Impact of health policies on catastrophic health expenditures in Turkey

Abstract

Objectives: Turkish Health Transformation Program has been launched in 2003, to improve the availability, quality, and the use of primary health care services. The program aimed to rebuild Turkish health system and establish a national based health insurance coverage. According to TURKSTAT figures, the proportion of households with catastrophic health expenditure decreased from 0.81 in 2002 to 0.14 in 2012. However, the ratio increased to 0.31 in 2014. The aim of the study is to investigate the determinants of catastrophic health expenditure and investigate the impact of health policies and factors on catastrophic health expenditure in Turkey. Methods: Catastrophic health expenditure is calculated from a national representative data derived from TURKSTAT, Household Budget Survey, belonging to the time period 2010 - 2015. Proportion of households facing catastrophic health expenditure are calculated by using the methodology proposed by Ke Xu (Xu 2005). Results: The average spending values of household with positive health expenditure have been decreased on pharmacy-related products(-36%), medical services (doctors)(-71%), hospital services(-84%), dentistry, and laboratory services. However, there was an increase in the average spending value on other medical products(+76%), medical aids(+79%) and other services. The average spending values of household with catastrophic health expenditure have been decreased on pharmacy-related products(-64%), medical services (doctors)(-57%), dentistry, and laboratory services. However, there was an increase in the average spending value on other medical products(+79%), medical aids(+193%) and hospital services(+93%). Conclusions: As a result, the increase in the number of households with catastrophic health expenditure could be the result of changes in health policy may impact on medical products, tools and equipment for treatment, other medicinal products, medical aids, other services and hospital services. Further studies should be done to investigate this effect.