Health-care reform in Turkey: Far from perfect

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... Turkey is the only country that has more emergency room visits than the population of the country; therefore, the high frequency of emergency medicine attrition is not surprising. 20 Even if the participants did not report an assault, it is a fact that the emergency room is the most common place where violence against doctors occurs, which could also be a reason for quitting. 21 The Turkish Internal Medicine Specialty Society reported that internal medicine specialists examine 100 patients/day at policlinics and 500 patients/day during shifts. ...
Objective: We aimed to evaluate the association between specialty choices and personality traits and other possible factors amongst resident doctors in Bursa, Turkey. Method: This cross-sectional study involved 237 resident doctors who had been placed at the Medical Specialization Examination (MSE) between 2014-1015. The data was collected with the application of a questionnaire comprised of 33 questions and the Ten-Item Personality Inventory (TIPI). Student’s t tests and Mann-Whitney U tests were used for the analysis of continuous variables, while chi-square tests were used for categorical variables. Results: We reached 76.8% (n=182) of the target population. Among the participants, 93.4% reported that they would have been willing to participate in specialized training when they were senior medical students. Current specialization was the first choice in the exam for 57.4% of the participants. Top three reasons for choosing the current specialty were interest, working conditions and score at MSE. Sex, compulsory service participation and MSE scores were the variables that significantly affected internal/surgical specialty choices. After conducting the analysis for the top five specialties, internal medicine residents were found to be less open to new experiences (p=0.021). Conclusion: It has been shown that sex, compulsory service participation and MSE scores primarily affect internal/surgical specialty choices. Additionally, internal medicine residents’ personalities were less open to experiences. We believe that our results can be a guide for future studies.
... BB hizmetlerinin sürekliliğinin önündeki engellerden birisi de mesai saatleri dışında BB hizmetlerinin sağlanmasındaki güçlüklerdir. Bu durum hastaların mesai saatleri dışında kalan zamanlarda yoğun biçimde hastane acillerini kullanmalarına yol açmaktadır [21] . Ulaşılabilirliği artırabilecek veya destekleyebilecek telefon / e-postaile konsültasyon yollarına nadiren başvurulmakta, web tabanlı hizmetler ve randevu sistemleri yaygın kullanım alanı bulamamaktadır. ...
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Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with continuous learning, and simultaneous improvements in the health system, on both the demand side (increased health insurance coverage, expanded benefits, and reduced cost-sharing) and the supply side (expansion of infrastructure, health human resources, and health services).
Emergency services burden and critical patients, 2012 (in Turkish).
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