Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleYalnız künye2026Financial Simulation of Remote Healthcare Implementation Strategies in Türkiye: A Monte Carlo Analysis Based on Specialty-Specific Eligibility
Demir, Hüseyin; Akar, Tuncay; Mertoğlu, Süleyman; Burmaoğlu, Serhat; Tekinarslan, Merve
The expansion of universal health coverage in Türkiye has intensified pressure on public healthcare providers through high outpatient volumes that strain capacity and financial sustainability. Remote healthcare delivery has emerged as a potential strategy to improve efficiency and access. However, limited evidence exists on how remote outpatient care should be implemented across medical specialties within a universal payer system, or how alternative implementation strategies perform financially. This study evaluates the specialty-specific feasibility and financial impact of remote outpatient care using comprehensive administrative data from a large public training and research hospital in Izmir, supplemented by qualitative input from clinical specialists. The analysis includes 577,984 outpatient visits recorded in 2022 across major medical specialties. Eligibility for remote delivery is identified using observable clinical proxies—imaging requests, laboratory tests, and prescription issuance—to capture visits not requiring physical examination or procedural intervention. Results show that 121,248 visits (21.0%) are suitable for remote delivery, accounting for 16.2% of expenditures ($0.68 million out of $4.20 million). Remote eligibility varies substantially across specialties, with high suitability in dermatology and infectious diseases but limited applicability in device-dependent fields such as pulmonology. Four implementation scenarios are simulated over a 10-year horizon: Regulatory Compliance, Evidence-Based Specialty-Specific, Follow-Up Only, and Hybrid Progressive. The Regulatory Compliance scenario yields the shortest break-even period (3 years) and highest ROI (1185%). The Hybrid Progressive scenario, incorporating phased specialty expansion and AI-supported triage, requires higher upfront costs but generates the largest cumulative net savings ($1.39 million). The findings demonstrate that financially sustainable remote outpatient care can be achieved through carefully designed, specialty-specific implementation strategies.
- MakaleAçık Erişim2026Semantic Architecture and Knowledge Evolution of Endoscopic Submucosal Dissection Research: A Computational Bibliometric Analysis
Demir, Huseyin; Akar, Tuncay; Mertoglu, Suleyman; Tekinarslan, Merve
Aim: The overarching intellectual structure, dominant thematic clusters, and longitudinal evolution of the endoscopic submucosal dissection (ESD) literature have yet to be systematically mapped. This study aims to characterize the semantic and thematic architecture of ESD research through computational text analytics and to reveal latent structural patterns and temporal dynamics within this domain. Methods: A corpus of 1,000 peer-reviewed publications was processed through an eight-stage computational pipeline that incorporated word embedding-based semantic analysis, unsupervised clustering, Latent Dirichlet Allocation (LDA) topic modeling, inter-topic network analysis, and temporal trend modeling. The primary outcome was characterization of the semantic architecture of ESD research, whereas secondary outcomes included topic relationships, temporal evolution, and model performance metrics. Results: Semantic analysis revealed two dominant clusters: a technically oriented domain encompassing device innovation and procedural optimization and a clinically oriented domain addressing therapeutic outcomes, organ-specific protocols, and adverse event management. Topic modeling identified nine coherent thematic categories, with limited integration between technical and clinical research trajectories. Temporal analysis revealed a pronounced post-2024 shift toward upper-gastrointestinal applications, particularly esophageal and gastric ESD, with relative stagnation in colorectal investigations. The optimal semantic clustering solution achieved a silhouette score of 0.215, while the nine-topic LDA model demonstrated a coherence score of 0.39. Conclusion: This study provides the first data-driven macro-structural characterization of the ESD literature, revealing a persistent bifurcation between technical innovation and clinical application streams. These findings offer a strategic framework to help clinicians, investigators, and curriculum developers identify priority areas for advancement in therapeutic endoscopy.