Financial protection in health in Turkey: the effects of the Health Transformation Programme.

Abstract:

:Financial protection should be the principal objective of any health system. Commonly used indicators for financial protection are out-of-pocket (OOP) payments as a share of total health expenditure and the amount of households driven into poverty by catastrophic health expenditures (CHEs). In the last decade, OOP health payments consisted of approximately one-fifth of the health finance resources in Turkey. Until the year 2008, Turkish health system covered different public and private financing programmes as well as different types of service provision. After 2008, universal financial coverage became a part of the Health Transformation Programme (HTP). This study aimed to evaluate the financial protection in health in the era of health reforms in Turkey between 2003 and 2009. Household expenditures were derived from nationally representative Turkish Household Budget Surveys (HBSs), 2003, 2006 and 2009. Proportion of households facing CHE and impoverishment are calculated by using the methodology proposed by Ke Xu. Probability of incurring and volume of OOP spending were assessed across the health insurance groups by two-part model approach using logistic and OLS regression methods. Our findings showed that the probability of incurring and volume of OOP spending increased gradually in publicly insured households between 2003 and 2009. However, there was a diminishing trend in CHE in Turkey during the period under consideration. The official data showing an ∼3-fold increase in per capita health care use since 2003 and our study findings on decreasing CHE in this period can be interpreted as positive impact of HTP. On the other hand, increased household consumption as a share of OOP health payment and the deterioration in the progressivity of OOP spending in this period should be monitored closely.

journal_name

Health Policy Plan

authors

Yardim MS,Cilingiroglu N,Yardim N

doi

10.1093/heapol/czt002

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

177-92

issue

2

eissn

0268-1080

issn

1460-2237

pii

czt002

journal_volume

29

pub_type

杂志文章
  • From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study.

    abstract::Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated s...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czp049

    authors: Jacobs B,Thomé JM,Overtoom R,Sam SO,Indermühle L,Price N

    更新日期:2010-05-01 00:00:00

  • The effectiveness of training in emergency obstetric care: a systematic literature review.

    abstract::Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the eviden...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czz028

    authors: Ameh CA,Mdegela M,White S,van den Broek N

    更新日期:2019-05-01 00:00:00

  • The worse the better? Quantile treatment effects of a conditional cash transfer programme on mental health.

    abstract::Poor mental health is a pressing global health problem, with high prevalence among poor populations from low-income countries. Existing studies of conditional cash transfer (CCT) effects on mental health have found positive effects. However, there is a gap in the literature on population-wide effects of cash transfers...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa079

    authors: Ohrnberger J,Fichera E,Sutton M,Anselmi L

    更新日期:2020-11-20 00:00:00

  • Review of international efforts to strengthen the global outbreak response system since the 2014-16 West Africa Ebola Epidemic.

    abstract::The 2014-16 West Africa Ebola epidemic was a watershed moment for global health. The outbreak galvanized global action around strengthening infectious disease prevention, detection and response capabilities. We examined the nascent landscape of international programmes, initiatives and institutions established in the ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czy102

    authors: Ravi SJ,Snyder MR,Rivers C

    更新日期:2019-02-01 00:00:00

  • Do home pregnancy tests bring women to community health workers for antenatal care counselling? A randomized controlled trial in Madagascar.

    abstract::Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tes...

    journal_title:Health policy and planning

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/heapol/czz080

    authors: Comfort AB,Juras RC,Bradley SEK,Ranjalahy Rasolofomanana J,Noeliarivelo Ranjalahy A,Harper CC

    更新日期:2019-10-01 00:00:00

  • Demand for private healthcare in a universal public healthcare system: empirical evidence from Sri Lanka.

    abstract::This paper examines healthcare utilization behaviour in Sri Lanka with special emphasis on the choice between costly private and free public healthcare services. We use a data set that combines nationwide household survey data and district level healthcare supply data. Our findings suggest that even with universal pub...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx085

    authors: Pallegedara A,Grimm M

    更新日期:2017-11-01 00:00:00

  • The impact of National Health Insurance on neonatal care use and childhood vaccination in Taiwan.

    abstract::The objective of this study was to assess the impact of National Health Insurance (NHI) on the utilization of neonatal care and childhood vaccination in Taiwan. Data are selected from two nationwide maternal and infant surveys undertaken in 1989 and 1996, which were funded by the Department of Health. The questionnair...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/17.4.384

    authors: Liu TC,Chen CS,Chen LM

    更新日期:2002-12-01 00:00:00

  • Targeting the poorest in a performance-based financing programme in northern Cameroon.

    abstract::Performance-Based Financing (PBF) is a promising approach to improve health system performance in developing countries, but there are concerns that it may inadequately address inequalities in access to care. Incentives for reaching the poor may prove beneficial, but evidence remains limited. We evaluated a system of t...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv130

    authors: Flink IJ,Ziebe R,Vagaï D,van de Looij F,van 't Riet H,Houweling TA

    更新日期:2016-07-01 00:00:00

  • Strengthening user participation through health sector reform in Colombia: a study of institutional change and social representation.

