refugees living outside the refugee camps in bad conditions. It is important that refugees are encouraged to apply to family health and community health centers in this context.

Impacts of COVID-19 pandemic period on depression, anxiety and stress levels of the healthcare employees in Turkey.

The COVID-19 pandemic has turned into a public health issue since December 2019 and has risen in all countries in the world. The healthcare employees taking part in the pandemic will eventually be affected by the process. The aim of the study is to determine the levels of the anxiety, depression, and stress of the healthcare employees during the COVID-19 pandemic in Turkey. As the data collection tool, an e-survey was used. In the first section, Depression, Anxiety and Stress Scale (DASS-21) was used. In the second section of the survey, the problems experienced by the healthcare employees during the pandemic and their working media were aimed to be defined. In the last section, the socio-demographic features of the employees were investigated. 2076 healthcare employees participated in the study. The results showed that the major cause of the anxiety or stress among healthcare employees comes from the fear to contaminate the COVID-19 virus to their families (86.9%). It was observed that the levels of depression, anxiety and stress of female employees are higher than that of male employees (p < 0.003). The highest depression, anxiety and stress levels of healthcare employees come from the pandemic, emergency, and internal services (p < 0.001). Health managers and policymakers need to make a move immediately to find solutions for the physical and psychological needs of the health employees. On the other hand, in order to minimize the risk, preparation of the work power plans beforehand and inclusion of obligatory referral chain into health services can be suggested.

The consumers' social media use in choosing physicians and hospitals: the case study of the province of Izmir.

Manifested as a reflection of the Internet technology progress, web 2.0 has transformed communication among people to different dimensions while increasing the social use of Internet. Thus, the concept of social media has entered our lives. Blogs, forums, Facebook, Twitter and YouTube applications are but few of the social media platforms with active users exceeding millions. As in many other subjects, these and others are also environments where people share information and their positive or negative experiential views with respect to healthcare issues and services. Hence, the social media communication and exchange of information are deemed influential on the process of receiving health services. In the present study that aims to determine social media use of individuals in their choice of physicians, dentists and hospitals, a survey, as a data collection instrument, has been carried out to 947 residents of the province of Izmir. Individuals participating in the study have stated that they have used social media in choosing a physician (41.9% of the participants), dentist (34.1% of the participants) and hospitals (41.7% of the participants). The study has revealed that individuals are affected by social media in their healthcare choices. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of the Family Medicine Practice in Ankara Province by Family Physicians.

Turkey's family physician or practice system was established in the beginning of the 2010 across Turkey's 81 provinces and provides low- cost health care, preventive and curative basic medical services to the population. Public health centers across Turkey have now become Family Health Centers (ASMs) as part of Turkey's efforts to harmonize its health care system with that of the European Union. The aim of This study is to analyze and evaluate the implementation and performance of Family Practice in Ankara province by family physicians. A questionnaire form of 42 question was designed and used to determine opinions of the physicians about effective service & quality improvement, patient-physician relationship, efficiency in the area of responsibility, productivity, job satisfaction and equity. The result of the study shows that family physicians were defined to be generally satisfied with the system and performance implementation and significant differences were found according to work seniority, gender and productivity of the participants. Finally this study should be taken within it's limitation. The work seniority and gender was one of the most important factor to improve satisfactions and productivity for family physicians in Turkey. The sample size was representative for the country, however, one limitation might be considered the increase of sample size in future research if appropriate funding became available in the future. This study did not have any source of funding.

Preferences, attitudes, and behaviors of health services consumers in Turkey.

OBJECTIVE: To investigate preferences, attitudes, and behaviors of consumers in health care services. METHODS: The study was conducted in the Turkish health care context. A total of 810 people who reside in the urban and rural residential areas of Ankara were surveyed. RESULTS: The study results suggest that consumer attitudes toward health care services differ by the demographic and socio-cultural characteristics of consumers. CONCLUSIONS: Several managerial recommendations pertinent to the analysis of consumer behavior and the development of long-term relationships with consumers were made. Also, future research suggestions were provided.

Outsourcing and its implications for hospital organizations in Turkey.

To thrive in this era of global competition, all organizations must explore new managerial approaches to get an edge in the marketplace. One increasingly appealing approach is outsourcing. Hospitals are particularly fertile environments for outsourcing, given their role as providers of a broad and complex array of services, many of which may be bought from other institutions. The purpose of this study is to determine the types of services that hospitals in Turkey buy from other organizations. The study sample included 14 university hospitals, 20 Ministry of Health Hospitals, 15 Social Insurance Organization Hospitals and 31 private hospitals in Istanbul, Ankara, Izmir, Antalya, and Eskisehir, which are the biggest cities in Turkey. The following services were found to be outsourced: hospital management information systems (83.8%), cleaning services (81.3%), maintenance services (72.5%), leased medical devices (75.0%), food services (60.0%), patient direction services (63.8%), magnetic imaging services (60.0%), other imaging services (48.8%), laboratory services (42.5%), security services (38.8%), laundry services (36.3%), patient transportation services (33.8%), accounting services (26.3%), ambulance services (22.5%), patient satisfaction measurement services (13.8%), consultancy services (12.5%), and financial and investment services (9.5%). Private hospitals bought more services than public facilities did. The sampled hospitals chose to outsource services in order to decrease costs (78.8%), increase the quality of services rendered (65.5%), increase flexibility and share risk (36.6%), and increase profits (11.2%). The results of this study suggest that outsourcing, when applied judiciously through cost and risk analysis, is a cost-effective approach that can be used by most hospitals.

The role of public relations activities in hospital choice.

