Hekim ve Hemşirelerin Çalışma Koşulları ile İlgili Tercihlerinin Kesikli Seçim Yöntemi ile İncelenmesi

Abstract

Health workforce has a critical importance in the effective delivery of healthcare services and for health systems to achieve their goals. On the other hand, the maldistribution of health workforce is a common problem of all countries regardless of their level of development. For this reason, policy makers develop various legal regulations, practices and incentive packages for the equitable distribution of the health workforce in rural and urban areas. This dissertation, conducted to determine the preferences of physicians and nurses regarding working conditions, provides evidence-based information for policy makers. Within the scope of the study, a city in the 1st Region (Ankara) and a state hospital in the 6th Region (Ağrı) were selected in terms of development level, and 126 physicians and 218 nurses were interviewed. In this study conducted with the Discrete Choice Experiment (DCE), the participants were presented with 18 hypothetical working condition scenarios with 1st region and 2nd region labels and they were asked to choose one. The analysis of the data has been used in the mixlogit method and the most important features affecting the preferences for working conditions were found to be region, wage, education opportunity, infrastructure, kindergarten, career opportunity and workload for physicians, while wage, region, infrastructure, workload, education opportunity, housing, career opportunity and kindergarten for nurses. Willingness to pay and the probability of accepting a job with certain characteristics were calculated using the coefficients of the attributes. Finally, in order to provide evidence-based information to policy makers, the likelihood of participants taking up specific incentive packages were estimated. As a result it was formed that working conditions have different levels of influence on physicians’ and nurses' preference in jobs in a particular region. In addition, discrete choice experiment is a very useful and promising quantitative method in determining the preferences of stakeholders in the field of health.