Equity and Healthcare Reform in Developing Economies : The Case of Turkey book cover
1st Edition

Equity and Healthcare Reform in Developing Economies
The Case of Turkey

  • Available for pre-order. Item will ship after October 30, 2020
ISBN 9780367559885
October 29, 2020 Forthcoming by Routledge
184 Pages - 25 B/W Illustrations

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Book Description

Ensuring equity in healthcare is the main concern of health policy makers in order to provide a sustainable health system. This concern is more prominent in developing countries due to the scarcity of resources. This book provides a comprehensive analysis and discussion on the distributive pattern of out-of-pocket pharmaceutical expenditures under the health reforms in Turkey and makes comparisons with pharmerging countries.

Turkey’s health reforms began in 2003 to address shortcomings related to financial protection and to improve health outcomes and the quality of healthcare services. The primary motivation was to ensure equity in the distribution of health resources, and this transformation process led to profound changes in how these resources were used, and in health financing in general. However, there is a lack of knowledge regarding the long-term effect of health reforms on the distribution patterns of health expenditures and health service use. This book offers a thorough equity analysis of the health financing system, affected by this health transformation program. Index and curve approaches are used in the equity analysis of pharmaceutical expenditures. The book examines the long-term effects of health system regulations on the health spending characteristics of households and improves the current understanding of equity in this context. It includes extensive international comparisons of healthcare services across a range of developing countries and highlights the significance of ensuring equity for emerging economies.

The author explores the existing evidence as well as future research directions and provides policy and planning advice for health policy makers to contribute to establishing a more equal health system design. Additionally, the book will be of interest to scholars and professionals in the fields of health economics, public health management and health financing.

Table of Contents

List of Figures

List of Tables

Chapter 1

Equity in Health Care Services

1.1. The Meaning and Key Concepts of Equity in Health Care

1.2. Globalization, Personalized Medicine, and an Increasing Concern for Equity in Health Care

1.3. Health System Differences and Equity in Health System

1.4. Health Trends and Equity

1.5. Social Inclusiveness and Equity in Health Care


Chapter 2

International Comparison of Equity in Health Care Services

2.1. International Comparison of Equity in Health Care Services

2.1.1. International Differences in the Level of Health Expenditures

2.1.2. International Differences Regarding the Concern for Equity

2.2. Health Reforms and Health Equity

2.3. Current Health System Problems and Increasing Need to Consider Equity in Health


Chapter 3

Equity in Health Services and Policy Advice for Developing Countries

3.1. Equity in Health Interventions in Developing Countries

3.1.1. Maternal and Newborn Health

3.1.2. Communicable (Infectious) Diseases

3.1.3. Noncommunicable Diseases

3.2. Equity in Distribution of Health Financing in Developing Countries

3.2.1. Catastrophic expenditure and impoverishment expenditure

3.3. Policy Advices to Improve Equities in Developing Countries


Chapter 4

Equity Lessons Learned From Pharmerging Countries

4.1. Characteristics of Pharmerging Countries

4.2. Brazil

4.3. China

4.4. India

4.5. Russia

4.6. Mexico

4.7. Thailand


Chapter 5

Equity in Health Services in Emerging Markets Similar to Turkey

5.1. Health Care Financing and Affordability in the N-11 Emerging Markets

5.2. Health Care Financing and Affordability for Turkey’s neighbors

5.3. Recommendations to Build Strong Health Systems in Southeastern Europe and Turkey


Chapter 6

Health Reform in Turkey and Inclusive Policies

6.1. Historical Background of Turkish Health Reform

6.1.1. A Brief Overview of Turkish Neoliberal Economy Policies

6.1.2. Historical Overview of Health Reforms in Turkey

6.1.3. Historical Overview of the Pharmaceutical Industry in Turkey

6.2. AKP’s Health Reform

6.2.1. Main Tenets of AKP’s Health Reform

6.2.2. Effects of AKP’s Health Reform on Different Functions of Health Care Services

6.3. Health Care Becomes Focused Policymaking Area of AKP Government

6.4. The Changing Direction of Turkish Economy and Need for Equity Analysis of Redistributive Policies


Chapter 7

Measurement of the Level of Equity in Health Care Services

7.1. Equity Measurement in Health Care Services

7.2. Index Approaches 1

7.2.1. Traditional Ways of Measuring Inequalities

7.2.2. Entropy Indices

7.2.3. Atkinson Index

7.2.4. Measurement of Progressivity of Distribution of OOP Health Expenditure Kakwani Index

7.3. Curve Approaches

7.3.1. Lorenz Curve

7.3.2. Concentration Curve Visualization of Lorenz and Concentration Curves


Chapter 8

Equity in Pharmaceutical Expenditures under Health Reform in Turkey

8.1. An Overview of the Level of OOP Health Expenditures and International Comparison

8.2. Consumption of Drugs (Million Boxes) and International Comparison

8.3. Growth Potential of Pharmaceutical Market and International Comparison

8.4. Equity Analysis of Households’ Pharmaceutical Expenditures in Turkey for the Years 2005–2015

8.4.1. The Results of Inequality Index Measures 2005–2015

8.4.2. Progressivity Analysis of the Burden of Pharmaceutical Expenses, 2005–2015

8.4.3. Lorenz and Concentration Curves for 2005, 2010, and 2015


Chapter 9

Advices for Health Policymakers to Consider Equity in the Distribution of Pharmaceutical Expenditures and Pharmaceutical Market Design

9.1. Pharmaceutical Market as an Interactive Policymaking Area in Health Care

9.2. Turkey’s Pharmaceutical Policy Reform and Equity

9.2.1. Turkey’s Pharmaceutical Policy Reform

9.2.2. The Effect of Turkey’s Pharmaceutical Policy Reform on Equity in the Burden of Pharmaceutical Expenses

9.3. Advice for Turkish Health Policymakers to Consider Equity in Pharmaceutical Market Design and Price Controls 249

9.3.1. The Need to Put Inclusive Policies on a Rational Basis

9.3.2. Health Policymakers Need to Consider that Populist Policies have Negative Poverty Effect on Welfare State of Individuals

9.3.3. Generic Drug Market Design and the Need for High-Priced Industrial Policy Strategy



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Songül Çınaroğlu is a Doctor in Health Administration and Assistant Professor in the Faculty of Economics and Administrative Sciences in the Department of Health Care Management at Hacettepe University, Turkey. She is a former visiting researcher at the University of Michigan (Ann Arbor) and of the University of Alabama (Birmingham). Her main research interest is health economics, policy and outcomes research.