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Citation - WoS: 4
Citation - Scopus: 6
Does the Unification of Health Financing Affect the Distribution Pattern of Out-Of Health Expenses in Turkey?
(Wiley, 2019-04-07) Çınaroğlu, Songül; Başer, Onur
Turkey has implemented health reforms for over a decade and has taken significant steps toward unifying health financing. This study investigated the financial burden associated with out-of-pocket (OOP) expenditures under universal health coverage, using national 2003–2015 household budget data from the Turkish Statistical Institute. Progress was evaluated using Kakwani–Suits indices and Lorenz concentration curves. The results indicate that overall, more than a decade after its unification, redistribution of wealth in the Turkish health financing system has benefitted the wealthy but not the poor. Both curve and index approaches (Kakwani index 2003 = -0.50; 2015 = -0.44) reveal an increasingly regressive pattern of OOP health expenditures. The effective use of fiscal space and good political leadership are essential for the successful continuation of reforms to combat poverty in Turkey.
Network Among Hta Ecosystem
(Springer Verlag, 2018-09-25) Çınaroğlu, Songül; Başer, Onur
This study intends to examine the main drivers of network relations among health technology assessment (HTA) organizations. Social network analysis was performed to determine the relations among HTA organizations and to visualize the main drivers of such collaboration. The members in HTA organizations such as International Society for Pharmacoeconomics and Outcomes Research, Health Technology Assessment international, International Network of Agencies for Health Technology Assessment, EuroScan, European Network for Health Technology Assessment, HTAsiaLink, and Health Technology Assessment Network for the Americas are said to create networks. Ten different HTA organizations were considered in the analysis, including the Ministry of Health (MoH) organizations, universities, for-profit organizations, and hospitals. The Fruchterman-Reingold algorithm was used to perform networking, and the average clustering coefficient and average path length were examined to measure collaborative performance. The network graph of the HTA ecosystem shows the highest collaborative frequency among HTA organizations, which are the members of MoH organizations, government agencies, universities, and nonprofit organizations. The average path length was 2.21, and the average clustering coefficient was 36.57, indicating an obvious clustering effect. The study results highlight that networking within the HTA ecosystem is driven by government organizations. Boosting the integration of the private sector into the system and creating data-sharing strategies are essential to foster HTA collaboration. Because HTA is shaped by local dynamics and no gold standard exists for HTA implementation, encouraging collaborative efforts is the only way to avoid redundant efforts and make health technologies available for everyone.
Citation - WoS: 19
Citation - Scopus: 19
Understanding the Relationship Between Effectiveness and Outcome Indicators To Improve Quality in Healthcare
(Routledge Journals, Taylor & Francis Ltd, 2016-12-27) Çınaroğlu, Songül; Başer, Onur
Healthcare institutions face significant challenges in implementing quality initiatives such as performance measurement. In the wake of multiple studies emphasising deficiencies in performance measurement in healthcare, measuring the performance of healthcare services to improve quality takes a great attention in the literature. Understanding the relationships between performance indicators is a first step for this. Effectiveness, which is one of the performance indicators in healthcare, reflects the effect of health interventions on health outcomes. Accessibility of services and utilisation are the two main dimensions of this concept. These indicators have the potential for improving outcomes, performance, and quality in health. This study explores the relationship between effectiveness and health outcome indicators as they relate to the development level and geographic region of 81 provinces in Turkey using a path analytic model. The numbers of hospitals and physicians are used as indicators of accessibility of healthcare services, while the average length of stay and number of surgical operations are used as indicators of utilisation. Life expectancy and general satisfaction from healthcare services are determined as outcome measures. According to the final path model, a strong relationship exists between accessibility indicators and health outcomes. A strong relationship was also found between life expectancy and general satisfaction with healthcare services, which are the objective and subjective outcome measures in healthcare, respectively. These results help our understanding of the relationship among key performance measures to improve health systems performance and quality.

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