Improving health-care planning for fracture patients in T�rkiye: insights from a nationwide study

Birinci, �uayip; Bingol, Izzet; Bak�rc�o�lu, Sancar; Oral, Melih; Y�lmaz, Engin T�rkay; Ya�ar, Niyazi Erdem; Ata, Naim; �lg�, Mustafa Mahir; Bayram, Sinem; Dumlup�nar, Ebru; Kamaci, Saygin

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Improving health-care planning for fracture patients in T�rkiye: insights from a nationwide study [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2023; 29(10): 1184-1190 | DOI: 10.14744/tjtes.2023.01364

Improving health-care planning for fracture patients in T�rkiye: insights from a nationwide study

�uayip Birinci¹, Izzet Bingol², Sancar Bak�rc�o�lu³, Melih Oral⁴, Engin T�rkay Y�lmaz⁴, Niyazi Erdem Ya�ar⁵, Naim Ata⁶, Mustafa Mahir �lg�⁶, Sinem Bayram⁶, Ebru Dumlup�nar⁷, Saygin Kamaci⁴
¹Ministry of Health, Deputy Minister, Ankara-T�rkiye
²Health Sciences University, Faculty of Medicine, Ankara Oncology Training and Research Hospital, Ankara-T�rkiye
³Department of Orthopedics and Traumatology, Tobb University of Economics and Technology, Ankara-T�rkiye
⁴Department of Orthopedics and Traumatology, Hacettepe University, Ankara-T�rkiye
⁵Department of Orthopedics and Traumatology, Health Sciences University, Ankara Bilkent City Hospital, Ankara-T�rkiye
⁶Ministry of Health, General Directorate of Health Information Systems, Ankara-T�rkiye
⁷Department of Biostatistics, Ankara University, Faculty of Medicine, Ankara-T�rkiye

BACKGROUND: The distribution of fractures may vary according to age and gender. In a country like T�rkiye, which has high population density and covers a large geographical area, it is important to understand the regional variations in fractures and identify the health institutions in which patients seek treatment to plan new health-care investments effectively. The objective of our study was to investigate the distribution of fractures across the seven regions of T�rkiye considering age, gender, and the level of health institutions the patients visited.
METHODS: Between January 2021 and May 2023, the total number of fractures, locations of the fractures, patient age and gender, geographical regions, and levels of the health-care institutions to which the patients presented were examined through the e-Nab�z personal health record system. Age groups were divided into pediatric (0�19 years), adult (20�64 years), and geriatric (≥65 years) categories. Geographical regions included the Marmara, Central Anatolia, Black Sea, Eastern Anatolia, Aegean, Mediterranean, and Southeastern Anatolia regions.
RESULTS: A total of 2,135,701 patients with 2,214,213 fractures were analyzed. Upper extremity fractures were the most common among all considered fracture groups (1,154,819 fractures, 52.2%). There were 643,547 fractures in the pediatric group, 1,191,364 fractures in the adult group, and 379,302 fractures in the geriatric group. While the total number of fractures was higher among men with 1,256,884 fractures (58.9%), the rate among women was higher in the geriatric group (67.2%). Geographically, the highest number of fractures was observed in the Marmara region (714,146 fractures), and 67.92% of all patients presented to secondary health-care institutions (1,500,780 fractures). The most commonly diagnosed fracture in the study population was distal radius fractures. The most common fracture in the geriatric group was femur fractures while distal radius fractures were the most common fractures in the adult and the pediatric groups.
CONCLUSION: By understanding the distribution of fractures in T�rkiye based on fracture site, geographical region, age, and gender, it becomes possible to improve the planning of patient access to health-care services. In regions with limited health resources, a more successful resource distribution can be achieved by considering fracture distributions and age groups.

Keywords: Age, distribution; fracture; regions; T�rkiye.

T�rkiye'deki k�r�k hastalar� i�in sa�l�k hizmetleri planlamas�n�n iyile�tirilmesi: �lke �ap�nda bir ara�t�rmadan i�g�r�ler

