What have health care reforms achieved in Turkey? An appraisal of the “Health Transformation Programme” |
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| Institution: | 1. Department of International Entrepreneurship, TOBB University of Economics and Technology, Sö?ütözü Cad No: 43, Sö?ütözü, Ankara 06560, Turkey;2. Department of Management, Ba?kent University, Ba?l?ca Kampüsü Eski?ehir Yolu 20. Km Ba?l?ca, Ankara 06810, Turkey;1. Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4BW, UK;2. Yunus Centre for Social Business and Health, Glasgow Caledonian University, Level 3—Buchanan House, 58 Port Dundas Road, Glasgow G4 0BA, UK;3. Institute of Health & Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK;1. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA;2. Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA;3. Department of Global Health & Population, Chan School of Public Health, Harvard University, 665 Huntington Ave., Rm 1115, Boston, MA 02115, USA;1. HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;2. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;1. Department of Public Health Dokuz Eylul University, Izmir, 35340, Turkey |
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| Abstract: | Poor health status indicators, low quality care, inequity in the access to health services and inefficiency due to fragmented health financing and provision have long been problems in Turkey's health system. To address these problems a radical reform process known as the Health Transformation Programme (HTP) was initiated in 2003.The health sector reforms in Turkey are considered to have been among the most successful of middle-income countries undergoing reform. Numerous articles have been published that review these reforms in terms of, variously, financial sustainability, efficiency, equity and quality. Evidence suggests that Turkey has indeed made significant progress, yet these achievements are uneven among its regions, and their long-term financial sustainability is unresolved due to structural problems in employment. As yet, there is no comprehensive evidence-based analysis of how far the stated reform objectives have been achieved. This article reviews the empirical evidence regarding the outcomes of the HTP during 10 years of its implementation.Strengthening the strategic purchasing function of the Social Security Institution (SSI) should be a priority. Overall performance can be improved by linking resource allocation to provider performance. More emphasis on prevention rather than treatment, with an effective referral chain, can also bring better outcomes, greater efficiency gains and contribute to sustainability. |
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| Keywords: | Healthcare reforms Turkey Efficiency Equity Financial sustainability Quality General/social health insurance Evidence-based evaluation Health Transformation Programme |
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