Journals / Journal of Health Systems and Policies / 2021 / Cilt: 3 - Sayı: 3

Regional Health Disparities in the Aftermath of Health System Reforms in Turkey

Pages
137–169
Publication Date
2021-12-15
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

To further reduce health inequities across regions, the quality aspect of healthcare provision needs to be prioritized.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Starting in 2003, Turkey introduced major health system reforms through the Health Transformation Program (HTP).
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Key Findings & Data:For this purpose, we use administrative records and individual-level data from the only regionally representative survey, Life Satisfaction Survey, undertaken by the Turkish Statistical Institute in 2013.
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Conclusion & Impact:To further reduce health inequities across regions, the quality aspect of healthcare provision needs to be prioritized.
🔬Design:Survey & Empirical Study
📍Scope:2003 Verileri
⚙️Variables:Health Status Disparities · Access to Health Care · Health Care Utilization

Abstract

Starting in 2003, Turkey introduced major health system reforms through the Health Transformation Program (HTP). The HTP aimed to address inequities in health care services across Turkey. This study explores whether regional disparities in several health care indicators persist ten years after the HTP. For this purpose, we use administrative records and individual-level data from the only regionally representative survey, Life Satisfaction Survey, undertaken by the Turkish Statistical Institute in 2013. First, the disadvantaged North-East, Middle-East, and South-East Anatolia regions experienced the most substantial increases in all health inputs and the odds of receiving the non-contributory Green Card insurance was also higher in these regions. Yet, there is still substantial disparity across regions in many health care access and satisfaction indicators. Especially, the disadvantaged regions still have lower utilization, lower satisfaction with healthcare, and lower subjective health scores in 2013 even after accounting for a wide range of control variables. While the HTP enabled the provision of a generous insurance benefits package, there is still room for progress in regional distribution of other major indicators such as subjective assessment of health, healthcare utilization, and satisfaction with health services. To further reduce health inequities across regions, the quality aspect of healthcare provision needs to be prioritized.

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Cite This Article

UGUR, Z., TİRGİL, A. (2021). Regional Health Disparities in the Aftermath of Health System Reforms in Turkey. Journal of Health Systems and Policies, Cilt: 3 - Sayı: 3, 137–169. https://ajindex.com/articles/773188

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References (12)

  1. Arsenault, C., English, M., Gathara, D., Malata, A., Mandala, W., & Kruk, M. E. (2019). Variation in competent and respectful delivery care in Kenya and Malawi: A retrospective analysis of national facility surveys. Tropical Medicine and International Health, 25,442-453.
  2. Atun, R. (2015). Transforming Turkey's health system-lessons for universal coverage. New England Journal of Medicine, 373,1285-1289.
  3. Atun, R., Aydın, S., Chakraborty, S., Sümer, S., Aran, M., Gürol, I., Nazlıoğlu, S., Özgülcü, Ş., Aydoğan, Ü., Ayar, B., Dilmen, U., Akdağ, R. (2013). Universal health coverage in Turkey: Enhancement of equity. The Lancet, 382,65-99.
  4. Baicker, K., Taubman, S. L., Allen, H. L., Bernstein, M., Gruber, J. H., Newhouse, J. P., Schneider, M.D., Wright, B.J., Zaslavsky, A.M., Finkelstein, A. N. (2013). The Oregon experiment-effects of medicaid on clinical outcomes. New England Journal of Medicine, 368,1713-1722.
  5. Banerjee, A., Duflo, E. (2011). Poor economics: A radical rethinking of the way to fight global poverty. New York: Public Affairs. Chaudhury, N., Hammer, J., Kremer, M., Muralidharan, K., Rogers, F. H. (2006). Missing in action: Teacher and health worker absence in developing countries. Journal of Economic Perspectives, 20,91-116.
  6. Das, J., Hammer, J. (2005). Which doctor? Combining vignettes and item response to measure clinical competence. Journal of Development Economics, 78,348-383.
  7. Dupas, P. (2009). What matters (and what does not) in households' decision to invest in malaria prevention? American Economic Review, 99,224-230.
  8. Engström, S., Foldevi, M., Borgquist, L. (2001). Is general practice effective? A systematic literature review. Scandinavian Journal of Primary Health Care, 19,131-144.
  9. Grogger, J., Arnold, T., León, A. S., Ome, A. (2014). Heterogeneity in the effect of public health insurance on catastrophic out-of-pocket health expenditures: The case of Mexico. Health Policy and Planning, 30,593-599.
  10. Gruber, J., Hendren, N., Townsend, R. M. (2014). The great equalizer: Health care access and infant mortality in Thailand. American Economic Journal: Applied Economics, 6,91-107. Hacettepe University Institute of Population Studies. (1994). Demographic Health Survey 1993, Ankara. Hacettepe University Institute of Population Studies. (2004). Demographic Health Survey 2003,
  11. Ankara.
  12. Karra, M., Fink, G., Canning, D. (2016). Facility distance and child mortality: A multi-country study of health facility access, service utilization, and child health outcomes