Public relations activities for all organizations can have an important effect on consumer decision-making when buying goods or services. This study examines the effect that public relations activities can have regarding consumer decisions and choice. To explore exemplify this relationship a questionnaire was given to 971 patients within public, university and private hospitals in Ankara, Turkey. Study results show that public relations activities were a crucial factor in determining consumer hospital choice. The majority of respondents reported that the behaviors and attitude of personnel as public relations activities that support the hospital's reputation within the public were the primary variables in hospital choice. Health care managers can use these findings to further understand how patients make informed choices related to usage of a health care facility and to develop and/or improve public relations activities.

Comparison of computing capability and information system abilities of state hospitals owned by Ministry of Labor and Social Security and Ministry of Health.

The main purpose of this study is to give an idea to the readers about how big and important the computing and information problems that hospital managers as well as policy makers will face with after collecting the Ministry of Labor and Social Security (MoLSS) and Ministry of Health (MoH) hospitals under single structure in Turkey by comparing the current level of computing capability of hospitals owned by two ministries. The data used in this study were obtained from 729 hospitals that belong to both ministries by using a data collection tool. The results indicate that there have been considerable differences among the hospitals owned by the two ministries in terms of human resources and information systems. The hospital managers and decision makers making their decisions based on the data produced by current hospital information system (HIS) would more likely face very important difficulties after merging MoH and MoLSS hospitals in Turkey. It is also possible to claim that the level and adequacy of computing abilities and devices do not allow the managers of public hospitals to use computer technology effectively in their information management practices. Lack of technical information, undeveloped information culture, inappropriate management styles, and being inexperienced are the main reasons of why HIS does not run properly and effectively in Turkish hospitals.

Conflict management in public university hospitals in Turkey: a pilot study.

By nature, hospitals are extremely complex organizations, combining many different professional groups within an intricate administrative structure. Conflicts therefore expectedly arise between individuals, groups, and departments. It is in the interest of health care administrators to periodically assess the major factors giving rise to these conflicts. In this study, a questionnaire designed to measure sources of conflict in the workplace was completed by 204 staff members at Gazi University Hospital. Of the participants, 30.9% were physicians, and 12.5% were administrators at various levels; 61.5% were female, and 38.5% were male. In terms of work experience, 52.6% of participants had worked less than 5 years at the hospital. The results of the study show that educational differences among the hospital staff were a major barrier to good communication and information flow between groups. Professionals in the same specialties experienced fewer conflicts. Another source of conflict was that resource allocation was considered unfair across departments. Although the hospital management provided an ombudsman for staff concerns, staff rarely resorted to the ombudsman because of the stigma associated with complaining. A lack of opportunity for career advancement was mentioned by 52% of the participants as a source of conflict. At present, job performance and rewards are not closely related in public university hospitals in Turkey because promotions and pay raises are strictly limited by law. Bureaucracy was also perceived to be a source of conflict, with 48.4% of participants saying that their performance was less than optimal because of the presence of multiple supervisors. This pilot study suggests that in Turkey, legislative reform is needed to give public university hospitals more flexibility regarding work incentives, open-door policies at the administrative level, and social interactions to improve teamwork among hospital staff.

Managerial implications of medical sales representative perceptions of job duties, job qualifications, and other performance-related issues.

This study examined the perceptions of medical sales representatives of job related duties, job qualifications needed, and motivating factors and tested for differences based on gender, age, years of experience and education using prior research as a base. This study also explored issues that may arise between sales people and physicians. The authors surveyed 132 medical sales representatives from pharmaceutical firms located in Ankara, Turkey. The authors' findings highlight the need in Turkey for developing in-service training programs for medical sales representatives, especially in the areas related to technical aspects of the product, effective marketing and personal selling strategies, and consumer relations. Training in these areas will help salespeople to better manage the problems typically encountered in physician-sales representative relations. While the study was conducted in Turkey, the results are similar to findings in prior research conducted in other countries and therefore may be of interest to all sales managers.

Hospital choice factors: a case study in Turkey.

In an attempt to test the robustness of the numerous American findings related to hospital choice in the context of another country, this study examines the factors affecting hospital choice decisions of 869 patients in three public and one private hospital policlinics in Ankara, Turkey and attempts to determine their importance levels. Identification of these factors and determining their effect levels is important in concentrating management efforts on these key areas and in formulating effective marketing strategies to retain and expand hospital patient bases in the future. Our findings highlight the importance of accessibility of hospital services to consumers in hospital choice as well as the role of hospital's image, its physical appearance, and technological capabilities in informing such choices. American health care managers can use these findings to further understand how patients make choices related to health care facilities and to develop marketing strategies that may more effectively market their facilities.

The pharmaceutical sales rep/physician relationship in Turkey: ethical issues in an international context.

In many developed countries, the physician/pharmaceutical sales representative relationship has increasingly become the focus of ethical questions. Given this context, the purpose of the present study was to determine the ethical dilemmas faced by pharmaceutical sales representatives in Turkey in their relations with physicians, and to identify possible solutions. Through an investigator-designed questionnaire, the ethical problems perceived by 215 pharmaceutical sales representatives were quantitatively analyzed. Nearly all of the participants (96.7%) reported that they had faced ethical dilemmas in marketing drugs to physicians. The most commonly reported problems included paramedical requests (for free lab test kits, etc.) and the necessity of bargaining with physicians over the use of their firm's drugs by offering gifts and sponsorships. The participants in the study felt that physicians were the primary source of ethical problems in the marketing of drugs, and the participants' most highly ranked potential solution to these ethical problems was a better understanding, on the part of physicians, of the role of pharmaceutical sales representatives. At the end of this study, suggestions are given with a view to helping health policy makers understand and address the current controversies involving drug company representatives and physicians.