Ekonomi Bölümü Koleksiyonu

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1936

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Citation - WoS: 40
Citation - Scopus: 38
Clinical and Economic Burden Associated With Cardiovascular Events Among Patients With Hyperlipidemia: a Retrospective Cohort Study
(2016) Wang, Li; Quek, Ruben G. W; Fox, Kathleen M; Gandra, Shravanthi R; Li, Lu; Başer, Onur
Background: Annual direct costs for cardiovascular (CV) diseases in the United States are approximately $195.6 billion, with many high-risk patients remaining at risk for major cardiovascular events (CVE). This study evaluated the direct clinical and economic burden associated with new CVE up to 3 years post-event among patients with hyperlipidemia. Methods: Hyperlipidemic patients with a primary inpatient claim for new CVE (myocardial infarction, unstable angina, ischemic stroke, transient ischemic attack, coronary artery bypass graft, percutaneous coronary intervention and heart failure) were identified using IMS LifeLink PharMetrics Plus data from January 1, 2006 through June 30, 2012. Patients were stratified by CV risk into history of CVE, modified coronary heart disease risk equivalent, moderate-and low-risk cohorts. Of the eligible patients, propensity score matched 243,640 patients with or without new CVE were included to compare healthcare resource utilization and direct costs ranging from the acute (1-month) phase through 3 years post-CVE date (follow-up period). Results: Myocardial infarction was the most common CVE in all the risk cohorts. During the acute phase, among patients with new CVE, the average incremental inpatient length of stay and incremental costs ranged from 4.4-6.2 days and $25,666-$30,321, respectively. Acute-phase incremental costs accounted for 61-75 % of first-year costs, but incremental costs also remained high during years 2 and 3 post-CVE. Conclusions: Among hyperlipidemic patients with new CVE, healthcare utilization and costs incurred were significantly higher than for those without CVE during the acute phase, and remained higher up to 3 years post-event, across all risk cohorts.
Citation - WoS: 1
Citation - Scopus: 2
Determinants of Turkish Female Labour Force Participation: an Analysis With Manufacturing Firm-Level Data
(Taylor & Francis, 2020) Karamollaoğlu, Nazlı; Soybilgen, Barış
Compared to other developing countries, Turkey has a very low female labour participation rate. Previous studies usually focus on the labour supply side of female employment. Unlike the previous literature, this paper investigates firm-level determinants of female employment in manufacturing firms using a unique micro data set constructed using different sources. After controlling for geographical variation, firm, and industry-specific factors, our results show that larger firms, exporter firms, firms with higher part-time worker ratio, and foreign-owned firms have higher female employment rate whereas younger firms, firms with higher labour productivity, and firms with long working hours have lower female employment rate.
Citation - WoS: 3
Citation - Scopus: 4
Does Credit Composition Matter for Current Account Dynamics? Evidence From Turkey
(Taylor & Francis, 2016) Toraganlı, Nazlı; Ertuğrul, Hasan Murat
Based on a dynamic approach using the Kalman filter we depict effects of time-varying interactions between different components of credit stock on the current account in the Turkish Economy for the period 2002Q3–2014Q3. We decompose the credit stock into consumer and non-financial corporate sector credit and show empirically that both types of credit stock have negative effects on the current account dynamics
Citation - WoS: 9
Citation - Scopus: 12
Elevated White Blood Cell Levels and Thrombotic Events in Patients With Polycythemia Vera: a Real-World Analysis of Veterans Health Administration Data
(Elsevier Inc., 2019) Wang, Li; Parasuraman, Shreekant V.; Sulena Shrestha; Paranagama, Dilan C.; Yu, Jingbo; Scherber, Robyn Marie; Başer, Onur
