---
title: "Socio‑economic and financial profiles of companion animal clinics in Ankara: a k‑means cluster ana"
id: "plos-one-6-socio-economic-and-financial-characteristics-of-companion-animal-clinics-in"
canonical_url: "https://medichelpline.com/clinical-feed/plos-one-6-socio-economic-and-financial-characteristics-of-companion-animal-clinics-in"
content_type: "clinical_feed_article"
specialty: "General"
source_name: "PLOS ONE (Medicine)"
source_url: "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364"
published_at: "2026-08-31T14:00:00.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Socio‑economic and financial profiles of companion animal clinics in Ankara: a k‑means cluster ana
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/plos-one-6-socio-economic-and-financial-characteristics-of-companion-animal-clinics-in
- **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md)
- **Primary Source:** PLOS ONE (Medicine)
- **Source URL:** [Original Journal Publication](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364)
- **Published At:** 2026-08-31T14:00:00.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- This study surveyed 35 **companion animal clinics** in Ankara Province, Türkiye, using a 44‑indicator questionnaire to capture socio‑economic and financial characteristics. The survey was conducted in person between 10 June 2019 and 19 February 2020; participation was voluntary and data were anonymized. - Financial performance was evaluated using five metrics: **net profit margin**, cost‑to‑income ratio, labour productivity, profit per patient, and asset turnover ratio, each categorized into tertiles for analysis. - The authors applied Principal Component Analysis followed by **k‑means clustering** to identify clinic profiles based on the collected indicators. - Four clusters emerged: Cluster 1 (10 clinics, 28.6%) comprised multi‑service clinics with the highest monthly costs (~$8,616.77) and income (~$10,671.77) driven by diverse services and investments in staff and equipment; Cluster 2 (8 clinics, 22.9%) represented moderately costing, efficiency‑oriented clinics with stable income; Cluster 3 (8 clinics, 22.9%) were cost‑efficient, mainly cat‑focused clinics achieving the highest profitability (~$5,093.65); Cluster 4 (9 clinics, 25.7%) specialized in exotic animal care, had the lowest monthly income (~$5,023.83) and struggled to reach regular profitability. - Key differentiators among clusters were operating cost structure and strategy, income sources, and service variety. Clinics aligning costs with income streams and adapting services to client needs showed better financial performance. - Methodological limitations reported in the article include voluntary sampling and the absence of a comprehensive official registry, preventing calculation of a response rate or sampling proportion. - Data supporting the analyses are available in a public repository (UNIPD) as cited by the authors. The authors reported no specific funding and no competing interests.
## Clinical Analysis & Structured Key Points
[ Skip to main content ](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#main-content) Advertisement * [plos.org](https://plos.org/) * [Create account](https://community.plos.org/registration/new) * [Sign in](https://journals.plos.org/user/secure/login?page=%2Fplosone%2Farticle%3Fid%3D10.1371%2Fjournal.pone.0357364) * * About * Browse * Publish * [](https://journals.plos.org/plosone/ "PLOS One") * Search [advanced search](https://journals.plos.org/plosone/search) * [Browse Topics](https://journals.plos.org/plosone/subjectAreaBrowse) Browse Subject Areas ? Click through the PLOS taxonomy to find articles in your field. For more information about PLOS Subject Areas, click [here](https://github.com/PLOS/plos-thesaurus/blob/master/README.md "Link opens in new window"). [](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364) [](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364) * 0 [Save](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#savedHeader) [Total Mendeley and Citeulike bookmarks.](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#savedHeader) * 0 [Citation](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#citedHeader) [Paper's citation count computed by Dimensions.](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#citedHeader) * 40 [View](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#viewedHeader) [PLOS views and downloads.](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#viewedHeader) * 0 [Share](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#discussedHeader) [Sum of Facebook, Twitter, Reddit and Wikipedia activity.](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364#discussedHeader) Open Access Peer-reviewed Research Article # Socio-economic and financial characteristics of companion animal clinics in Ankara Province, Türkiye: A cluster-based classification * Arzu Peker , Contributed equally to this work with: Arzu Peker, Lorenzo Serva Roles Conceptualization, Data curation, Investigation, Methodology, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing Affiliation Department of Animal Health Economics and Management, Faculty of