    abstract::The challenge of achieving community participation as a component of health sector reform is especially great in low- and middle-income countries where there is limited experience of community participation in social policy making. This paper concentrates on the social representations of different actors at different ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/16.suppl_2.52

    authors: Mosquera M,Zapata Y,Lee K,Arango C,Varela A

    更新日期:2001-12-01 00:00:00

  • Does donor proliferation in development aid for health affect health service delivery and population health? Cross-country regression analysis from 1995 to 2010.

    abstract:Background:Previous literature suggests that increasing numbers of development aid donors can reduce aid effectiveness but this has not been tested in the health sector, which has experienced substantial recent growth in aid volume and number of donors. Methods:Based on annual data for 1995-2010 on 139 low- and middle...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw164

    authors: Pallas SW,Ruger JP

    更新日期:2017-05-01 00:00:00

  • Community-Based Interventions for Newborns in Ethiopia (COMBINE): Cost-effectiveness analysis.

    abstract::About 87 000 neonates die annually in Ethiopia, with slower progress than for child deaths and 85% of births are at home. As part of a multi-country, standardized economic evaluation, we examine the incremental benefit and costs of providing management of possible serious bacterial infection (PSBI) for newborns at hea...

    journal_title:Health policy and planning

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/heapol/czx054

    authors: Mathewos B,Owen H,Sitrin D,Cousens S,Degefie T,Wall S,Bekele A,Lawn JE,Daviaud E

    更新日期:2017-10-01 00:00:00

  • Persistent low adherence to hypertension treatment in Kyrgyzstan: How can we understand the role of drug affordability?

    abstract::It is well known that cardiovascular diseases (CVD) are a growing cause of mortality and morbidity in low-and middle-income countries (LMIC). While hypertension (HTN), a leading risk factor for CVD, can be easily managed with widely available medicines, there is a huge gap in treatment for HTN in many LMIC. One such c...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw080

    authors: Murphy A,Jakab M,McKee M,Richardson E

    更新日期:2016-12-01 00:00:00

  • The effect of health insurance and health facility-upgrades on hospital deliveries in rural Nigeria: a controlled interrupted time-series study.

    abstract:Background:Access to quality obstetric care is considered essential to reducing maternal and new-born mortality. We evaluated the effect of the introduction of a multifaceted voluntary health insurance programme on hospital deliveries in rural Nigeria. Methods:We used an interrupted time-series design, including a con...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx034

    authors: Brals D,Aderibigbe SA,Wit FW,van Ophem JCM,van der List M,Osagbemi GK,Hendriks ME,Akande TM,Boele van Hensbroek M,Schultsz C

    更新日期:2017-09-01 00:00:00

  • A home visit-based early childhood stimulation programme in Brazil-a randomized controlled trial.

    abstract::Home visiting programmes are increasingly recognized as one of the most effective interventions to improve child health and development in low-income settings. However, the best platforms to deliver such programmes remain unclear. We conducted a randomized controlled trial to test the relative effectiveness of child d...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa195

    authors: Brentani A,Walker S,Chang-Lopez S,Grisi S,Powell C,Fink G

    更新日期:2021-01-26 00:00:00

  • Reproductive health and AIDS prevention in sub-Saharan Africa: the case for increased male participation.

    abstract::Reproduction is a dual commitment, but so often in much of the world, it is seen as wholly the woman's responsibility. She bears the burden not only of pregnancy and childbirth but also the threats from excessive child bearing, some responsibility for contraception, infertility investigation and often undiagnosed sexu...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/11.1.84

    authors: Mbizvo MT,Bassett MT

    更新日期:1996-03-01 00:00:00

  • Rehabilitating health services in Cambodia: the challenge of coordination in chronic political emergencies.

    abstract::The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress t...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/14.3.229

    authors: Lanjouw S,Macrae J,Zwi AB

    更新日期:1999-09-01 00:00:00

  • Eliciting health care priorities in developing countries: experimental evidence from Guatemala.

    abstract::Although some methods for eliciting preferences to assist participatory priority setting in health care in developed countries are available, the same is not true for poor communities in developing countries whose preferences are neglected in health policy making. Existing methods grounded on self-interested, monetary...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv022

    authors: Font JC,Forns JR,Sato A

    更新日期:2016-02-01 00:00:00

  • Managing the health care market in developing countries: prospects and problems.

    abstract::There is increasing interest in the prospects for managed market reforms in developing countries, stimulated by current reforms and policy debates in developed countries, and by perceptions of widespread public sector inefficiency in many countries. This review examines the prospects for such reforms in a developing c...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/9.3.237

    authors: Broomberg J

    更新日期:1994-09-01 00:00:00

  • Delivery-related complications and determinants of caesarean section rates in India.

