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OECD ÜLKELERİNİN SAĞLIK SİSTEMİ VERİMLİLİĞİNİN İNCELENMESİ

Year 2023, Volume: 3 Issue: 2, 1 - 23, 29.12.2023

Tuğba Akça Pakize Yiğit Mail Özçelik

https://doi.org/10.61349/iesbad.1293232

Abstract

Küresel olarak sağlık harcamaları büyük bir artış trendi içindedir. Ancak sağlık hizmetlerine ayrılan kaynaklar sınırlıdır ve bu durum sistem düzeyinde verimliliğe yönelik tedbirleri zorunlu kılmaktadır. Araştırmanın amacı, 2003 ve 2019 yıllarına ait sağlık göstergeleri ile Ekonomik İş Birliği Örgütü ve Kalkınma Örgütü (OECD) ülkelerinin sağlık sistemi verimliliğini incelemektir. Çalışmada, Türkiye’nin sağlıkta dönüşüm öncesi ve devam eden süreçte OECD ülkeleri arasındaki verimlilik düzeyinin nasıl değişim gösterdiği de gözlemlenmiştir. OECD ülkelerinin sağlık sistemi verimlilik düzeylerinin belirlenmesinde, girdi odaklı Charnes, Cooper ve Rhodes (CCR) ve Banker, Charnes ve Cooper (BCC) Veri Zarflama Analizi (VZA) kullanılmıştır. Girdi ve çıktı değişkenleri arasındaki ilişki korelasyon analizi ile test edilmiş, verimli ve verimsiz ülkelerin girdi ve çıktı değişkenleri bakımından karşılaştırmaları Mann Whitney U testi ve bağımsız örneklem t testi ile incelenmiştir. VZA sonuçlarına göre, 2003 yılında 11 ülke toplam verimli (CCR), 13 ülke teknik verimli (BCC), 11 ülke ölçek verimli, 2019 yılında 5 ülke toplam verimli, 8 ülke teknik verimli, 5 ülke ölçek verimli olarak bulunmuştur. Türkiye 2003 ve 2019 yılı verilerine göre, hem CCR hem de BCC analiz modellerinde verimli çıkmıştır.