Background: Patients with polycythemia vera (PV) have a substantial risk of thrombotic events (TEs). The objective of the present analysis was to describe the association between white blood cell (WBC) levels and occurrence of TEs among patients with PV from a large real-world population. Patients and Methods: The present retrospective analysis using Veterans Health Administration claims data (October 1, 2005, to September 30, 2012) evaluated adult patients assigned to 4 WBC count categories (WBC count < 7.0, 7.0-8.4, 8.5 to < 11.0, and ≥ 11.0 × 109/L) to compare the risk of TEs (reference, WBC count, < 7.0 × 109/L group). Analysis was performed using a Cox proportional hazards model, considering WBC status as a time-dependent covariate. Results: Of the 1565 patients with PV included in the present analysis, the WBC count was < 7.0 × 109/L for 428 (27.3%), 7.0 to 8.4 × 109/L for 375 (24.0%), 8.5 to < 11.0 × 109/L for 284 (18.1%), and ≥ 11.0 × 109/L for 478 (30.5%). Of the 1565 patients, 390 (24.9%) had experienced a TE during the study period. The mean follow-up ranged from 3.6 to 4.5 years. Compared with the reference group (WBC count < 7.0 ×109/L), the hazard ratio for TEs was 1.10 (95% confidence interval [CI], 0.82-1.48; P = .5395), 1.47 (95% CI, 1.10-1.96; P = .0097), and 1.87 (95% CI, 1.44-2.43; P < .0001) for patients with a WBC count of 7.0 to 8.4, 8.5 to < 11.0, and ≥ 11.0 ×109/L, respectively. Conclusion: A positive, significant association between an increased WBC count of ≥ 8.5 ×109/L and the occurrence of TEs was observed in patients with PV. The potential thrombogenic role of WBCs in patients with PV supports the continued inclusion of WBC count control in disease management and evaluation of the response to therapy. © 2019 The AuthorsPatients with polycythemia vera (PV) have a substantial risk of thrombotic events (TEs). In the present retrospective analysis using Veterans Health Administration claims data, 25% of 1565 patients experienced a TE during follow-up. We observed a positive, significant association between white blood cell (WBC) counts ≥ 8.5 × 109/L and TE occurrence (reference, WBC count < 7.0 × 109/L), supporting continued inclusion of WBC count control in disease management. © 2019 The Authors
Citation - WoS: 5
Citation - Scopus: 5
Evidence for Financial Contagion in Endogenous Volatile Periods
(Wiley, 2015) Ulusoy, Veysel; Kılıç, Erdem
The objective of this study is to analyze cross-border contagious dynamics in both foreign exchange markets and stock exchange markets. Propagation is analyzed with respect to the transmission of excessive volatility that is endogenously determined. The contagion process is discussed in the context of financial systems, foreign direct investments and trade. Implementing a vector autoregressive-multivariate generalized autoregressive conditional heteroskedasticity (VAR-MGARCH) model, we show that country-specific turbulence in financial markets is able to create unanticipated financial contagion across countries. Diversified trade and financial relations decrease the risk of exposure to contagion from external markets. The world's largest economies, however, play a price-setter role, and diversification is of secondary importance. Asymmetric transmission of the empirically predicted contagion prevails in the latter case.
Citation - WoS: 6
Citation - Scopus: 8
Gendering Resistance: Multiple Faces of the Kurdish Women's Struggle
(Wiley, 2019) Göksel, Nisa
The article explores the Kurdish women's movement in Turkey by bridging two forms of resistance: those of guerrilla women fighters and of activist women. Based on my extensive ethnographic and archival research, I ask how women under conditions of war engage in different modes of resistance. In what ways does the "heroic resistance" of guerrilla women resonate with and/or contradict the everyday, "ordinary" struggles of activist women? The potent image of the Kurdish guerrilla woman that emerged in the early 1990s is constitutive of many other modes of political subjectivities, even among women who do not or cannot become guerrillas. One of those subjectivities is that of the activist woman. My analysis suggests that women's activism opens up a middle ground of action between "heroic" and "ordinary" resistance by reconciling revolutionary politics with everyday activism around gender-based violence, democracy, and human rights. Although both revolutionary movement participants and scholars of revolutionary resistance often contrast the "ordinary" with the realm of armed resistance, this article challenges this dichotomy. I take the two realms of resistance-the ordinary and the heroic-as the core constituents of revolutionary resistance, and I reconsider the gendered interplay between them.
