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OECD Reviews of Health Care Quality: Turkey 2014

Raising Standards

image of OECD Reviews of Health Care Quality: Turkey 2014

Turkey underwent a very ambitious reform programme  in 2003, the so-called "Health Transformation Programme". Access to healthcare in Turkey has greatly increased with the attainment of Universal Health Coverage, as also demonstrated by improvement in health outcomes, most notably around maternal and child health and infectious diseases. However, despite these significant achievements, Turkey has a significant way to travel to deliver high-quality health services to its population. Governance of the health system is highly centralised and typified by directive control from the Ministry of Health, and information collected in different part of the system is not always fully exploited.

The OECD Review of Health Care Quality in Turkey recommends a number of changes to address these shortcomings. The key recommendations are that: i) Turkey needs to develop robust systems to standardise and monitor the quality of care, encourage continuous professional development and incorporate patient views; ii) some loosening of the governance structure would be welcome, to allow regions greater flexibility to assess and respond to local health needs and to continue to provide health workers with incentives for improve quality; iii) data on health sector activity and outcomes need to be made more available and more usable for individual patients and clinicians, while greater effort is needed to increase the robustness of Turkey’s information systems at national level and harmonise performance measures to OECD and other international comparators.

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Paying for health care in Turkey

This chapter focuses on the role of payment systems in supporting the development of Turkey’s health-care system and improving the health of the Turkish people. The last decade of health reform in Turkey has seen high levels of spending directed at maximising the services delivered by a low number of health professionals. A key feature of Turkish health policy has been the use of performance-based payments that link the salaries of specialists working in public hospitals to the number of services they deliver. The approach has been different in primary care, where steep financial penalties have been introduced where doctors do not deliver a basic set of child and maternal health services. The combination of these reforms has served its purpose in achieving one of the more remarkable extensions of health care to the population in the last half century. To prepare the health-care system for tomorrow’s challenges, policy makers now need to grapple with how payment systems can sensibly evolve to reward quality and not just quantity.

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