1st Edition

Equity and Healthcare Reform in Developing Economies The Case of Turkey

By Songül Çınaroğlu Copyright 2021
    174 Pages 25 B/W Illustrations
    by Routledge

    174 Pages 25 B/W Illustrations
    by Routledge

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    Ensuring equity in healthcare is the main concern of health policymakers 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 policymakers 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.

    1 Equity in healthcare services

    The meaning and key concepts of equity in healthcare

    Globalization, personalized medicines, and an increasing concern for equity in healthcare

    Health system differences and equity in health system

    Health trends and equity

    Social inclusiveness and equity in healthcare

    2 International comparison of equity in healthcare services

    International comparison of equity in healthcare services

    Health reforms and health equity

    Current health system problems and increasing need to consider equity in health

    3 Equity in health services and policy advice for developing countries

    Equity in health interventions in developing countries

    Equity in distribution of health financing in developing countries

    Policy advice to improve equities in developing countries

    4 Equity lessons learned from pharmerging countries

    Characteristics of pharmerging countries







    5 Equity in health services in emerging markets similar to Turkey

    Healthcare financing and affordability in the N-11 emerging markets

    Healthcare financing and affordability for Turkey’s neighbors

    Recommendations to build strong health systems in Southeastern Europe and Turkey

    6 Health reform in Turkey and inclusive policies

    Historical background of Turkish health reform

    AKP’s health reform

    Healthcare becomes focused policymaking area of AKP government

    The changing direction of Turkish economy and need for equity analysis of redistributive policies

    7 Measurement of the level of equity in healthcare services

    Equity measurement in healthcare services

    Index approaches

    Curve approaches

    8 Equity in pharmaceutical expenditures under health reform in Turkey

    An overview of the level of OOP health expenditures and international comparison

    Consumption of drugs (million boxes) and international comparison

    Growth potential of pharmaceutical market and international comparison

    Equity analysis of households’ pharmaceutical expenditures in Turkey for the years 2005–2015

    9 Advice for health policymakers to consider equity in the distribution of pharmaceutical expenditures and pharmaceutical market design

    Pharmaceutical market as an interactive policymaking area in healthcare

    Turkey’s pharmaceutical policy reform and equity expenses

    Advice for Turkish health policymakers to consider equity in pharmaceutical market design and price controls

    Generic drug market design and the need for high-priced industrial policy strategy


    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.