�uayip Birinci¹, Izzet Bingol², Sancar Bak�rc�o�lu³, Melih Oral⁴, Engin T�rkay Y�lmaz⁴, Niyazi Erdem Ya�ar⁵, Naim Ata⁶, Mustafa Mahir �lg�⁶, Sinem Bayram⁶, Ebru Dumlup�nar⁷, Saygin Kamaci⁴
¹Sa�l�k Bakanl��, Bakan Yard�mc�s�, Ankara, T�rkiye
²Sa�l�k Bilimleri �niversitesi T�p Fak�ltesi, Ankara Onkoloji E�itim Ve Ara�t�rma Hastanesi, Ankara-T�rkiye
³Tobb Ekonomi Ve Teknoloji �niversitesi, Ortopedi Ve Travmatoloji Anabilim Dal�,Ankara-T�rkiye
⁴Hacettepe �niversitesi, Ortopedi Ve Travmatoloji Anabilim Dal�, Ankara, T�rkiye
⁵Sa�l�k Bilimleri �niversitesi, Ankara Bilkent �ehir Hastanesi, Ortopedi Ve Travmatoloji Klini�i, Ankara, T�rkiye
⁶Sa�l�k Bakanl��, Sa�l�k Bilgi Sistemleri Genel M�d�rl��, Ankara, T�rkiye
⁷Ankara �niversitesi T�p Fak�ltesi Biyoistatistik Anabilim Dal�, Ankara, T�rkiye

AMA�: K�r�klar�n da��l�m�, ya�a ve cinsiyete g�re de�i�ebilmektedir. T�rkiye gibi y�ksek n�fus yo�unlu�una ve b�y�k bir y�z�l��m�ne sahip bir �lkede k�r�klar�n b�lgelere g�re de�i�imi ve hastalar�n hangi sa�l�k kurulu�u basama��na ba�vurdu�unu bilmek yeni sa�l�k yat�r�mlar�n�n planlanmas�nda �nemli olabilmektedir. �al��mam�zda, T�rkiye�nin 7 b�lgesine g�re k�r�klar�n yerinin, ya�, cinsiyet ve ka��nc� sa�l�k kurulu�u basama��na ba�vuruldu�unun ara�t�r�lmas� ama�lanm��t�r.
GERE� VE Y�NTEM: Ocak 2021 ve May�s 2023 tarihleri aras�nda ki�isel sa�l�k kay�t sistemi olan E-nab�z �zerinden toplam k�r�k say�lar�, k�r�klar�n yerleri, ya�, cinsiyet, co�rafik b�lge ve ba�vurulan sa�l�k kurulu�unun basama�� incelendi. Ya� gruplar� pediatrik (0-19 ya�), eri�kin (20-64 ya�) ve geriatrik (≥65 ya�) olarak ayr�ld�. Co�rafi b�lgeler, Marmara B�lgesi (MR), �� Anadolu B�lgesi (�AR), Karadeniz B�lgesi (KR), Do�u Anadolu B�lgesi (DAR), Ege B�lgesi (ER), Akdeniz B�lgesi (AR), G�neydo�u Anadolu B�lgesi (GAR) olarak belirlendi.
BULGULAR: Toplam 2.135.701 hastan�n 2.214.213 k�r�� al��maya dahil edildi. En s�k �st ekstremite k�r�klar� g�r�ld�. (1.154.819 k�r�k, %52.2) Pediatrik grupta 643.547, eri�kin grupta 1.191.364, geriatrik grupta da 379.302 k�r�k g�r�ld�. Toplam k�r�k say�s� erkeklerde 1.256.884 (%58.9) ile daha fazla iken, geriatrik grupta kad�nlar�n oran� daha fazlayd� (%67.2). Marmara b�lgesi 714.146 k�r�k ile en s�k k�r�k g�r�len b�lgeydi. �kinci basamak sa�l�k kurulu�u ba�vuranlar�n oran� %67.92�idi (1.500.780 k�r�k). T�m populasyon genelinde en s�k g�r�len k�r�klar distal radius k�r�klar� ve parmak k�r�klar� olarak bulundu. Geriatrik hasta grubunda en s�k g�r�len k�r�klar femur k�r�klar� iken eri�kin ve pediatrik ya� gruplar�nda en s�k g�r�len k�r�k tipi distal radius k�r�klar� olarak bulundu.
SONU�: T�rkiye�de k�r�k da��l�m�n�n k�r�k yerine, b�lgelere, ya�a ve cinsiyete g�re bilinmesi ile hastalar�n sa�l�k hizmetine ula��m�n�n planlanmas� daha iyi yap�labilir. S�n�rl� sa�l�k kayna�� olan b�lgelerde k�r�k da��l�mlar� ve ya� gruplar� g�zetilerek daha ba��r�l� bir kaynak da��l�m� sa�lanabilir.

Anahtar Kelimeler: B�lge, da��l�m; k�r�k; T�rkiye; ya�.

Corresponding Author: Engin T�rkay Y�lmaz, T�rkiye
Manuscript Language: English

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