Citation - WoS: 25
Citation - Scopus: 25
Impact of Switching From an Initial Tumor Necrosis Factor Inhibitor on Health Care Resource Utilization and Costs Among Patients With Rheumatoid Arthritis
(2015) Roy, Sanjoy; Ganguli, Arijit; Xie, Lin; Başer, Onur; Cifaldi, Mary
Purpose: Despite improved clinical outcomes for the majority of patients, nearly 30% of patients with rheumatoid arthritis (RA) who initiate tumor necrosis factor antagonist (anti-TNF) biologic agents fail to respond to their first-line anti-TNF and switch to another anti-TNF or a non-TNF biologic. How this change affects health care costs and resource utilization is unknown. We therefore compared RA patients taking first-line anti-TNFs who switched to a second anti-TNF versus those patients who switched to an alternate biologic. Methods: Health care claims data were obtained from a large US database for eligible adults with confirmed RA diagnoses who initiated anti-TNF treatment and switched to another biologic. Health care costs and utilization during the first 12 months' postswitch were compared. Generalized linear models were used to adjust for differences in demographic and clinical characteristics before switching. Findings: Patients who switched to a second anti-TNF rather than a non-TNF biologic were generally younger (53.0 vs. 55.3 years; P < 0.0001) and less likely to be female (79.7% vs. 82.7%; P = 0.0490). Of the 3497 eligible patients who switched from first-line anti-TNFs, 2563 (73.3%) switched to another anti-TNF and 934 (26.7%) switched to a non-TNF. Adalimumab was the most frequently prescribed (43.4%) second-line anti-TNF, and abatacept was the most common non anti-TNF (71.4%). Patients who switched to a second anti-TNF remained on their first medication for a significantly shorter period (342.5 vs 420.6 days; P < 0.0001) and had lower comorbidity indices and higher disease severity at baseline than those who switched to a non anti-TNF. After adjusting for baseline differences, patients who switched to second anti-TNFs versus a non-TNF incurred lower RA-related costs ($20,938.9 vs $22,645.2; P = 0.0010) and total health care costs ($34,894.6 vs $38,437.2; P = 0.0010) 1 year postswitch. These differences were driven by increased physician office visit costs among the non-TNF group. Implications: Among the anti-TNF initiators who switched therapy, more patients switched to a second anti-TNF than to a non-TNF. Switching to a second anti-TNF treatment was associated with lower all-cause and RA-related health care costs and resource utilization than switching to a non-TNF. Because switching therapy may be unavoidable, finding a treatment algorithm mitigating this increase to any extent should be considered. These data are limited by their retrospective design. Additional confounding variables that could not be controlled for may affect results. (C) 2015 The Authors. Published by Elsevier HS journals, Inc.
Citation - Scopus: 1
Infant Mortality in Turkey: Causes and Effects in a Regional Context
(Wiley, 2020) Bilgel, Firat
This study attempts to identify the causal and/or direct effects of sociocultural determinants of infant mortality in Turkey within a regional context using causal graph analysis and global and local spatial models. The conceptual framework, combined with the data, shows that fertility and consanguinity have direct effects on infant mortality rates, and that female illiteracy, as a proxy for maternal education, is the main cause of rising infant mortality even in the presence of latent confounding. The surface of estimates further shows that the local effects of female illiteracy and consanguinity are non-stationary across space, calling for location-specific policies.
Citation - WoS: 7
Citation - Scopus: 7
Market Access and Regional Dispersion of Human Capital Accumulation in Turkey
(Wiley, 2020) Karahasan, Burhan Can; Bilgel, Fırat
Building on early advances in development economics, the theoretical construct of new economic geography asserts that geography plays a crucial role in educational human capital accumulation. Based on this expectation, this study investigates the impact of market access on provincial human capital accumulation in Turkey. Results indicate that market access matters for understanding why some regions lag behind others in terms of average years of schooling. Our results are robust to the inclusion of spatial mechanisms, different specifications of the spatial weight matrix, endogeneity and alternative measurements of market access and to a host of other factors that affect regional human capital accumulation.