Veterinary Medicine, Ankara University, Ankara, Türkiye ⨯ * Lorenzo Serva , Contributed equally to this work with: Arzu Peker, Lorenzo Serva Roles Data curation, Methodology, Validation, Writing – original draft, Writing – review & editing * E-mail: lorenzo.serva@unipd.it Affiliation Department of Animal Medicine, Production and Health, University of Padova, Viale dell’Università 16, Legnaro, Padova, Italy [ ![ORCID logo](https://journals.plos.org/resource/img/orcid_16x16.png) https://orcid.org/0000-0003-0660-9637 ](https://orcid.org/0000-0003-0660-9637 "ORCID Registry") ⨯ * Yılmaz Aral , Roles Conceptualization, Investigation, Validation, Writing – review & editing ¶‡ YA, SO, OA and LM also contributed equally to this work. Affiliation Department of Animal Health Economics and Management, Faculty of Veterinary Medicine, Ankara University, Ankara, Türkiye ⨯ * Şükrü Orkan , Roles Data curation, Visualization, Writing – review & editing ¶‡ YA, SO, OA and LM also contributed equally to this work. Affiliation Department of Animal Health Economics and Management, Faculty of Veterinary Medicine, Ankara University, Ankara, Türkiye ⨯ * Oğuz Altın , Roles Data curation, Investigation, Visualization, Writing – review & editing ¶‡ YA, SO, OA and LM also contributed equally to this work. Affiliation Department of Animal Health Economics and Management, Faculty of Veterinary Medicine, Dicle University, Diyarbakır, Türkiye [ ![ORCID logo](https://journals.plos.org/resource/img/orcid_16x16.png) https://orcid.org/0000-0001-7767-4781 ](https://orcid.org/0000-0001-7767-4781 "ORCID Registry") ⨯ * Luisa Magrin Roles Methodology, Writing – original draft, Writing – review & editing ¶‡ YA, SO, OA and LM also contributed equally to this work. Affiliation Department of Animal Medicine, Production and Health, University of Padova, Viale dell’Università 16, Legnaro, Padova, Italy [ ![ORCID logo](https://journals.plos.org/resource/img/orcid_16x16.png) https://orcid.org/0000-0002-2153-6117 ](https://orcid.org/0000-0002-2153-6117 "ORCID Registry") ⨯ # Socio-economic and financial characteristics of companion animal clinics in Ankara Province, Türkiye: A cluster-based classification * Arzu Peker, * Lorenzo Serva, * Yılmaz Aral, * Şükrü Orkan, * Oğuz Altın, * Luisa Magrin ![PLOS](https://journals.plos.org/resource/img/logo-plos-full-color.svg) x * Published: August 31, 2026 * * [Article](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364) * [Authors](https://journals.plos.org/plosone/article/authors?id=10.1371/journal.pone.0357364) * [Metrics](https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0357364) * [Comments](https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0357364) * [Media Coverage](http://plos.altmetric.com/details/doi/10.1371/journal.pone.0357364) * [Abstract](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#abstract0) * [1. Introduction](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#sec001) * [2. Materials and methods](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#sec002) * [3. Results](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#sec010) * [4. Discussion](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#sec014) * [5. Conclusion](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#sec017) * [Supporting information](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#sec019) * [Acknowledgments](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#ack) * [References](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#references) * [Reader Comments](https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0357364) * [Figures](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364) ## Abstract Companion animal clinics are an integral part of urban veterinary practice. Yet such clinics face several challenges, including rising operational costs, intense market competition, and shifting pet owners’ expectations. In contrast to previous studies focused on veterinary business models, little in-depth examination of determinants of clinic performance has been conducted to date. To address this gap, the current study evaluated the socio-economic and financial characteristics of companion animal clinics in Ankara Province, Türkiye, using Principal Component Analysis followed by k-means clustering. A cross-sectional survey was conducted among the owners or managers of 35 companion animal clinics using a questionnaire comprising 44 indicators. Cluster 1 (10 clinics, 28.57%), which included multi-service clinics, had the highest costs ($8616.77) and income ($10671.77) due to service diversity and high investments in staff and equipment. Cluster 2 (8 clinics, 22.86%) included clinics characterized by moderate costs and stable income, oriented toward efficiency and targeted services. Cluster 3 (8 clinics, 22.86%) included cost-efficient clinics that mainly provided cat care and achieved the highest profitability of $5093.65. Cluster 4 (9 clinics, 25.71%) included clinics specializing in the care of exotic animals, with the lowest monthly income of $5023.83 and difficulties in achieving regular profitability. The results of our study revealed that the differences between clinic profiles are generally