the comparsion between public, private and university hospitals in

The Journal of Academic Social Science Studies

International Journal of Social Science

Volume 6 Issue 3, p. 1299-1311, March 2013

THE COMPARSION BETWEEN PUBLIC, PRIVATE AND

UNIVERSITY HOSPITALS IN TERMS OF ONLINE WEB

SERVICES IN TURKEY

TÜRKİYE’DEKİ DEVLET, ÖZEL VE ÜNİVERSİTE HASTANELERİNİN ONLİNE

WEB SERVİSLERİ BAKIMINDAN KARŞILAŞTIRILMASI

Asst. Prof. Dr. Abdulkadir ÖZDEMİR Atatürk University Faculty of Economics and Administrative Sciences, Management Information

Systems

Selçuk BAKAN Atatürk University Research Hospital Information Technology Department

Associate. Prof. Dr. Abdullah NARALAN Atatürk University Faculty of Economics and Administrative Sciences, Management Information

Systems

Abstract

Nowadays, some opportunities such as accessing test results, making

appointment for treatment, making investigation for selection of doctors or

hospitals, informing advices or complains are some simple operations, and

contacting with doctors for consultation encourge people to use internet.

In this research, a comparison of providing online health services between

public, university and private hospitals have been made in terms of presenting

these services.

This study has been carried out as access and investigation of websites

between April and July 2011. More than 350 hospitals including public,

university, and private hospitals which are operating currently in the city centre

in Turkey have been included to this research. Hospitals without websites have

1300

Abdulkadir ÖZDEMİR – Selçuk BAKAN – Abdullah NARALAN

been excluded. The content of websites and the variety of health services has

been examined and links in websites has been checked that whether it works

properly.

Hospitals will provide presenting of health services online and taking

advantage of this services without going to hospitals for people who have to go

there personally. This kind of services provide commercial advantages, because

of the importance of time in these days.

Key Words: Internet, Web Sites, Health Services

Öz

Günümüzde hastaneye gitmek için sıra alma işleminin internetten

yapılabiliyor ve test sonuçlarına internetten erişilebiliyor olması, doktor

muayenesi için randevu alma, doktor seçimi için çalışma listelerine ulaşabilme,

hasta ve ailelerinin sağlık problemleri ile ilgili bilgi almada hekimlerle çevrimiçi

bağlantı kurabilme gibi imkanlar insanları interneti kullanmaya teşvik eder hale

gelmiştir.

Bu çalışmada hastane web sitelerinin internet üzerinden çevrimiçi olarak

verdikleri sağlık hizmetleri araştırılmış, kamu hastaneleri, üniversite hastaneleri

ve özel hastaneler arasında bu hizmetlerin sunumu açısından bir karşılaştırma

yapılmıştır.

Bu çalışma Nisan-Temmuz 2011 tarihleri arasında site erişim ve

incelemeleri şeklinde gerçekleştirilmiştir. Araştırmaya Türkiye genelinde ve şehir

merkezlerinde faaliyet gösteren 350’den fazla devlet hastanesi, üniversitesi

hastanesi ve A sınıfı özel hastane dahil edilmiştir. Web sitesi olmayan hastaneler

çalışma dışı bırakılmıştır. Sitelerin içerikleri incelenmiş, sitelerde çevrimiçi olarak

hangi sağlık hizmetlerinin verildiğine bakılmış ve verilen linklerin sağlıklı olarak

çalışıp çalışmadığı kontrol edilmiştir.

Hastane web sitelerinde çevrimiçi sağlık hizmetleri sunumu ile bu tür

hizmetleri almak için sağlık kurumuna bizzat gelmesi gereken insanların

bulundukları yerlerde bu hizmetlerden faydalanmasını sağlayacaktır. Zamanın

büyük bir öneme sahip olduğu günümüzde, insanlara kolaylık sağlayacak bu tür

hizmetler kuruluşlar açısından da ticari avantajlar sağlayacaktır.

Bu çalışma asli görevi sağlık hizmeti sunmak olan tüm hastanelerin, web

sitesine sahip olmaları, web sitesi olan hastanelerin de etkin olarak çevrimiçi

hizmet sunma gerekliliğini ortaya çıkarmaktadır.

Anahtar Kelimeler: İnternet, Web Sitesi, Sağlık Hizmetleri

The Comparsion Between Public, Private And University Hospitals

In Terms Of Online Web Services In Turkey 1301

INTRODUCTION

In recent years, development of information technology causes more usage of

internet in Turkey as in the world. Presenting more desirable options have generalized

usage of internet at home and workplaces. Internet has become usable more frequently

in many fields such as communication, education, shopping and banking.