Citation - WoS: 30
Citation - Scopus: 29
Out-Of Inr Values and Outcomes Among New Warfarin Patients With Non-Valvular Atrial Fibrillation
(2015) Schein, Jeffrey R; Wang, Li; Damaraju, Chandrasekharrao, V; Nelson, Winnie W; Başer, Onur
Background Although efficacious in stroke prevention in non-valvular atrial fibrillation, many warfarin patients are sub-optimally managed. Objective To evaluate the association of international normalized ratio control and clinical outcomes among new warfarin patients with non-valvular atrial fibrillation. Setting Adult non-valvular atrial fibrillation patients (a parts per thousand yen18 years) initiating warfarin treatment were selected from the US Veterans Health Administration dataset between 10/2007 and 9/2012. Method Valid international normalized ratio values were examined from the warfarin initiation date through the earlier of the first clinical outcome, end of warfarin exposure or death. Each patient contributed multiple in-range and out-of-range time periods. Main outcome measure The relative risk ratios of clinical outcomes associated with international normalized ratio control were estimated. Results 34,346 patients were included for analysis. During the warfarin exposure period, the incidence of events per 100 person-years was highest when patients had international normalized ratio < 2:13.66 for acute coronary syndrome; 10.30 for ischemic stroke; 2.93 for transient ischemic attack; 1.81 for systemic embolism; and 4.55 for major bleeding. Poisson regression confirmed that during periods with international normalized ratio < 2, patients were at increased risk of developing acute coronary syndrome (relative risk ratio: 7.9; 95 % confidence interval 6.9-9.1), ischemic stroke (relative risk ratio: 7.6; 95 % confidence interval 6.5-8.9), transient ischemic attack (relative risk ratio: 8.2; 95 % confidence interval 6.1-11.2), systemic embolism (relative risk ratio: 6.3; 95 % confidence interval 4.4-8.9) and major bleeding (relative risk ratio: 2.6; 95 % confidence interval 2.2-3.0). During time periods with international normalized ratio > 3, patients had significantly increased risk of major bleeding (relative risk ratio: 1.5; 95 % confidence interval 1.2-2.0). Conclusion In a Veterans Health Administration non-valvular atrial fibrillation population, exposure to out-of-range international normalized ratio values was associated with significantly increased risk of adverse clinical outcomes.
Citation - WoS: 8
Citation - Scopus: 8
Out-Of International Normalized Ratio Values and Healthcare Cost Among New Warfarin Patients With Non-Valvular Atrial Fibrillation
(2015) Wang, Li; Nelson, Winnie W.; Schein, Jeffrey R.; Damaraju, Chandrasekharrao, V; Başer, Onur
Patients with out-of-range international normalized ratio (INR) values <2.0 and >3.0 have been associated with increased risk of thromboembolic and bleeding events. INR monitoring is costly, because of associated physician and nurse time, laboratory resource use, and dose adjustments.
Citation - WoS: 59
Citation - Scopus: 60
Risk of Stroke/Systemic Embolism, Major Bleeding and Associated Costs in Non-Valvular Atrial Fibrillation Patients Who Initiated Apixaban, Dabigatran or Rivaroxaban Compared With Warfarin in the United States Medicare Population
(2017) Amin, Alpesh; Lien Vo; Trocio, Jeffrey; Keshishian, A; Liu, Xianchen; Mardekian, Jack; Zhang, Qisu; Rosenblatt, Lisa; Dina, Oluwaseyi; Başer, Onur; Le, Hannah
Objective: To compare the risk and cost of stroke/systemic embolism (SE) and major bleeding between each direct oral anticoagulant (DOAC) and warfarin among non-valvular atrial fibrillation (NVAF) patients. Methods: Patients (65 years) initiating warfarin or DOACs (apixaban, rivaroxaban, and dabigatran) were selected from the Medicare database from 1 January 2013 to 31 December 2014. Patients initiating each DOAC were matched 1:1 to warfarin patients using propensity score matching to balance demographics and clinical characteristics. Cox proportional hazards models were used to estimate the risks of stroke/SE and major bleeding of each DOAC vs. warfarin. Two-part models were used to compare the stroke/SE- and major-bleeding-related medical costs between matched cohorts. Results: Of the 186,132 eligible patients, 20,803 apixaban-warfarin pairs, 52,476 rivaroxaban-warfarin pairs, and 16,731 dabigatran-warfarin pairs were matched. Apixaban (hazard ratio [HR]=0.40; 95% confidence interval [CI] 0.31, 0.53) and rivaroxaban (HR=0.72; 95% CI 0.63, 0.83) were significantly associated with lower risk of stroke/SE compared to warfarin. Apixaban (HR=0.51; 95% CI 0.44, 0.58) and dabigatran (HR=0.79; 95% CI 0.69, 0.91) were significantly associated with lower risk of major bleeding; rivaroxaban (HR=1.17; 95% CI 1.10, 1.26) was significantly associated with higher risk of major bleeding compared to warfarin. Compared to warfarin, apixaban ($63 vs. $131) and rivaroxaban ($93 vs. $139) had significantly lower stroke/SE-related medical costs; apixaban ($292 vs. $529) and dabigatran ($369 vs. $450) had significantly lower major bleeding-related medical costs. Conclusions: Among the DOACs in the study, only apixaban is associated with a significantly lower risk of stroke/SE and major bleeding and lower related medical costs compared to warfarin.