Keywords

OECD ülkeleri Sağlık sistemi Verimlilik Veri zarflama analizi

References

  • Afonso, A., & Aubyn, M. St. (2005). Non-Parametric Approaches to Education and Health Efficiency in OECD Countries. Journal of Applied Economics, 8(2), 227–246.
  • Afonso, A., & Aubyn, M. St. (2006). Relative Efficiency of Health Provision: A DEA Approach with Non-Discretionary Inputs. SSRN Electronic Journal, 33, 1-32.
  • Afonso, A., & Aubyn., M. St. (2007). Assessing health efficiency across countries with a two-step and bootstrap analysis. Applied Economics Letters, 18(15), 1427–1430.
  • Amponsah, S., & Amanfo, S.E. (2017). Efficiency and Productivity Growth in the Health Care Systems of Ghana : Regional Comparison Analysis using DEA. 1–34.
  • Aydın, A. (2019). OECD Ülkelerinin Sağlık Hizmetleri Etkinliğinin Veri Zarflama Analizi ile Değerlendirilmesi, Yüksek Lisans Tezi, Adnan Menderes Üniversitesi Sosyal Bilimler Enstitüsü, Aydın.
  • Banker, R. D., Charnes, A., & Cooper, W. W. (1984). Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis. Management Science, 30(9), 1078–1092.
  • Banker, R.D., Cooper, W., Seiford, L.M., & Zhu, J. (2011). Returns to scale in DEA. International Series in Operations Research & Management Science, 164, 41-70.
  • Behr, A., & Theune, K. (2017). Health System Efficiency: A Fragmented Picture Based on OECD Data. PharmacoEconomics - Open, 1(3), 203–221.
  • Çakmak, E., & Örkcü, H. H. (2016). Türkiye ’ deki İllerin Etkinliklerinin Sosyo- Ekonomik Temel Göstergelerle Veri Zarflama Analizi Kullanarak İncelenmesi. Sosyal Bilimler Enstitüsü Dergisi, 6(1), 30–48.
  • Çetin, V. R., & Bahçe, S. (2016). Measuring the efficiency of health systems of OECD countries by data envelopment analysis. Applied Economics, 48(37), 3497–3507.
  • Chai, P., Zhang, Y., Zhou, M., Liu, S., & Kinfu, Y. (2019). Technical and scale efficiency of provincial health systems in China: A bootstrapping data envelopment analysis. BMJ Open, 9(8), 1–9.
  • Cheng, Z., Cai, M., Tao, H., He, Z., Lin, X., Lin, H., & Zuo, Y. (2016). Efficiency and productivity measurement of rural township hospitals in China: a bootstrapping data envelopment analysis. BMJ open, 6(e011911), 1–10.
  • Cooper, W. W., Seiford, L. M., & Tone, K. (2006). Introduction to data envelopment analysis and its uses: With DEA-solver software and references, New York.
  • European Union. (2015). Comparative efficiency of health systems , corrected for selected lifestyle factors Final report. Içinde European Commision: C. Final Repo (s. 156).
  • Evans, D. B., Tandon, A., Murray, C. J. L., & Lauer, J. A. (2000). The comparative efficiency of National of Health Systems in producing health: An analysis of 191 countries. World Health Organization, 29(29), 1–36.
  • Gavurova, B., Kocisova, K., & Sopko, J. (2021). Health system efficiency in OECD countries: dynamic network DEA approach. Health Economics Review, 11(1), 1–25.
  • Gün, İ., Yılmaz, F., & Şenel, İ. K. (2021). Efficiency Analysis of Health Systems in World Bank Countries. Archives of Health Science and Research, 8(2), 147–152.
  • Hadad, S., Hadad, Y., & Simon-Tuval, T. (2013). Determinants of healthcare system’s efficiency in OECD countries. European Journal of Health Economics, 14(2), 253–265.
  • Helling, D. K., Nelson, K. M., Ramirez, J. E., & Humphries, T. L. (2006). Kaiser permanente Colorado region pharmacy department: Innovative leader in pharmacy practice. Journal of the American Pharmacists Association, 46(1), 67–76.
  • Hernández, A. R., & Sebastián, M. S. (2014). Assessing the technical efficiency of health posts in rural Guatemala: A data envelopment analysis. Global Health Action, 7(1), 1–9.
  • Hollingsworth, B., & Peacock, S. J. (2008). Efficiency measurement in health and health care. Içinde Efficiency Measurement in Health and Health Care.
  • Hurst, J., & Jee-hughes, M. (2000). Performance Measurement and Improvement in OECD Health Systems. Içinde OECD Labour Market and Social Policy Occasional Papers (Sayı 8).
  • Hussey, P. S., Vries, H.d., Romley, J., Wang, M. C., Chen, S. S., Shekelle, P.G., & McGlynn, E. A. (2009). A systematic review of health care efficiency measures: Health care efficiency. Health Services Research, 44(3), 784–805.