related to operating cost structures and strategies, income sources, and the variety of services provided to clients. Clinics that manage operational costs in line with income streams and adapt to client needs tend to perform better financially. In conclusion, veterinary professionals can use these insights to improve their strategies, optimize resource use, and improve financial performance. ## Figures ![Table 7](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t007) ![Table 8](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t008) ![Table 1](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t001) ![Table 2](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t002) ![Table 3](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t003) ![Table 4](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t004) ![Table 5](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t005) ![Table 6](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t006) ![Table 7](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t007) ![Table 8](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t008) ![Table 1](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t001) ![Table 2](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t002) ![Table 3](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t003) **Citation:** Peker A, Serva L, Aral Y, Orkan Ş, Altın O, Magrin L (2026) Socio-economic and financial characteristics of companion animal clinics in Ankara Province, Türkiye: A cluster-based classification. PLoS One 21(8): e0357364. https://doi.org/10.1371/journal.pone.0357364 **Editor:** Faham Khamesipour, MOHME: Iran Ministry of Health and Medical Education, IRAN, ISLAMIC REPUBLIC OF **Received:** March 10, 2025; **Accepted:** August 17, 2026; **Published:** August 31, 2026 **Copyright:** © 2026 Peker et al. This is an open access article distributed under the terms of the [Creative Commons Attribution License](http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. **Data Availability:** The minimal data set is available at the Research Data repository UNIPD, via . **Funding:** The author(s) received no specific funding for this work. **Competing interests:** The authors have declared that no competing interests exist. ## 1. Introduction In veterinary clinics, there is an interaction of many dynamics, including a client-focused culture. Today’s urban clinics face the need to meet changing client expectations while operating with limited resources, and therefore struggle to compete in various areas [[1](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref001)]. However, due to its significant contribution towards pet welfare and wellbeing, awareness of the business models is imperative for financial viability and service development. Successful practice in veterinary care is a combination of medical skill and additional professionally-related competencies, including communications, interpersonal skills, and business management skills [[2](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref002)]. In recent years in Türkiye, the number of private veterinary clinics operating for pets has been rapidly increasing and becoming widespread, especially in metropolitan cities such as Ankara, Istanbul and Izmir [[3](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref003)]. As one of the largest urban centers in Türkiye, Ankara has been witnessing a consistent increase in pet ownership, accompanied by increased awareness of animal welfare, changing social dynamics and increased demand for pets as a result of COVID-19 [[4](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref004),[5](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref005)]. The nature of city apartment living and modern lifestyles created an environment in which people preferred cats and even small dog breeds as companion animals [[6](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref006),[7](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref007)]. According to Chamber of Veterinary Surgeons Ankara Region, there are around 528 veterinary clinics (including companion animal, farm animal and mixed clinics) actively working in the region [[8](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref008)]. Veterinary clinics offer not only routine veterinary services but also offer diagnostics, pet hoteling, grooming and some speciality services [[9](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref009)]. However, some veterinarians have outdated views of their business model and believe that offering more complex services will provide them with financial and revenue advantages [[10](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref010)]. Although the industry is growing overall, veterinary clinics face numerous challenges. With high operating costs, intense competition, and constantly changing client demands [[11](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref011)], clinics are under considerable pressure to optimize their services in response to the market. For meaningful development of strategies by clinicians and policymakers for sustainable growth and better service delivery in the sector, these challenges must