State Gun Control Laws, Gun Ownership and the Supply of Homicide Organ Donors
(Elsevier, 2020) Bilgel, Fırat
The likelihood of being a potential deceased organ donor is higher for individuals who have been exposed to situations typically characterized by a severe head trauma or stroke that result in brain death. Employing count data models that account for overdispersion and/or excessive counts of zeros, this paper assesses the unintended consequences of enforcing stricter gun control laws and the effects of gun ownership on homicide organ donor supply in the United States using county data for the period 2009–2015. The findings confirm the transplantation paradox hypothesis that stricter gun control laws reduce the expected cases of gun homicides and thereby reduce deceased organ donor supply and exacerbate the organ shortage. The findings are robust to several measures of the strength of gun control laws, restricted samples and spurious outcome variables. However, the direction of the impact of gun ownership levels on homicide organ donor supply proved to be inconclusive.
Citation - WoS: 3
Citation - Scopus: 2
The Economic Impact of Symptomatic Menopause Among Low-Socioeconomic Women in the United States
(2016) Başer, Onur; Keshishian, A; Xie, Lin; Wang, Yuexi
Background: Menopausal symptoms have a significant negative impact on patient's quality of life and increase healthcare costs among women. Methods: This retrospective analysis used data from a U.S. national database (01 January 2008-31 December 2010). Patients with a diagnosis of menopause symptoms or a prescription claim for hormone therapy were matched to control patients. Healthcare resource utilization and costs during the 6-month follow-up period were compared. Generalized linear models were used to adjust for differences in baseline and demographic characteristics between the cohorts. Results: A total of 71,076 patients were included in each cohort. Patients with menopausal symptoms were more likely to have depression and anxiety and incurred significantly higher follow-up healthcare costs ($7237 vs $6739, p < 0.001) and healthcare utilization during the 6-month follow-up period. Conclusion: Patients diagnosed with menopausal symptoms or treated with hormone therapy incurred significantly higher healthcare costs than those without menopausal symptoms or treatment.
Citation - WoS: 19
Citation - Scopus: 18
Understanding the Relationship Between Effectiveness and Outcome Indicators To Improve Quality in Healthcare
(2018) Çınaroğlu, Songül; Başer, Onur
Healthcare institutions face significant challenges in implementing quality initiatives such as performance measurement. In the wake of multiple studies emphasising deficiencies in performance measurement in healthcare, measuring the performance of healthcare services to improve quality takes a great attention in the literature. Understanding the relationships between performance indicators is a first step for this. Effectiveness, which is one of the performance indicators in healthcare, reflects the effect of health interventions on health outcomes. Accessibility of services and utilisation are the two main dimensions of this concept. These indicators have the potential for improving outcomes, performance, and quality in health. This study explores the relationship between effectiveness and health outcome indicators as they relate to the development level and geographic region of 81 provinces in Turkey using a path analytic model. The numbers of hospitals and physicians are used as indicators of accessibility of healthcare services, while the average length of stay and number of surgical operations are used as indicators of utilisation. Life expectancy and general satisfaction from healthcare services are determined as outcome measures. According to the final path model, a strong relationship exists between accessibility indicators and health outcomes. A strong relationship was also found between life expectancy and general satisfaction with healthcare services, which are the objective and subjective outcome measures in healthcare, respectively. These results help our understanding of the relationship among key performance measures to improve health systems performance and quality.

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