İktisadi ve İdari Bilimler Fakültesi / Faculty of Economics and Administrative Sciences
Permanent URI for this collectionhttps://hdl.handle.net/11727/1399
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Item The Impact Of High-Performance Human Resource Practices On Subjective Career Success: The Mediating Role Of Psychological Capital And Organizational Commitment(JOURNAL OF EAST EUROPEAN MANAGEMENT STUDIES, 2024-06-19) Toyata, Berk; Kizrak, Meral; Cakar, MehmetUtilizing insights from positive psychology, social exchange theory, and social cognitive career theory, this study aims to investigate the mediating role of psychological capital and organizational commitment in the relationship between high-performance human resource (HR) practices and subjective career success. Data were collected from a sample of 429 private sector employees working on European Union projects in Turkey. Hypotheses were tested using regression, correlation, and mediation analyses, as well as Sobel test statistics. Results indicate that high-performance HR practices, organizational commitment, and psychological capital positively influence subjective career success. Additionally, there is evidence that, unlike organizational commitment, psychological capital mediates the relationship between high-performance HR practices and subjective career success. Our study underscores the need for organizations to foster and develop psychological capital among their employees to maximize the effectiveness of HR practices in promoting subjective career success.Item What Have Health Care Reforms Achieved in Turkey? An Appraisal of the "Health Transformation Programme"(2015) Okem, Zeynep Guldem; Cakar, Mehmet; 26183890Poor health status indicators, low quality care, inequity in the access to health services and inefficiency due to fragmented health financing and provision have long been problems in Turkey's health system. To address these problems a radical reform process known as the Health Transformation Programme (HTP) was initiated in 2003. The health sector reforms in Turkey are considered to have been among the most successful of middle-income countries undergoing reform. Numerous articles have been published that review these reforms in terms of, variously, financial sustainability, efficiency, equity and quality. Evidence suggests that Turkey has indeed made significant progress, yet these achievements are uneven among its regions, and their long-term financial sustainability is unresolved due to structural problems in employment. As yet, there is no comprehensive evidence-based analysis of how far the stated reform objectives have been achieved. This article reviews the empirical evidence regarding the outcomes of the HTP during 10 years of its implementation. Strengthening the strategic purchasing function of the Social Security Institution (SSI) should be a priority. Overall performance can be improved by linking resource allocation to provider performance. More emphasis on prevention rather than treatment, with an effective referral chain, can also bring better outcomes, greater efficiency gains and contribute to sustainability. (C) 2015 Elsevier Ireland Ltd. All rights reserved.Item The Effect of Cultural Distance on Medical Tourism(2017) Esiyok, Bulent; Cakar, Mehmet; Kurtulmusoglu, Feride Bahar; 0000-0001-7469-5309; HTR-6588-2023This study analyses the relationships between the origin countries of international patients and their cultural distance from the destination country in the context of medical tourism. A novel panel dataset is used, covering 109 origin countries whose citizens came to Turkey and received medical treatment during 2012-2014. After accounting for control variables such as religious similarity, Turkish diaspora in the origin country, physical distance, GDP per capita and number of inbound tourists, the study finds that cultural distance has an impact on the choice of destination for medical tourism. This impact persists at the medical specialty level.Item Seemingly Embedded But Obviously Exploitative Relations: Organizational Contingencies of Mutual Dependence, Power Imbalance and Embedded Relations(2016) Ozen, Sukru; Uysal, Ozgur Ozmen; Cakar, MehmetWe examine effects of mutual dependence and power imbalance on embedded relations between organizations in an industrial district setting. Employing qualitative methodology, we conducted an exploratory research on manufacturer-retailer relations in the Siteler Furniture District in Ankara. The findings indicated that manufacturer's size and retailer's competitive strategy shape their dependencies and embedded relations. Illustrating various patterns of relationships for different combinations of size and strategy in manufacturer-retailer dyads, we found that mutual dependence enhances embedded relations. We also found that power imbalance does not necessarily hinder them, but generates one-sided relations: the more dependent party tries to build them at the expense of being exploited by the less dependent one. Our study implies that embedded relations may entail exploitation particularly in governed networks where power inequalities are high.Item The Effect of Different Information Sources on The Anxiety Level of Pregnant Women Who Underwent Invasive Prenatal Testing(2016) Cakar, Mehmet; Kasnakoglu, Berna Tari; Okem, Zeynep Guldem; Okuducu, Ummuhan; Beksac, M. Sinan; 26867089Objective: The goal is to explore the effects of age, education, obstetric history and information sources on the (Beck) anxiety levels of pregnant women attending invasive prenatal testing.Methods: Questionnaire results from 152 pregnant women are utilized. Results are analyzed through an independent samples t-test and a two-step cluster analysis attempting to categorize patients in terms of the chosen variables.Results: t-Tests reveal that age, education and bad obstetric history do not significantly affect anxiety levels. Descriptive statistics indicate that almost 60% of patients feel anxious mostly because of the fear of receiving bad news, followed by the fear of miscarriage, the fear of pain and the fear of hurting the baby. According to the cluster analysis, patients who use doctors or nurses as information sources have significantly lower anxiety levels, while those who do not receive information from any source have the second lowest level of anxiety. Patients who receive information from personal sources (i.e. friends and family) have the highest level of anxiety. Anxiety levels do not change