be understood through evidence-based knowledge of the socio-economic and financial dynamics peculiar to veterinary practices. Few prior studies have examined veterinary clinics in terms of economic and management aspects [[1](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref001),[3](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref003),[6](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref006),[11](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref011),[12](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref012)], but none have comprehensively combined socio-economic and financial data to identify socio-economic patterns among veterinary clinics. This study represents the first application of the k-means clustering approach to veterinary clinics by exploring their socio-economic and financial characteristics. Our study aims to identify k-means clusters based on socio-economic focus and financial performance by analyzing data from companion animal clinics in Ankara Province, Türkiye. This study, therefore, contributes to the literature on veterinary economics by providing a comprehensive framework that helps in understanding the financial and operational dynamics of the clinics that deal with companion animals. ## 2. Materials and methods ### 2.1. Selected veterinary clinics, study areas and structure of the questionnaire The study included data obtained from the cross-sectional survey conducted with 35 veterinary clinics (specialized in companion animals) located in Ankara province of Türkiye. A set of 44 indicators, important for representing clinics in socio-economic and financial analyses based on previous literature findings [[6](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref006),[11](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone.0357364.ref011)], formed the basis of the questionnaire, which was then used to interview 35 veterinary clinics. The participating companion animal clinics were recruited through voluntary participation. Because no comprehensive official registry of all eligible companion animal clinics operating in Ankara Province was available during the study period, the total target population could not be determined. Consequently, neither an exact response rate nor the sampling proportion could be calculated. Before conducting the surveys, a written Informed Consent Form was provided to each clinic owner, outlining the purpose, procedures, and confidentiality measures of the study. The surveys were conducted between 10.06.2019 and 19.02.2020, with each interview lasting approximately 60 minutes. Through in-person interviewing, both multi-choice and open-ended questionnaires have been utilized. All collected data were fully anonymized, and confidentiality was strictly maintained. This study did not involve the collection or use of medical records or archived samples, and at no point did the researchers have access to any personally identifiable information of the participants. [Tables 1](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone-0357364-t001) and [2](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357364#pone-0357364-t002) below present first variables—qualitative and quantitative, respectively—that act in statistics analysis as indicators. Five important financial metrics—profit margin, cost-to-income ratio, labour productivity, profit-per-patient, and asset turnover ratio—have been used to evaluate financial wellbeing and operational effectiveness for the clinics. [![thumbnail](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t001)](https://journals.plos.org/plosone/article/figure/image?size=medium&id=10.1371/journal.pone.0357364.t001 "Click for larger image") Download: * [PNG larger image](https://journals.plos.org/plosone/article/figure/image?download&size=large&id=10.1371/journal.pone.0357364.t001) * [TIFF original image](https://journals.plos.org/plosone/article/figure/image?download&size=original&id=10.1371/journal.pone.0357364.t001) Table 1. General characteristics of the veterinary clinics based on the qualitative variables. [ https://doi.org/10.1371/journal.pone.0357364.t001](https://doi.org/10.1371/journal.pone.0357364.t001) [![thumbnail](https://journals.plos.org/plosone/article/figure/image?size=inline&id=10.1371/journal.pone.0357364.t002)](https://journals.plos.org/plosone/article/figure/image?size=medium&id=10.1371/journal.pone.0357364.t002 "Click for larger image") Download: * [PNG larger image](https://journals.plos.org/plosone/article/figure/image?download&size=large&id=10.1371/journal.pone.0357364.t002) * [TIFF original image](https://journals.plos.org/plosone/article/figure/image?download&size=original&id=10.1371/journal.pone.0357364.t002) Table 2. General characteristics of the veterinary clinics based on the quantitative variables. [ https://doi.org/10.1371/journal.pone.0357364.t002](https://doi.org/10.1371/journal.pone.0357364.t002) For each of these five metrics, tertile segments have been developed for the clinics. ### 2.2. Calculation of financial performance parameters 1. **Net Profit Margin:** It can also be defined as the relation of net profit to tot
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