Financial Sustainability of Turkish Health Care System

Abstract

Sustainability in health care systems, and how to attain financial sustainability through reform are among the main topics discussed by policy makers today. The aim of this study is to determine the experts’ viewpoints about financial sustainability of the health care system in Turkey, and to determine the financial sustainability status of system and the public university hospitals, also to suggest the policies required to create a sustainable health care system. This study brings together viewpoints of experts, and recent financial data of health care system and public university hospitals. Both qualitative and quantitative research methods are employed in this study. The qualitative data, which are obtained through semi-structured interviews, evaluated through content analysis. The quantitative data are obtained from publicly avaiable data sources and Revolving Fund Financial Management System. For statistical analysis, revenue and expenditure of health care system are compared. Ratio analysis and Grey Relational Analysis are used in assessing financial sustainability of public university hospitals. The content analysis results indicates that an important proportion of expertsthink that Turkey health system faced with unsustainability problem. The results for the comparison of health spending with basic macroeconomic variables reveal that increase in health expenditure has been greater than economic growth since the 1980s; but financial sustainability has become possible because of the increasing gross national product and following health reforms implemented after 2003. The ratio analysis results indicate that public university hospitals cannot meet the criteria for financial sustainability and , but can meet cost of services, and cannot meet operating expenses. Finally, the Grey Relational Analysis results reveal significant variability in hospital performance in terms of financial sustainability within each year.