It appears that the expected benefits from the health reforms in Turkey have been partially achieved in the short run.

BackgroundSince 2003, Turkey has implemented major health care reforms to develop easily accessible, high-quality, efficient, and effective healthcare services for the population. The purpose of this study was to bring out opinions of the Turkish people on health system reform process, focusing on several aspects of health system and assessing whether the public prefer the current health system or that provided a decade ago.MethodsA cross sectional survey study was carried out in Turkey to collect data on people’s opinions on the healthcare reforms. Data was collected via self administered household’s structured questionnaire. A five-point Likert-type scale was used to score the closed comparative statements. Each statement had response categories ranging from (1) “strongly agree” to (5) “strongly disagree.” A total of 482 heads of households (response rate: 71.7%) with the mean age of (46.60 years) were selected using a multi stage sampling technique from seven geographical regions in Turkey from October 2011 to January 2012. Multiple logistic regressions were performed to identify significant contributing factors in this study.ResultsEmploying descriptive statistics it is observed that among the respondents, more than two third of the population believes that the changes have had positive effects on the health system. A vast majority of respondents (82.0%) believed that there was an increase in accessibility, 73.7% thought more availability of health resources, 72.6% alleged improved quality of care, and 72.6% believed better attitude of politician/mass media due to the changes in the last 10 years. Indeed, the majority of respondents (77.6%) prefer the current health care system than the past. In multivariate analysis, there was a statistically significant relationship between characteristics and opinions of the respondents. The elderly, married females, perceived themselves healthy and those who believe that people are happier now than 10 years ago have a more positive opinion of the changes. While, the single unemployed from rural region who perceived themselves as unhealthy and believe that people are unhappy now compare to ten years ago showed less positive opinions.ConclusionsHence, we conclude that from the people’s perspective overall the health system reforms were most likely successful.

Our study examines the long-term relationship among per capita gross domestic product (GDP), per capita health expenditures and population growth rate in Turkey during the period 1984-2006, employing the Johansen multivariate co-integration technique. Related previous studies on OECD countries have mostly excluded Turkey-itself an OECD country. The only study on Turkey examines the period 1984-1998. However, after 1998, major events and policy changes that had a substantial impact on income and health expenditures took place in Turkey, including a series of reforms to restructure the health and social security system. In contrast to earlier findings in the literature, we find that the income elasticity of total health expenditures is less than one, which indicates that health care is a necessity in Turkey during the period of analysis. According to our results, a 10% increase in per capita GDP is associated with an 8.7% increase in total per capita health expenditures, controlling for population growth. We find that the income elasticity of public health expenditures is less than one. But, in the case of private health care expenditures, the elasticity is greater than one, meaning that private health care is a luxury good in Turkey.

This study aims to compare and scrutinize development levels of cities and regions in Turkey. Socioeconomic statics that effects development levels of cities acquired form Ministry of Development. Within the context of the essay, factor analysis relying to principles components utilized and as a result, 10 basic factors found. Based on these factors, development indexes developed for cities and six development stages defined: Advanced (1), High (2), Upper Intermediate(3), Average(4), Low(5), Very Low(6). İstanbul is the only city that reaches advanced level and its development index doubled Ankara, the second most developed city. Comparing development indexes of the regions, we classified Marmara, West Anatolia, Aegean and Mediterranean close to upper intermediate level. Low-level regions are East Anatolia and Southeast Anatolia regions. In overall Turkey with 3 levels of development could be included in upper intermediate level. Even though 63% of all cities are between 4-6 developments levels the reason that Turkey's average appears as 3 rd level is mainly because high population concentrated in advanced and upper intermediate regions. Finally yet importantly, main problem of these highly developed regions is unemployment.

Objectives: This study was aimed to assess validation and reliability of knowledge of, attitude toward and practice (KAP) of a Case-mix and Diagnosis Related Group (DRG) system questionnaire. Methods: A sample of 238 health care providers selected conveniently from three public hospitals in Turkey was enrolled in a cross-sectional study from September 1 until November 30, 2012. The mean age was 38.63 years (standard deviation [SD] 10.52), ranging from age 21 to 60 years. More than one-half were males (52.1%), nearly two-fifths were medical doctors (39.9%), one-third were nurses (33.2%), one-sixth were auxiliary staff (16.4%) and the remaining were coders (10.5%). Only one-third (33.6%) of respondents attended a workshop or training program in the Case-mix or DRG system. After examining content validity, factor analysis was conducted, internal consistency of the questionnaire was assessed by Cronbach’s alpha estimate, and test-retest reliability was evaluated. Results: The sample adequacy for extraction of the factors was confirmed by the Kaiser-Meyer-Olkin test (0.915) and the Bartlett test (1052). Factor analysis showed three factors, including attitude (36.43%), practice (23.39%) and knowledge (17%), with a total variance of 76.82%. The reliability of each section of the questionnaire was as follows: knowledge (0.963), attitude (0.964) and practice (0.973). Cronbach’s alpha total was 0.941, which showed excellent internal consistency. Conclusions: This study demonstrated that the designed questionnaire provided high construct validity and reliability, and could be adequately used to measure KAP among health care staff of the Case-mix and DRG system in Turkey.

Background/aim: The COVID-19 Pandemic originated in Wuhan, China, in December 2019 and became one of the worst global health crises ever. While struggling with the unknown nature of this novel coronavirus, many researchers and groups attempted to project the progress of the pandemic using empirical or mechanistic models, each one having its drawbacks. The first confirmed cases were announced early in March, and since then, serious containment measures have taken place in Turkey. Materials and methods: Here, we present a different approach, a Bayesian negative binomial multilevel model with mixed effects, for the projection of the COVID-19 pandemic and apply this model to the Turkish case. The model source code is available at https://github.com/kansil/covid-19. We predicted confirmed daily cases and cumulative numbers for June 6th to June 26th with 80%, 95% and 99% prediction intervals (PI). Results: Our projections showed that if we continued to comply with measures and no drastic changes are seen in diagnosis or management protocols, the epidemic curve would tend to decrease in this time interval. Also, the predictive validity analysis suggests that proposed model projections should be in the 95% PI band for the first 12 days of the projections. Conclusion: We expect that drastic changes in the course of the COVID-19 in Turkey will cause the model to suffer in predictive validity, and this can be used to monitor the epidemic. We hope that the discussion on these projections and the limitations of the epidemiological forecasting will be beneficial to the medical community, and policymakers.

The Covid-19 pandemic is described as the most serious global health crisis during the last century and is considered a "global human security" problem. The pandemic negatively affects economic security, food safety, health, physical, social, and political security components of the human security phenomenon. Hence, combating the pandemic necessitates the simultaneous consideration of health security and all aspects of human security together. The pandemic has brought social life, the health system, and economic life to a standstill in Turkey, similar to the situation almost all around the globe. In Turkey, where the first case was recorded on March 11, 2020, social life measures to limit daily routine were quickly taken to reduce the spread of the pandemic. A new normalization period started at the beginning of June 2020. The fiscal stimulus packages implemented to reduce the impact of the pandemic in Turkey are estimated to be 12.8% of GDP. This study has demonstrated Covid-19's development and progress in Turkey compared to the world experience. Health, financial, and fiscal measures implemented to combat the pandemic are presented throughout the article. Our study took a snapshot of the pandemic process from the beginning. It should be mentioned that uncertainty in the pandemic requires continuous monitoring of the process.

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