In this research, a consideration of providing online health services between

public, university and private hospitals have been made in terms of presenting these

services. While conducting this study, with the ideas of which health services can be

provided online, what kind of health services can be useful for people, many important

hospitals’ websites has been visited in Turkey as in the world. These ideas constitutes

the main topics of this paper.

MATERIAL-METHOD

This study has been carried out as access and investigation of websites between

April and July 2011. Hospitals including 259 public, 55 university, and 48 A class

private hospitals which are operating currently in the city centre in Turkey have been

included to this research. Data of this study has been gathering with examining

hospitals’ websites. Hospitals without websites have been excluded from this study.

The content of websites and the variety of health services has been examined. Links in

websites has been checked that whether it works properly. During the research,

unreachable sites and sites in preparation phase has been identified and at the end of

the research, these sites has been visited again to update data.

FINDINGS

In this research, many different criterions have been examined, but only 11 of

them have been used.

Having a Web Site: This term can be summarised as having a website which is

in enterprise’s own servers. As shown in Table 1, University Hospitals have the highest

rate which is close to rate of Private Hospitals in terms of this service. However, Public

Hospitals have the lowest rate. Table 1. Having a Web Site

Public Hospitals University Hospitals Private Hospitals

Frequency

Percentage

Frequency

Percentage Frequen

cy Percent

age

Availabl

e 233 89,9 54 98,1 46 95,8

Unavaila

ble 26 10,1 1 1,9 2 4,2

Total 259 100 55 100 48 100

1302


Figure 1. Having a Web Site

Online Appointment: This system which is thought that it should be all kinds

of hospitals’ websites is provide making treatment appointment whenever patients

want without going to hospitals. Hence, they will not wait to take a place for treatment

and they will minimize the wasting of time. According to research, 60,1% of Public

Hospitals, 53,7% of University Hospitals, and 69,5% of Private Hospitals are providing

this service. As shown in Table 2, Private Hospitals have the highest percent, but

almost half of other kind of hospitals present the same service.

Table 2. Online Appointment


Frequen

cy

Percent

age

Frequen

cy Percentage

Frequen

cy

Percent

age

Availabl

e 140 60,1 29 53,7 32 69,5

Unavaila

ble 93 39,9 25 46,3 14 30,5

Total 233 100 54 100 46 100

Figure 2. Online Appointment

Getting Test Results Online: This is an online system which provides getting

test results which are studied in hospitals’ laboratories. This service is available in

Public Hospitals’ websites with higher percent as 95,3. At the same time, University

Hospitals and Private Hospitals provide this service with rate of 63% and 80,4%

respectively.



Table 3. Online Test Result


Frequen

cy

Percent

age

Frequen

cy Percentage

Frequen

cy

Percent

age

Availabl

e 222 95,3 34 63 37 80,4

Unavaila

ble 11 4,7 20 37 9 19,6

Total 233 100 54 100 46 100

Figure 3. Online Test Result

Online Doctor Selection: In this system, patients can get examined by doctor

who can be selected by them online. This service is available 42,5% of rate in Public

Hospitals’ websites, but University Hospitals’ and Private Hospitals’ have 1,9% and

4,3% of low rate. In Turkey, hospitals which depend on Ministry of Health and have

suitable physical infrastructure is presenting this service since October 2007. However,

this basic right for patient and their relatives is not valid for University and Private

Hospitals. It is identified that the rate of having this system is too low as shown in

Table 4.

Table 4. Online Doctor Selection


Frequen

cy

Percent

age

Frequen

cy Percentage

Frequen

cy

Percent

age

Availabl

e 99 42,5 1 1,9 2 4,3

Unavaila

ble 134 57,5 53 98,1 44 95,7

Total 233 100 54 100 46 100

1304


Figure 4. Online Doctor Selection

E-Membership: In this system, to be created a healthy file which includes all

information about patient, people can be a member of the websites. This service is

available 17,6% of rate in Public Hospitals’ websites, 11,1% of rate in University

Hospitals and 39,1% of rate in Private Hospitals. In case of increasing this rate, it can be

foreseen that patients and doctors can take advantage of it.

Table 5. E-Membership


Frequen

cy Percent

age Frequen

cy Percentage

Frequency

Percentage

Availabl

e 41 17,6 6 11,1 18 39,1

Unavaila

ble 192 82,4 48 88,9 28 60,9

Total 233 100 54 100 46 100

Figure 5. E-Membership

E-Consultation: In this system, online people and patient can get information

about health problems and healthy life. This service is available 39,5% of rate in Public

Hospitals’ websites, 22,2% of rate in University Hospitals and 34,8% of rate in Private

Hospitals. People can make interactive connections with doctors and get help about

their health problems by means of this service availability. Besides, people can take

advantage of online consultation.