  • Keskin, H. İ. (2018). Türkiye’de Sağlıkta Dönüşüm Programı ve Kamu Hastanelerinin Etkinliği. Akdeniz Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 38, 124–150.
  • Kocaman, A. M., Mutlu, M.E., Bayraktar, D., & Araz, Ö. M. (2012). OECD Ülkelerinin Sağlık Sistemlerinin Etkinlik Analizi. Endüstri Mühendisliği Dergisi, 23(4), 14–31.
  • Kutlar, A., & Babacan, A. (2008). Türkiye’deki Kamu Üniversitelerinde CCR Etkinliği-Ölçek Etkinliği Analizi: DEA Tekniği Uygulaması. Kocaeli Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 15(1), 148–172.
  • Lee, S., & Kim, C. (2018). Estimation of association between healthcare system efficiency and policy factors for public health. Applied Sciences (Switzerland), 8(12).
  • Miszczynska, K., & Miszczyński, P. M. (2021). Measuring the efficiency of the healthcare sector in Poland – a window-DEA evaluation. International Journal of Productivity and Performance Management, 1–27.
  • Mujasi, P. N., Asbu, E. Z., & Puig-Junoy, J. (2016). How efficient are referral hospitals in Uganda? A data envelopment analysis and tobit regression approach. BMC Health Services Research, 16(1), 1–14.
  • OECD. (2016). Health at a Glance, Europe 2016 State Of Health In The Europe Cycle OECD. European Commission (pp:1-200).
  • OECD Statistics 2021. (2021). OECD. http://stats.oecd.org/. (Erişim Tarihi: 02.04.2021).
  • Özçelik, M. (2019). Türki̇ye sağlik si̇stemi̇ veri̇mli̇li̇ği̇ni̇n i̇ncelenmesi̇, Doktora Tezi, İstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
  • Özçelik M., & Yiğit P. (2020). Türkiye sağlık sistemi verimliliğinin incelenmesi. Cukurova Medical Journal, 45(3), 992–1017.
  • Özdemir, A. İ. (2009). Hizmet Sektörü Etkinliğinin Makro Düzeyde İncelenmesi: Karadeniz Ekonomik İşbirliği Teşkilatı Üyesi Ülkelerin Sağlık Sektörü Üzerine Bir Analiz. Erciyes Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 33, 189–204.
  • Ravangard, R., Hatam, N., Teimourizad, A., & Jafari, A. (2014). Factors affecting the technical efficiency of health systems: A case study of economic cooperation organization (ECO) countries (2004–10). International Journal of Health Policy and Management, 3(2), 63–69.
  • T.C. Sağlık Bakanlığı. (2015). Sağlık İstatistikleri 2014, No:1010. https://www.saglik.gov.tr/TR,84956/saglik-istatistikleri-yilligi-2014-yayinlanmistir.html (Erişim Tarihi: 10.12.2021).
  • Şener, M., & Yiğit, V. (2017). Sağlık Si̇stemleri̇ni̇n Teknik Veri̇mli̇li̇ği̇: OECD Ülkeleri̇ Üzeri̇nde Bi̇r Araştırma. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 1(26), 266–290.
  • Shafiee, M., Sangi, M., & Ghaderi, M. (2013). Bank performance evaluation using dynamic DEA A slacks-based measure approach. Data Envelopment Analysis and Decision Science, 4(3), 81–90.
  • Smarzewska, D., Wereda, W.S.& Jonczyk, J.A. (2022). Assessment of the Health Care System in Poland and Other OECD Countries Using the Hellwig Method. Int. J. Environ. Res. Public Health, 19 (16733),1-16.
  • Stefko, R., Gavurova, B., & Kocisova, K. (2018). Healthcare efficiency assessment using DEA analysis in the Slovak Republic. Health Economics Review, 8(6), 1–12.
  • Top, M., Konca, M., & Sapaz, B. (2019). Technical efficiency of healthcare systems in African countries: An application based on data envelopment analysis. Health Policy and Technology, 17(24), 1–7.
  • TÜİK.(2020). Türkiye İstatistik Kurumu. https://data.tuik.gov.tr/Bulten/Index?p=Health-Expenditure-Statistics-2019-33659 (Erişim Tarihi: 10.12.2021).
  • Yaşar, F., & Yıldırım, S. (2017). İmalat İşletmelerinde Etkinlik Ölçümü: Bist 100 Örneği. Bingöl Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 7(7), 193–220.
  • Yeşilyurt, E. (2007). Türkiye’de Eğitim Hastanelerinin Etkinlik Analizi. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 21(1), 61–74.
  • Yükçü, S., & Atağan, G. (2009). Etkinlik, Etkililik Ve Verimlilik Kavramlarinin Yarattiği Karişiklik. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 23(4), 1–13.
  • Zakowska, I., & Godycki-Cwirko, M. (2020). Data envelopment analysis applications in primary health care: a systematic review. Family practice, 37(2), 147–153.

