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Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis
BACKGROUND: In 2003, the Turkish government introduced a major health system reform, the Health Transformation Program (HTP), aimed at achieving Universal Health Coverage (UHC). HTP has helped to expand insurance coverage and health benefits for the uninsured population groups, which included low-in...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Edinburgh University Global Health Society
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150612/ https://www.ncbi.nlm.nih.gov/pubmed/30254742 http://dx.doi.org/10.7189/jogh.08.020412 |
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author | Tirgil, Abdullah Gurol-Urganci, Ipek Atun, Rifat |
author_facet | Tirgil, Abdullah Gurol-Urganci, Ipek Atun, Rifat |
author_sort | Tirgil, Abdullah |
collection | PubMed |
description | BACKGROUND: In 2003, the Turkish government introduced a major health system reform, the Health Transformation Program (HTP), aimed at achieving Universal Health Coverage (UHC). HTP has helped to expand insurance coverage and health benefits for the uninsured population groups, which included low-income households and the unemployed, through the Green Card scheme, a non-contributory health insurance funded by the government. The Green Card scheme expansion began in 2005 and increased rapidly after 2008, following the introduction of a new comprehensive benefits package, to cover an additional 13 million people. METHODS: We examine the impact of the Green Card scheme on the utilization of outpatient, inpatient, specialist, and diagnostics services using the Turkish Health Survey data (2010), using a kinked regression design. We take advantage of a sharp break in the availability of health insurance at a particular income level (minimum wage) to examine the impact of the Green Card scheme on health service utilization. RESULTS: Our results show that having a Green Card increases the fraction of people using outpatient services by 68.30 percentage points, inpatient visit by 34.60 percentage points, and specialist visit by 74.10 percentage points. CONCLUSIONS: Our findings suggest that a non-contributory health insurance program, such as the Green Card scheme in Turkey, could provide increased access to health care services by the poor and provide important lessons for countries which aim to introduce health programs targeting poor as part of a transition to UHC. |
format | Online Article Text |
id | pubmed-6150612 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Edinburgh University Global Health Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-61506122018-09-25 Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis Tirgil, Abdullah Gurol-Urganci, Ipek Atun, Rifat J Glob Health Articles BACKGROUND: In 2003, the Turkish government introduced a major health system reform, the Health Transformation Program (HTP), aimed at achieving Universal Health Coverage (UHC). HTP has helped to expand insurance coverage and health benefits for the uninsured population groups, which included low-income households and the unemployed, through the Green Card scheme, a non-contributory health insurance funded by the government. The Green Card scheme expansion began in 2005 and increased rapidly after 2008, following the introduction of a new comprehensive benefits package, to cover an additional 13 million people. METHODS: We examine the impact of the Green Card scheme on the utilization of outpatient, inpatient, specialist, and diagnostics services using the Turkish Health Survey data (2010), using a kinked regression design. We take advantage of a sharp break in the availability of health insurance at a particular income level (minimum wage) to examine the impact of the Green Card scheme on health service utilization. RESULTS: Our results show that having a Green Card increases the fraction of people using outpatient services by 68.30 percentage points, inpatient visit by 34.60 percentage points, and specialist visit by 74.10 percentage points. CONCLUSIONS: Our findings suggest that a non-contributory health insurance program, such as the Green Card scheme in Turkey, could provide increased access to health care services by the poor and provide important lessons for countries which aim to introduce health programs targeting poor as part of a transition to UHC. Edinburgh University Global Health Society 2018-12 2018-09-19 /pmc/articles/PMC6150612/ /pubmed/30254742 http://dx.doi.org/10.7189/jogh.08.020412 Text en Copyright © 2018 by the Journal of Global Health. All rights reserved. http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. |
spellingShingle | Articles Tirgil, Abdullah Gurol-Urganci, Ipek Atun, Rifat Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis |
title | Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis |
title_full | Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis |
title_fullStr | Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis |
title_full_unstemmed | Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis |
title_short | Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis |
title_sort | early experience of universal health coverage in turkey on access to health services for the poor: regression kink design analysis |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150612/ https://www.ncbi.nlm.nih.gov/pubmed/30254742 http://dx.doi.org/10.7189/jogh.08.020412 |
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