Table 6. E-Consultation


Frequen

cy

Percent

age

Frequen

cy Percentage

Frequen

cy

Percent

age

Availabl

e 92 39,5 12 22,2 16 34,8

Unavaila

ble 141 60,5 42 77,8 30 65,2

Total 233 100 54 100 46 100

Figure 6. E-Consultation

E-Baby: With this online service, a portal is created on hospitals’ websites for

new born babies. In this system, all information about babies including diary, calendar

of vaccine and photo album are stored and the development of babies can be

monitored online. This service is available 3% of rate in Public Hospitals’ websites,

9,3% of rate in University Hospitals and 47% of rate in Private Hospitals as shown in

Table 7.

Table 7. E-Baby


Frequen

cy

Percent

age

Frequen

cy Percentage

Frequen

cy

Percent

age

Availabl

e 7 3 5 9,3 22 47,8

Unavaila

ble 226 97 49 90,7 24 52,2

Total 233 100 54 100 46 100

1306


Figure 7. E-Baby

E-Get Well Message: This service provides sending a get well message to

patients online. This service is available 18% of rate in Public Hospitals’ websites, 9,3%

of rate in University Hospitals and 32,6% of rate in Private Hospitals.

Table 8. E-Get Well Message


Frequen

cy Percent

age Frequen

cy Percentage

Frequency

Percentage

Availabl

e 42 18 5 9,3 15 32,6

Unavaila

ble 191 82 49 90,7 31 67,4

Total 233 100 54 100 46 100

Figure 8. E-Get Well Message

E-Visit: In this system, patients can be monitored and made interactive

conversations by means of cameras which are setup in hospital. This service is

available 0,086% of rate in Public Hospitals’ websites 3,7% of rate in University

Hospitals and 10,9% of rate in Private Hospitals. Both E-Get Well Message and E-Visit

services can be considered as a reducer of number of visitors. With increase of these

hospitals which are providing these services, the infection about hospitals can drop

and take under control undoubtedly. For this situation, both systems should use in all

kind of hospitals increasingly.

Table 9. E-Visit


Frequen

cy Percent

age Frequen

cy Percentage

Frequency

Percentage

Availabl

e 2 0,086 2 3,7 5 10,9

Unavaila

ble 231 99,14 52 96,3 41 89,1

Total 233 100 54 100 46 100



Figure 9. E-Visit

E-News: This system informs people with development, announcements, and

actual news about health and its system. This service is not presenting in Public and

University Hospitals at all, but Private Hospitals have 6,5% of rate as low.

Table 10. E-News


Frequen

cy

Percent

age

Frequen

cy Percentage

Frequen

cy

Percent

age

Availabl

e 0 0 0 0 3 6,5

Unavaila

ble 233 100 54 100 43 93,5

Total 233 100 54 100 46 100

Figure 10. E-News

E-Complain or Advice: In this system, patients and their relatives state

their positive and negative opinions. This service is available 59,2% of rate in Public

Hospitals’ websites 40,7% of rate in University Hospitals and 67,4% of rate in Private

Hospitals. For development and growth of an enterprise, it is so important to know the

opinion of people who buy service or goods. For this reason, faults, deficiencies about

management of hospital have to be seen to develop some strategies to prevent them.

On the other hand, with using this service on websites more effectively, the quality of

services can be improved in terms of people’s pleasure.

1308


Table 11. E-Complain or Advice


Frequen

cy

Percent

age

Frequen

cy Percentage

Frequen

cy

Percent

age

Availabl

e 138 59,2 22 40,7 31 67,4

Unavaila

ble 95 40,8 32 59,3 15 32,6

Total 233 100 54 100 46 100

Figure 11. E-Complain or Advice

All findings which are obtained in this research are shown in Table 12.

Table 12. Comparison of Hospitals’ Websites


Available

(%)

Unavailable

(%)

Available

(%)

Unavailable

(%)

Available

(%)

Unavailabl

e (%)

Having a Web Site 233 (89,9) 26 (10,1) 54 (98,1) 1 (1,9) 46 (95,8) 2 (4,2)

Online Appointment 140 (60,1) 93 (39,9) 29 (53,7) 25 (46,3) 32 (69,5) 14 (30,5)

Online Test Result 222 (95,3) 11 (4,7) 34 (63) 20 (37) 37 (80,4) 9 (19,6)

Doktor Seçimi 99 (42,5) 134 (57,5) 1 (1,9) 53 (98,1) 2 (4,3) 44 (95,7)

E-Membership 41 (17,6) 192 (82,4) 6 (11,1) 48 (88,9) 18 (39,1) 28 (60,9)

E-Consultation 92 (39,5) 141 (60,5) 12 (22,2) 42 (77,8) 16 (34,8) 30 (65,2)

E-Bebeğim 7 (3) 226 (97) 5 (9,3) 49 (90,7) 22 (47,8) 24 (52,2)

