The Turkish commercial health insurance industry

Physicians’ Concerns About Home Health Care in Turkey: How Supportive Are They?

Home health care is a low-cost alternative to traditional inpatient care and an appealing alternative for developing countries such as Turkey, where financial resources for health care are particularly scarce. To gain insight into the concerns of physicians regarding this possibility, a survey was administered to 200 physicians sampled at a large academic medical center in central Turkey. The results of the study indicate that 14% of the participants think that home health care in general is not appropriate for Turkey; however, 58% of participants felt that being close to one’s family when ill can have a significant effect on the course of the illness and recovery. The results of the study suggest that home health care is seen as an economically appealing but somewhat medically controversial area that nonetheless shows promise for future development in Turkey and other similarly developing countries.

Financial profiling of public hospitals: an application by data mining

This paper presents an application of the data mining method to determine the financial profiles of the public hospitals in Turkey. The study is based on the data compiled in 2004, covering 645 public hospitals run by the Ministry of Health (MoH) as the main provider of primary and secondary health services in Turkey. The public hospitals, currently financed by a mixture of funds allocated from the general budget and individually operated revolving funds, need urgent solutions to their financial problems as a part of an ongoing national reform effort. The analysis adopts the Chi-Square Automatic Interaction Detector (CHAID) decision tree algorithm, as one of the most efficient and up-to-date data mining method used for segmentation. The study has found that the public hospitals could be categorized by the CHAID into 12 different profiles in terms of their financial performance. These profiles have guided us in determining the key financial indicators to be focused upon in the public hospitals and present best practices to improve their respective financial performances. The findings have also allowed policy suggestions as to the financial strategies that may be considered in improving the financial performance of the public hospitals toward a successful health sector reform in Turkey.

National health system steps in Turkey: concerns of family physician residents in Turkey regarding the proposed national family physician system

Many countries are currently struggling with the public desire for improved health care and provision of basic services on the one hand, and the rising costs of health care on the other. Turkey is acutely experiencing this problem because of its relatively advanced level of economic development and its relatively low level of health status compared to Organization for Economic Cooperation and Development and European Union countries. Since 1990, there has been vigorous debate in the Turkish society regarding the best way to improve public health through improved primary health care. The current government is pursuing a proposal that has been mentioned before, but in a more serious effort than has been previously made. This is an approach to primary care based on systems such as those in the United Kingdom and in Germany, and the basic components are family physicians who have a particular list of patients whom they provide care for. Financing of the system is to be provided with a new general health insurance scheme. In this study, 38 family practice residents at the 3 major training hospitals for this specialty completed an investigator-designed questionnaire for the purpose of characterizing their concerns regarding this proposed system of primary health care delivery. The participants' responses indicated that the new system, which is known as the Family Physician System, will contribute importantly toward raising the overall level of health in Turkey. Specific expected benefits include closer patient-physician relationships, increased job satisfaction on the part of family physicians, and an overall increase in income for the physicians working in the system.

Job dissatisfaction among public hospital physicians is a universal problem: evidence from Turkey

Several recent reports show that many physicians feel discontented and unhappy with their work situation. This could be due in part to factors such as declining social status, loss of influence on health care organizations, and reduced income. The professional life of physicians is characterized by long working days and pressure for efficiency. This threatens the quality of patient care. In this study we investigated levels of job stress as well as job and life satisfaction among a sample of 168 physicians (80 women and 88 men) who work in a large government facility in Ankara, Turkey. A self-administered questionnaire was distributed to physicians to determine factors contributing to stress and job satisfaction. The most important results of the study show that the participants were unhappy with their salary, did not have enough time to follow developments in medicine, and had a limited social life due to heavy workloads. The results of the study show that physicians who work in public facilities have low motivation due to the nature of their organizations. Public hospital working conditions and staff salaries must be improved to promote health professionals and healthy society.

The pharmaceutical sales rep/physician relationship in Turkey: ethical issues in an international context

In many developed countries, the physician/pharmaceutical sales representative relationship has increasingly become the focus of ethical questions. Given this context, the purpose of the present study was to determine the ethical dilemmas faced by pharmaceutical sales representatives in Turkey in their relations with physicians, and to identify possible solutions. Through an investigator-designed questionnaire, the ethical problems perceived by 215 pharmaceutical sales representatives were quantitatively analyzed. Nearly all of the participants (96.7%) reported that they had faced ethical dilemmas in marketing drugs to physicians. The most commonly reported problems included paramedical requests (for free lab test kits, etc.) and the necessity of bargaining with physicians over the use of their firm's drugs by offering gifts and sponsorships. The participants in the study felt that physicians were the primary source of ethical problems in the marketing of drugs, and the participants' most highly ranked potential solution to these ethical problems was a better understanding, on the part of physicians, of the role of pharmaceutical sales representatives. At the end of this study, suggestions are given with a view to helping health policy makers understand and address the current controversies involving drug company representatives and physicians.

Appropriateness of admission and length of stay in a Turkish Military Hospital

The purpose of this study was to determine the extent of inappropriate days of stay in a Turkish military hospital, and to explore the variables correlated with these. A review was made of the medical records of surgery patients admitted to the hospital of Gülhane Military Medical Academy. To determine the appropriateness of lengths of hospitalization, a Turkish version of the Appropriateness Evaluation Protocol (AEP) was applied retrospectively. A total of 375 patients'files were reviewed; and 21.3% of the hospital admissions were evaluated as inappropriate. Multiple logistic regression analysis showed that inappropriate length of stay was significantly increased with relation to age, emergency status, military rank, and distance from the hospital to the patient's home. The results of the study suggest that changes in physicians' behavior and in the organization of hospital activities may be effective in improving the quality and efficiency of hospital care.