Sağlık Hizmetleri Kullanımında Hakkaniyet: Türkiye Sağlık Sisteminin Değerlendirilmesi

Abstract

ABSTRACT

AKSUNGUR, Abide. The Equity in Health Care Utilization: Evaluation of Turkish Health Care System, Ph.D. Dissertation, Ankara, 2020. Many people have been witnessing problems in accessing to health care services due to current innustice in many health systems in the World despite Access to health services is considered to be basic human right and there is a consensus at the international level on the importance of justice in providing health services. The objective of this study is to investigate the impact of different variables which are predisposing (age, gender, marital status, etc.), enabling (health insurance, education level, income level, etc.) and need (general health status, number of disease) factors used in Andersen’s Behavioral Model of Health Services Utilization frequently used in the relevant literature on the utilization of health services (utilization of health services from family medcine physicians and specialized physicians, utilization of day care services, utilization of hospital services) and to eveluate the level of equity in utilization of health services by years in Turkey by using the data collected from individual eged 15 and more in the sample of 2008, 2010, 2012, 2014 and 2016 Turkey Health Surveys Data. The analysis of the data was done by using Statistical Package for The Social Science (SPSS- 23). Chi-squared analysis, Concentration Index and Regression Analysis were the statistical methods to analyse data. According to the study findings monthly income, education level and number of diseases were the factors having impact on health status and health services utilization. It was found that the equity was achieved in Access to health services and there was an improvement in equity level by years in Turkish Health System. The findings showed that disadventegaous groups (widow, individuals with lower income and education level, etc.) had used health care services more. Based on this finding it can be concluded that disadvetangous groups have not faced with any barriers in utilization of health services. Besides, it was found that age, gender, marital staus, health insurance and working status were the variables having effect on health services utilization. It can be recommended that the studies examining equity in health care utilization should be repeated and planned routinely in establishing health care policies in terms of improving equity in health care utilization. Keywords: Behavioral Model, Equity, Concentration Index, Health Care Utilization.