EXAMINATION OF HEALTH SYSTEM EFFICIENCY IN OECD COUNTRIES

Year 2023, Volume: 3 Issue: 2, 1 - 23, 29.12.2023

Tuğba Akça Pakize Yiğit Mail Özçelik

https://doi.org/10.61349/iesbad.1293232

Abstract

Globally, health expenditures are in an increasing trend. However, the resources allocated to health services are limited and this necessitates measures for efficiency at the system level. The aim of the research is to examine the health indicators of 2003 and 2019 and the efficiency of the health system of the Organization for Economic Cooperation and Development (OECD) countries. In the study, it was observed how Turkey's efficiency level changed between OECD countries before and during the transition period in health. Input-oriented Charnes, Cooper and Rhodes ( CCR), and Banker, Charnes and Cooper ( BCC) Data Envelopment Analysis (DEA) were used to determine the efficiency levels of OECD countries. In order to determine the relationship between input and output variables, Pearson correlation analysis, differences in input and output variables of efficient and inefficient countries were examined with Mann-Whitney U test and t test. According to the DEA results, , 11 countries were found to be total efficiency (CCR) in 2003, 13 countries to be technically efficiency (BCC), 11 countries to scale efficiency, in 2019, 5 countries were total efficiency, 8 countries were technically efficiency, and 5 countries were scale efficiency. According to Turkey's 2003 and 2019 data, it was efficient in both CCR and BCC analysis models.

