Impact of healthcare reforms on out-of-pocket health expenditures in Turkey for public insurees

• Published in: The European journal of health economics Vol. 13; no. 3; pp. 337 - 346
• Main Authors: Erus, Burcay, Aktakke, Nazli
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer 01.06.2012; Springer-Verlag; Springer Nature B.V
• Subjects: Adult; Civil service; Copayments; Economic Policy; Female; Health care; Health care expenditures; Health care industry; Health Care Management; Health care policy; Health Care Reform - economics; Health Care Reform - statistics & numerical data; Health Care Surveys; Health Economics; Health expenditures; Health Expenditures - statistics & numerical data; Health insurance; Health Services Accessibility - economics; Health Services Accessibility - statistics & numerical data; Health Status Disparities; Hospitals; Households; Humans; Income level; Insurance coverage; Insurance providers; Insurance, Health, Reimbursement - economics; Insurance, Health, Reimbursement - statistics & numerical data; Male; Medicine; Medicine & Public Health; Multivariate Analysis; Original Paper; Pharmacoeconomics and Health Outcomes; Physicians; Public Finance; Public Health; Reforms; Regulatory reform; Residence Characteristics - statistics & numerical data; Single-Payer System - economics; Single-Payer System - statistics & numerical data; Social insurance; Socioeconomic Factors; Studies; Turkey; Turkey; Health insurance; I18; Out-of-pocket health expenditures; Turkey; Financial burden; Health reform
• ISSN: 1618-7598; 1618-7601; 1618-7601
• DOI: 10.1007/s10198-011-0306-2

The Turkish healthcare system has been subject to major reforms since 2003. During the reform process, access to public healthcare providers was eased and private providers were included in the insurance package for public insurees. This study analyzes data on out-of-pocket (OOP) healthcare expenditures to look into the impact of reforms on the size of OOP health expenditures for premium-based public insurees. The study uses Household Budget Surveys that provide a range of individual-and household-level data as well as healthcare expenditures for the years 2003, before the reforms, and 2006, after the reforms. Results show that with the reforms ratio of households with non-zero OOP expenditure has increased. Share and level of OOP expenditures have decreased. The impact varies across income levels. A semi-parametric analysis shows that wealthier individuals benefited more in terms of the decrease in OOP health expenditures.