Zeynep Güldem ÖKEM

Micro and Macro Aspects of Health Economics in Turkey

2007

(Supervisor: Fatma Doğruel)

ABSTRACT

There has been a major shift in economic policies in Turkey after 1980. The Structural Adjustment Policies implemented in this context required an increased role for the market and a reduced role of the state in economic activities. These policies caused increased poverty, impeded social development, particularly in terms of the health services.  A significant observation as to the post 1980 health sector in Turkey has been inequity in finance and provision of health care. The government health expenditures could not be reduced and health service provision could not be improved.

Equity is both an analytical tool for assessing public responsiveness to the health care needs of the population and an objective for the health sector. Due to imperfections in the functioning of the health care market, there is a need for government activity. As such, equity guides government in areas requiring intervention to improve finance and provision in health services. Health care resources should be allocated according to need, where they are needed most. In this way, improved equity in health sector brings increased efficiency.  Based on the data derived from a Health Services Utilization Survey (1992), the findings of the equity analysis of the health sector in Turkey indicated that access to health services has been significantly restricted in terms of financial status and geographical location.

The study also queries the relevance of health status, as representative of human capital, in testing convergence in growth rates among provinces in Turkey.  A Chronic Disease Index (CDI) is derived from the aforementioned equity analysis and used in convergence estimation. The findings suggested that the differences in health status have been effective in explaining conditional convergence among provinces.  The CDI also constitutes a better indicative, as compared to conventional development indices, for sector specific intervention requirements. This implies that an equity-based measurement provides a better guidance in meeting sectoral requirements.