Keywords

OECD countries Health system Efficiency Data envelopment analysis

References

  • Afonso, A., & Aubyn, M. St. (2005). Non-Parametric Approaches to Education and Health Efficiency in OECD Countries. Journal of Applied Economics, 8(2), 227–246.
  • Afonso, A., & Aubyn, M. St. (2006). Relative Efficiency of Health Provision: A DEA Approach with Non-Discretionary Inputs. SSRN Electronic Journal, 33, 1-32.
  • Afonso, A., & Aubyn., M. St. (2007). Assessing health efficiency across countries with a two-step and bootstrap analysis. Applied Economics Letters, 18(15), 1427–1430.
  • Amponsah, S., & Amanfo, S.E. (2017). Efficiency and Productivity Growth in the Health Care Systems of Ghana : Regional Comparison Analysis using DEA. 1–34.
  • Aydın, A. (2019). OECD Ülkelerinin Sağlık Hizmetleri Etkinliğinin Veri Zarflama Analizi ile Değerlendirilmesi, Yüksek Lisans Tezi, Adnan Menderes Üniversitesi Sosyal Bilimler Enstitüsü, Aydın.
  • Banker, R. D., Charnes, A., & Cooper, W. W. (1984). Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis. Management Science, 30(9), 1078–1092.
  • Banker, R.D., Cooper, W., Seiford, L.M., & Zhu, J. (2011). Returns to scale in DEA. International Series in Operations Research & Management Science, 164, 41-70.
  • Behr, A., & Theune, K. (2017). Health System Efficiency: A Fragmented Picture Based on OECD Data. PharmacoEconomics - Open, 1(3), 203–221.
  • Çakmak, E., & Örkcü, H. H. (2016). Türkiye ’ deki İllerin Etkinliklerinin Sosyo- Ekonomik Temel Göstergelerle Veri Zarflama Analizi Kullanarak İncelenmesi. Sosyal Bilimler Enstitüsü Dergisi, 6(1), 30–48.
  • Çetin, V. R., & Bahçe, S. (2016). Measuring the efficiency of health systems of OECD countries by data envelopment analysis. Applied Economics, 48(37), 3497–3507.
  • Chai, P., Zhang, Y., Zhou, M., Liu, S., & Kinfu, Y. (2019). Technical and scale efficiency of provincial health systems in China: A bootstrapping data envelopment analysis. BMJ Open, 9(8), 1–9.
  • Cheng, Z., Cai, M., Tao, H., He, Z., Lin, X., Lin, H., & Zuo, Y. (2016). Efficiency and productivity measurement of rural township hospitals in China: a bootstrapping data envelopment analysis. BMJ open, 6(e011911), 1–10.
  • Cooper, W. W., Seiford, L. M., & Tone, K. (2006). Introduction to data envelopment analysis and its uses: With DEA-solver software and references, New York.
  • European Union. (2015). Comparative efficiency of health systems , corrected for selected lifestyle factors Final report. Içinde European Commision: C. Final Repo (s. 156).
  • Evans, D. B., Tandon, A., Murray, C. J. L., & Lauer, J. A. (2000). The comparative efficiency of National of Health Systems in producing health: An analysis of 191 countries. World Health Organization, 29(29), 1–36.
  • Gavurova, B., Kocisova, K., & Sopko, J. (2021). Health system efficiency in OECD countries: dynamic network DEA approach. Health Economics Review, 11(1), 1–25.
  • Gün, İ., Yılmaz, F., & Şenel, İ. K. (2021). Efficiency Analysis of Health Systems in World Bank Countries. Archives of Health Science and Research, 8(2), 147–152.
  • Hadad, S., Hadad, Y., & Simon-Tuval, T. (2013). Determinants of healthcare system’s efficiency in OECD countries. European Journal of Health Economics, 14(2), 253–265.
  • Helling, D. K., Nelson, K. M., Ramirez, J. E., & Humphries, T. L. (2006). Kaiser permanente Colorado region pharmacy department: Innovative leader in pharmacy practice. Journal of the American Pharmacists Association, 46(1), 67–76.
  • Hernández, A. R., & Sebastián, M. S. (2014). Assessing the technical efficiency of health posts in rural Guatemala: A data envelopment analysis. Global Health Action, 7(1), 1–9.
  • Hollingsworth, B., & Peacock, S. J. (2008). Efficiency measurement in health and health care. Içinde Efficiency Measurement in Health and Health Care.
  • Hurst, J., & Jee-hughes, M. (2000). Performance Measurement and Improvement in OECD Health Systems. Içinde OECD Labour Market and Social Policy Occasional Papers (Sayı 8).
  • Hussey, P. S., Vries, H.d., Romley, J., Wang, M. C., Chen, S. S., Shekelle, P.G., & McGlynn, E. A. (2009). A systematic review of health care efficiency measures: Health care efficiency. Health Services Research, 44(3), 784–805.
  • Keskin, H. İ. (2018). Türkiye’de Sağlıkta Dönüşüm Programı ve Kamu Hastanelerinin Etkinliği. Akdeniz Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 38, 124–150.
