Evaluation of public hospitals undergoing affiliation process with financial and organizational performance perspective

With regards to health institutions, affiliation is utilised as a merger or cooperation model and is accepted as a type of integration. Affiliation in health institutions can be achieved depending on different factors such as growth, organisational, financial, clinical and operational. Among these factors requiring affiliation, the ones made depending on organizational and financial factors are more preferred by health institutions. Affiliation, legislative work of which was completed in 2011 in Turkey, was introduced in 2013 entirely. The current study aims to determine the financial and organisational performance of the affiliation practice that has been in effect in Turkey for seven years and to evaluate the problems experienced in this process and the advantages and disadvantages provided by the system. In the study, a mixed method that combines qualitative and quantitative methods has been adopted as a method. In the quantitative part of the study, the financial and organisational performance of ten affiliated public hospitals, whose data was obtained from the Ministry of Health, before the merger and for the next year were evaluated with DEA (Data Envelopment Analysis). In the qualitative part of the study, the data obtained as a result of semi-structured interviews conducted to discover the experiences of administrators working in affiliated hospitals were evaluated with content analysis. At the end of the study, it was determined that there were partial improvements in fixed expenses, variable expenses and total income of hospitals, and the number of outpatients, inpatients and operations performed increased as a result of the effective use of their input resources. In addition, it was determined that affiliation has emerged as an imperative need, there are problems in the organizational context after affiliation, there are advantages and disadvantages of affiliation application, and it has created changes in both the organizational and financial structure of hospitals. Lastly, it was revealed that hospitals, universities and patients, who are the stakeholders of the affiliation practice, have made significant gains in this process, the process continues for the future of the application, the participation of all stakeholders should be ensured and the necessary corrections should be made by the competent authorities in order to develop the affiliation application.