Değer Bazlı Ödeme Yönteminin Türkiye Sağlık Sisteminde Uygulanabilirliği Üzerine Nitel Bir Araştırma

Abstract

In healthcare systems, appropriately designed payment methods have the potential to improve patients' well-being and overall healthcare. For this reason, the determination of the right payment model is still discussed around the world. In order to improve productivity, economic efficiency and quality of care, patient-centered repayment models need to be improved. Value-based payment reforms are designed to reduce healthcare spending, promote high-quality care, and ensure that healthcare is paid for quality rather than quantity.In this study, it is aimed to get the opinions of the participants about this method, to determine what the value means, with which parameters it can be measured, what the pros and cons can be when it is used for repayment, and whether the Turkish health system is suitable for this repayment method. Grounded theory approach and delphi technique, one of the qualitative study methods, are used in the study. In accordance with the purpose of the thesis, 28 participants among the health system stakeholders are determined through purposeful sampling. Analysis of the data is done through Maxquda 2020. It is determined who will support and who will oppose the value-based payment method proposed in the study, what benefits it will bring, how it can be applied and what parameters should be in the model. The value parameters obtained as a result of the qualitative analysis are graded by the participants according to their importance with the delphi study. The study is completed by providing consensus in the 2nd round. At the end of the study, the value in health is defined as “a quality service”. Although there are some deficiencies, the participants think that the value-based repayment method should be applied. The Turkish health system is ready for this change in terms of information system and infrastructure. In the study, 15 parameters that can be used in the calculation of the value are determined. It is recommended to take measures against those who will oppose the transition and the groups that do not want to innovate. Transparency in health data should be at the forefront. Steps should be taken to contribute to the health literacy of the society. As a result, it is thought that Turkey will be successful by making the necessary revisions in the value-based payment method.