E-Get Well Message 42 (18) 191 (82) 5 (9,3) 49 (90,7) 15 (32,6) 31 (67,4)

E-Visit 2 (0,086) 231 (99,14) 2 (3,7) 52 (96,3) 5 (10,9) 41 (89,1)

E-News 0 (0) 233 (100) 0 (0) 54 (100) 3 (6,5) 43 (93,5)

E- Complain or Advice 138 (59,2) 95 (40,8) 22 (40,7) 32 (59,3) 31 (67,4) 15 (32,6)

Distribution of Services On the Basis of Hospital

Obtained findings on the basis of hospitals’ graphs show the relation of

presentation of services with different angles. As shown in the graphs, variety of

services in Private Hospitals is presenting a better way in comparison with Public and

University Hospitals.



Figure 12. The service rates of public hospitals’ websites

Figure 13. The service rates of university hospitals’ websites

1310


Figure 14. The service rates of private hospitals’ websites

CONCLUSION

Internet finds a widespread use within the health sector just like any other area

of the human life. People who need information about health now can also take

advantage of the internet. It is reported that İnternet more than half of the internet

users now use the internet to obtain information about matters related to health [1].

Also internet is a very valuable communication tool that helps health professionals,

patients and people who carry out research about health to establish communication

and share knowledge. In addition to the diagnosis and advice of the doctors, internet

helps patients to be proactive in relation to how to learn to maintain a healthy life style

[2]. One of the shortcomings of the health sector is that the knowledge base in relation

to health related matters and illnesses. Internet has played a role to overcome this

shortcoming. Internet not only is used as a knowledge base, but also is used as a tool to

prepare before a doctor visit. While some patients ask family or friends to gain

information, most of the patients use the internet to obtain this knowledge [3]. With the

advent of the internet the old way of doctor-patient relationship and the treatments

have changed, whereby the patients look into other options and information regarding

the health [4]. When an infinite source of knowledge base such as the internet meets

matters that are directly related to human health the importance of the hospital

websites became more pronounced. That enforces public, university and private

hospital website ownership rate increases, while making sure the websites are created

in more detail and kept up-to-date.

Rapid advances of information technologies gained more pace with the usage

of internet both in the world and in our country and in parallel to this the internet

usage in relation to the matters related to health became more wide spread. People use

internet before and after getting health treatments. In addition to websites about the



health, people also use internet by accessing hospital websites to gain information

about health, illnesses, treatment methods and ways, which medication to use etc. Not

only that, internet also helps make the whole process of health matters much simpler

and faster.

By means of developing internet technologies, some health services can be

given online as well. Accessing laboratories’ test results, making appointment for

treatment, making investigation for selection of doctors or hospitals, informing advices

or complains are some simple operations which can be done online. With that, internet

plays a critical role in terms of maintenance of people’ health.

Because of all these matters, there is a need to have a website and use it

effectively for public benefit in terms of online services.

In this research, online services which are presenting on websites of public,

university, and private hospitals has been considered in Turkey. According to research,

Private hospitals have high level of service quality more than other hospitals. Public

hospitals follow private hospitals in terms of number of service and its quality in

comparison with university hospitals. In other words, university hospitals can be

considered as the worst one in terms of presenting online health services.

To increase quality in health services and provide facilities in different angle for

people, Ministry of Health, universities and private hospitals should find ways to

present these services more effectively. On the other hand, online health services can

cause some problems. The first matter that can be considered is security of digital

environment. People have privacy in terms of personal information. This information

can be stolen by some malicious people. Therefore, the owners of websites have to take

measures to prevent this situation.

REFERENCES

1. POWELL, J.A., DARVELL, M., GRAY, J. A. M. “The Doctor, the Patient and the

World-Wide Web: How the Internet is Changing Healthcare”. Journal of the

Royal Society of Medicine, 96(2), 2003, s.s.74-76.

2. SALO, D., PEREZ, C., LAVERY, R., MALANKAR, A., BORENSTEIN, M.,

BERNSTEIN, S., “Tatient Education and the Internet: Do Patients want us to

provide them with medical web sites to learn more about their medical

problems?", The Journal of Emergency Medicine, 26(3), 2004, 293300, Elsevier Inc.

3. BUDTZ, S., WITT, K., “Consulting the Internet before visit to general practice.

Patients' use of the Internet and other sources of health information”,

Scandinavian Journal of Primary Health Care, 20(3), 2002, Taylor & Francis Health

Sciences (publisher), part of the Taylor & Francis Group.

4. ERDAL, M., SAYGILI, S., İnternet Sağlık Sektöründe Gizlilik ve Etik Standartlar, 2001,

Erişim tarihi: 06.01.2011 http://inet-tr.org.tr/inetconf7/bildiriler/41.doc.

http://inet-tr.org.tr/inetconf7/bildiriler/41.doc

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