This comprehensive review of Turkey's health care system shows that health status has improved rapidly in Turkey in recent decades, partly as a result of higher health spending. It describes the introduction of an ambitious Health Transformation Programme in 2003 which brought universal health insurance to Turkey in 2008 and has begun the process of public hospital reforms and the rolling out of family-practitioner services throughout the country. Challenges remain, however, including completing the Health Transformation Programme and ensuring that the new health system provides value for money and stays affordable. This report analyses these challenges and sets out policy suggestions aimed at addressing them.
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List of Abbreviations and Turkish Terms Executive Summary Chapter 1. Historical Overview of the Turkish Health System Prior to Recent Health Reforms -1.1. Health financing in Turkey in 2003 -1.2. Health expenditures and out-of-pocket payments -1.3. Provision of health services -1.4. Governance arrangements in the Turkish health sector -1.5. Conclusions -Annex 1.A1. Historical Overview of the Turkish health system and key policy developments Chapter 2. Recent Health Reforms in Turkey -2.1. The Health Transformation Programme -2.2. Health coverage and health financing reform in Turkey under the HTP (2003-2008) -2.3. Relationship between purchaser and provider -2.4. Service delivery reforms -2.5. Governance reforms under the HTP -2.6. Important cross-cutting issues: human resources and health information systems -2.7. Public health Chapter 3. The Performance of the Turkish Health System and its Determinants -3.1. Introduction -3.2. Performance assessment -3.3. Conclusions -Annex 3.A1. The performance of the Turkish health system based on comparisons with all countries of the world Chapter 4. Policy Challenges and Options for Further Reform -4.1. Introduction -4.2. The evidence-base on successful health care reforms -4.3. Contextual issues -4.4. Assessment of the Health Transformation Programme to date -4.5. Completing the Health Transformation Programme 2009-2013 -4.6. Longer-term issues facing the Turkish health system -4.7 Conclusions and key suggestions for the future References