Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Tirgil, Abdullah, Gurol-Urganci, Ipek, Atun, Rifat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Edinburgh University Global Health Society 2018
Materias:
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
_version_ 1783357022610128896
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
work_keys_str_mv AT tirgilabdullah earlyexperienceofuniversalhealthcoverageinturkeyonaccesstohealthservicesforthepoorregressionkinkdesignanalysis
AT gurolurganciipek earlyexperienceofuniversalhealthcoverageinturkeyonaccesstohealthservicesforthepoorregressionkinkdesignanalysis
AT atunrifat earlyexperienceofuniversalhealthcoverageinturkeyonaccesstohealthservicesforthepoorregressionkinkdesignanalysis