according to test type.Conclusions: Doctors and nurses should allocate enough time for providing information about prenatal diagnosis before the procedure. This will reduce the anxiety level as well as the felt necessity to search for information from other sources, such as personal or popular which will further increase the level of anxiety.Item Economic Analysis of Prenatal Screening Strategies for Down Syndrome in Singleton Pregnancies in Turkey(2017) Okem, Zeynep Culdem; Orgul, Gokcen; Kasnakoglu, Berna Tari; Cakar, Mehmet; Beksac, M. Sinan; 29040895Objectives: To examine the costs and outcomes of different screening strategies for Down Syndrome (DS) in singleton pregnancies. Study design: A decision-analytic model was developed to compare the costs and the outcomes of different prenatal screening strategies. Five strategies were compared for women under 35-year of age: 1A) triple test (TT), 2A); combined test (CT), 3A) Non-invasive Prenatal Screening Test by using cell free fetal DNA (NIPT), 4A) and 5A) NIPT as a second-step screening for high-risk patients detected by either TT, or CT respectively. For women >= 35-year of age, 1B) implementing invasive test (amniocentesis-AC) and 2B) NIPT for all women were compared. Data was analyzed to obtain the outcomes, total costs, the cost per women and the incremental cost-effectiveness ratios (ICERs) for screening strategies. Results: Among the current strategies for women under 35 years old, CT is clearly dominated to TT, as it is more effective and less costly. Although, the current routine practice (2A) is the least-costly strategy, implementing NIPT as a second step screening to high-risk women identified by CT (5A) would be more effective than 2A; leading to a 10.2% increase in the number of detected DS cases and a 96.3% reduction in procedural related losses (PRL). However, its cost to the Social Security Institution that is a public entity would be 17 times higher and increase screening costs by 1.5 times. Strategy 5A would result in an incremental cost effectiveness of 6,873,082 (PPP) US$ when compared to the current one (2A). Strategy 1B-for offering AC to all women >= 35-year of age is dominated over NIPT (2B), as it would detect more DS cases and would be less costly. On the other hand, there would be 206 PRL associated with AC, but NIPT provides clear clinical benefits as there would be no PRL with NIPT. Conclusions: NIPT leads to very high costs despite its high effectiveness in terms of detecting DS cases and avoiding PRL. The cost of NIPT should be decreased, otherwise, only individuals who can afford to pay from out-of-pocket could benefit. We believe that reliable cost-effective prenatal screening policies are essential in countries with low and smiddle income and high birth rates as well. (C) 2017 Elsevier B.V. All rights reserved.Item Concerns of Pregnant Women in "Prenatal Screening/Diagnosis" Practice and Termination of Pregnancy(2020) Kasnakoglu, Berna Tari; Cakar, Mehmet; Okem, Zeynep Guldem; Tanacan, Atakan; Fadiloglu, Erdem; Orgul, Gokcen; Beksac, Mehmet Sinan; 32157675Objective To investigate the reasons for decision-making and concerns of patients in the field of prenatal screening, invasive prenatal diagnostic testing (IPDT), and termination of pregnancy (TOP). Study Design This questionnaire-based study consisted of 107 pregnant women who were referred for prenatal screening to the Hacettepe University Hospital. The questionnaire given to patients was prepared from scratch since there is no standard set of questions measuring patients' feelings and concerns regarding prenatal screening/diagnosis, IPDT, and TOP. Results Our questionnaire results showed that it is possible to classify decision-making factors into 6 groups: psychological, social, fear, religious/ faith, support, and trust. The majority of patients were undecided (48.6 %) about IPDT if prenatal screening test results were risky. Only 23.4 % of patients were willing to accept IPDT. On the other hand, 55.1 % of patients were not willing to undergo TOP if the fetal karyotyping results were abnormal. Religious factors seem to be important in refusing IPDT and TOP. Conclusion Physicians should re-evaluate their practice in the field of prenatal screening and diagnosis in light of the high refusal rates of IPDT and TOP. Understanding factors influencing women's decision-making processes provides insight for service providers to help women at high risk of having foetal anomalies to make better-informed choices.Item Budget impact of incorporating non-invasive prenatal testing in prenatal screening for Down syndrome in Turkey(2019) Okem, Zeynep Guldem; Orgul, Gokcen; Kasnakoglu, Berna Tari; Cakar, Mehmet; Beksac, Mehmet SinanObjectives: To provide information to the government about the budget impact of implementing non-invasive prenatal testing (NIPT) into prenatal screening strategies to detect Down syndrome (DS) in singleton pregnancies in Turkey; the likely costs or savings associated with NIPT in comparison to the current practice were calculated. Methods: A decision-analytic model was developed to calculate the cost estimates for 1,309,771 women who gave birth in 2016; 84.8% of whom were <35-years-of-age. The superior combined test (CT) among current strategies is compared with contingent NIPT for women <35-years-of-age; and usual practice of amniocentesis (AC) for women >= 35 years-of-age was replaced with universal NIPT. Results: When the market price of NIPT (1,077 PPPUS$) is used, contingent NIPT offered to high-risk women <35-years-of-age adds 34,907,225 PPPUS$; and for women-35 >= years-of-age the universal NIPT leads to 142,785,818 PPPUS$ more cost to the government compared to current strategies. The additional costs with NIPT are partially compensated by the cost-savings due to reduction of the number of invasive tests and procedure related losses (17,826,476 PPPUS$ for women <35-years-of-age and 37,070 PPPUS$ for women >= 35-years-of-age). Results are sensitive to the NIPT costs; with a lower cost of NIPT, a total saving would be 33,116,046 PPPUS$ with new strategies. Conclusions: NIPT might be the choice of prenatal screening strategies if its price is lowered to economically acceptable levels. Until that time, currently accepted protocols seem to be more realistic. On the other hand, decision makers should also consider possible savings and the women's quality of life that can be improved with the new technology. (C) 2019 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.