    abstract::Caesarean section rates have been increasing worldwide, raising the question of the appropriateness of the selection of cases for the procedure. This paper examines the levels and correlates of delivery-related complications and caesarean section deliveries in 18 selected states of India in terms of specific maternal ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/17.1.90

    authors: Mishra US,Ramanathan M

    更新日期:2002-03-01 00:00:00

  • Health governance and healthcare reforms in China.

    abstract::This article examines the role of health governance in shaping the outcomes of healthcare reforms in China. The analysis shows that the failure of reforms during the 1980s and 1990s was in part due to inadequate attention to key aspects in health governance, such as strategic interactions among government, providers a...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs109

    authors: Ramesh M,Wu X,He AJ

    更新日期:2014-09-01 00:00:00

  • Evidence on access to medicines for chronic diseases from household surveys in five low- and middle-income countries.

    abstract::The 2011 United Nations (UN) General Assembly Political Declaration on Prevention and Control of Non-Communicable Diseases (NCDs) brought NCDs to the global health agenda. Essential medicines are central to treating chronic diseases such as hypertension and diabetes. Our study aimed to quantify access to essential med...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu107

    authors: Vialle-Valentin CE,Serumaga B,Wagner AK,Ross-Degnan D

    更新日期:2015-10-01 00:00:00

  • User fees and drug pricing policies: a study at Harare Central Hospital, Zimbabwe.

    abstract::In 1991, Zimbabwe introduced cost recovery measures as part of its programme of economic reforms, following a course taken by many developing countries. The system of user fees in public health care, aimed to 'protect and support the vulnerable groups' by exemption or incremental fees based on 4 income brackets. Drugs...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/10.3.319

    authors: Chisadza E,Maponga CC,Nazerali H

    更新日期:1995-09-01 00:00:00

  • Collaboratively reframing mental health for integration of HIV care in Ethiopia.

    abstract:BACKGROUND:Integrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes. METHOD:We describe a model for integrating complex specialty care wit...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu058

    authors: Wissow LS,Tegegn T,Asheber K,McNabb M,Weldegebreal T,Jerene D,Ruff A

    更新日期:2015-07-01 00:00:00

  • Investigating the remuneration of health workers in the DR Congo: implications for the health workforce and the health system in a fragile setting.

    abstract::The financial remuneration of health workers (HWs) is a key concern to address human resources for health challenges. In low-income settings, the exploration of the sources of income available to HWs, their determinants and the livelihoods strategies that those remunerations entail are essential to gain a better under...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv131

    authors: Bertone MP,Lurton G,Mutombo PB

    更新日期:2016-11-01 00:00:00

  • Do community factors have a differential impact on the health outcomes of boys and girls? Evidence from rural Pakistan.

    abstract::In countries with large gender disparities in health status, can investments in local communities mitigate the gender bias observed in intra-household resource allocations? This paper explores the evidence for gender differences in the impact of community prices and infrastructure on child nutritional outcomes. Standa...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czl007

    authors: Holmes J

    更新日期:2006-05-01 00:00:00

  • National and sub-national analysis of the health benefits and cost-effectiveness of strategies to reduce maternal mortality in Afghanistan.

    abstract:BACKGROUND:Afghanistan has one of the highest rates of maternal mortality in the world. We assess the health outcomes and cost-effectiveness of strategies to improve the safety of pregnancy and childbirth in Afghanistan. METHODS:Using national and sub-national data, we adapted a previously validated model that simulat...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs026

    authors: Carvalho N,Salehi AS,Goldie SJ

    更新日期:2013-01-01 00:00:00

  • Programmatic pathways to child survival: results of a multi-country evaluation of Integrated Management of Childhood Illness.

    abstract:OBJECTIVE:To summarize the expectations held by World Health Organization programme personnel about how the introduction of the Integrated Management of Childhood Illness (IMCI) strategy would lead to improvements in child health and nutrition, to compare these expectations with what was learned from the Multi-Country ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czi055

    authors: Bryce J,Victora CG,Habicht JP,Black RE,Scherpbier RW,MCE-IMCI Technical Advisors.

    更新日期:2005-12-01 00:00:00

  • Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso.

    abstract::Policy entrepreneurs are individuals who attempt to influence the policy process and its outcomes through their opportunistic or incremental actions. Their success in the policy-making process has been associated with the convergence of four factors: behavioural traits; institutional factors; network position and poli...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv044

    authors: Shearer JC

    更新日期:2015-12-01 00:00:00

  • 'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

    abstract::'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of tra...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu001

    authors: Mwacalimba KK,Green J

    更新日期:2015-03-01 00:00:00

  • The experience of purchaser-provider split in the implementation of family physician and rural health insurance in Iran: an institutional approach.

    abstract:BACKGROUND:The Iranian health system, under the banner of family physician (FP) programme, has undergone substantial reforms to change utilization of health services, improve quality of care and enhance affordability. The national implementation of FP initiated in 2005 in parallel with rural health insurance (RHI) in r...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu135

    authors: Takian A,Rashidian A,Doshmangir L

    更新日期:2015-12-01 00:00:00