  • Kocaman, A. M., Mutlu, M.E., Bayraktar, D., & Araz, Ö. M. (2012). OECD Ülkelerinin Sağlık Sistemlerinin Etkinlik Analizi. Endüstri Mühendisliği Dergisi, 23(4), 14–31.
  • Kutlar, A., & Babacan, A. (2008). Türkiye’deki Kamu Üniversitelerinde CCR Etkinliği-Ölçek Etkinliği Analizi: DEA Tekniği Uygulaması. Kocaeli Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 15(1), 148–172.
  • Lee, S., & Kim, C. (2018). Estimation of association between healthcare system efficiency and policy factors for public health. Applied Sciences (Switzerland), 8(12).
  • Miszczynska, K., & Miszczyński, P. M. (2021). Measuring the efficiency of the healthcare sector in Poland – a window-DEA evaluation. International Journal of Productivity and Performance Management, 1–27.
  • Mujasi, P. N., Asbu, E. Z., & Puig-Junoy, J. (2016). How efficient are referral hospitals in Uganda? A data envelopment analysis and tobit regression approach. BMC Health Services Research, 16(1), 1–14.
  • OECD. (2016). Health at a Glance, Europe 2016 State Of Health In The Europe Cycle OECD. European Commission (pp:1-200).
  • OECD Statistics 2021. (2021). OECD. http://stats.oecd.org/. (Erişim Tarihi: 02.04.2021).
  • Özçelik, M. (2019). Türki̇ye sağlik si̇stemi̇ veri̇mli̇li̇ği̇ni̇n i̇ncelenmesi̇, Doktora Tezi, İstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
  • Özçelik M., & Yiğit P. (2020). Türkiye sağlık sistemi verimliliğinin incelenmesi. Cukurova Medical Journal, 45(3), 992–1017.
  • Özdemir, A. İ. (2009). Hizmet Sektörü Etkinliğinin Makro Düzeyde İncelenmesi: Karadeniz Ekonomik İşbirliği Teşkilatı Üyesi Ülkelerin Sağlık Sektörü Üzerine Bir Analiz. Erciyes Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 33, 189–204.
  • Ravangard, R., Hatam, N., Teimourizad, A., & Jafari, A. (2014). Factors affecting the technical efficiency of health systems: A case study of economic cooperation organization (ECO) countries (2004–10). International Journal of Health Policy and Management, 3(2), 63–69.
  • T.C. Sağlık Bakanlığı. (2015). Sağlık İstatistikleri 2014, No:1010. https://www.saglik.gov.tr/TR,84956/saglik-istatistikleri-yilligi-2014-yayinlanmistir.html (Erişim Tarihi: 10.12.2021).
  • Şener, M., & Yiğit, V. (2017). Sağlık Si̇stemleri̇ni̇n Teknik Veri̇mli̇li̇ği̇: OECD Ülkeleri̇ Üzeri̇nde Bi̇r Araştırma. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 1(26), 266–290.
  • Shafiee, M., Sangi, M., & Ghaderi, M. (2013). Bank performance evaluation using dynamic DEA A slacks-based measure approach. Data Envelopment Analysis and Decision Science, 4(3), 81–90.
  • Smarzewska, D., Wereda, W.S.& Jonczyk, J.A. (2022). Assessment of the Health Care System in Poland and Other OECD Countries Using the Hellwig Method. Int. J. Environ. Res. Public Health, 19 (16733),1-16.
  • Stefko, R., Gavurova, B., & Kocisova, K. (2018). Healthcare efficiency assessment using DEA analysis in the Slovak Republic. Health Economics Review, 8(6), 1–12.
  • Top, M., Konca, M., & Sapaz, B. (2019). Technical efficiency of healthcare systems in African countries: An application based on data envelopment analysis. Health Policy and Technology, 17(24), 1–7.
  • TÜİK.(2020). Türkiye İstatistik Kurumu. https://data.tuik.gov.tr/Bulten/Index?p=Health-Expenditure-Statistics-2019-33659 (Erişim Tarihi: 10.12.2021).
  • Yaşar, F., & Yıldırım, S. (2017). İmalat İşletmelerinde Etkinlik Ölçümü: Bist 100 Örneği. Bingöl Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 7(7), 193–220.
  • Yeşilyurt, E. (2007). Türkiye’de Eğitim Hastanelerinin Etkinlik Analizi. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 21(1), 61–74.
  • Yükçü, S., & Atağan, G. (2009). Etkinlik, Etkililik Ve Verimlilik Kavramlarinin Yarattiği Karişiklik. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 23(4), 1–13.
  • Zakowska, I., & Godycki-Cwirko, M. (2020). Data envelopment analysis applications in primary health care: a systematic review. Family practice, 37(2), 147–153.
There are 46 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Tuğba Akça 0000-0002-5608-1669

Pakize Yiğit 0000-0002-5919-1986

Mail Özçelik 0000-0003-0094-6050

Publication Date December 29, 2023
Published in Issue Year 2023 Volume: 3 Issue: 2

Cite

APA Akça, T., Yiğit, P., & Özçelik, M. (2023). OECD ÜLKELERİNİN SAĞLIK SİSTEMİ VERİMLİLİĞİNİN İNCELENMESİ. İstanbul Esenyurt Üniversitesi İşletme Ve Yönetim Bilimleri Fakültesi Sosyal Bilimler Araştırmaları Dergisi, 3(2), 1-23. https://doi.org/10.61349/iesbad.1293232
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