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The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey

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  • Cesur, Resul
  • Güneş, Pınar Mine
  • Tekin, Erdal
  • Ulker, Aydogan

Abstract

This paper examines the impact of universal, free, and easily accessible primary healthcare on population health as measured by age-specific mortality rates, focusing on a nationwide socialized medicine program implemented in Turkey. The Family Medicine Program (FMP), launched in 2005, assigns each Turkish citizen to a specific state-employed family physician who offers a wide range of primary healthcare services that are free-of-charge. Furthermore, these services are provided at family health centers, which operate on a walk-in basis and are located within neighborhoods in close proximity to the patients. To identify the causal impact of the FMP, we exploit the variation in its introduction across provinces and over time. Our estimates indicate that the FMP caused the mortality rate to decrease by 25.6% among infants, 7.7% among the elderly, and 22.9% among children ages 1–4. These estimates translate into 2.6, 1.29, and 0.13 fewer deaths among infants, the elderly, and children ages 1–4, respectively. Furthermore, the effects appear to strengthen over time. We also show evidence to suggest that the FMP has contributed to an equalization of mortality across provinces. Finally, our calculations indicate that each family physician saves about 0.15, 0.46, and 0.005 lives among infants, the elderly, and children ages 1–4 per province every year.

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  • Cesur, Resul & Güneş, Pınar Mine & Tekin, Erdal & Ulker, Aydogan, 2017. "The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey," Journal of Public Economics, Elsevier, vol. 150(C), pages 75-93.
  • Handle: RePEc:eee:pubeco:v:150:y:2017:i:c:p:75-93
    DOI: 10.1016/j.jpubeco.2017.03.007
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    2. Akbulut-Yuksel, Mevlude & Okoye, Dozie & Turan, Belgi, 2020. "Expressway to Power: Infrastructure Projects and Political Support," IZA Discussion Papers 13795, Institute of Labor Economics (IZA).
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    6. Dafeng Xu, 2020. "Free Wheel, Free Will! The Effects of Bikeshare Systems on Urban Commuting Patterns in the U.S," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 664-685, June.
    7. Andreas Kotsadam & Jo Thori Lind & Jørgen Modalsli, 2017. "Call the Midwife - Health Personnel and Mortality in Norway 1887-1921," CESifo Working Paper Series 6831, CESifo.
    8. Herrera-Almanza, Catalina & Rosales-Rueda, Maria F., 2020. "Reducing the Cost of Remoteness: Community-Based Health Interventions and Fertility Choices," Journal of Health Economics, Elsevier, vol. 73(C).
    9. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    10. Oyvat, Cem & Tekgüç, Hasan, 2019. "Ethnic fractionalization, conflict and educational development in Turkey," International Journal of Educational Development, Elsevier, vol. 67(C), pages 41-52.
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    12. Susan P Sparkes & Rifat Atun & Till Bӓrnighausen, 2019. "The impact of the Family Medicine Model on patient satisfaction in Turkey: Panel analysis with province fixed effects," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-13, January.
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    More about this item

    Keywords

    Healthcare; Mortality; Health; Turkey;
    All these keywords.

    JEL classification:

    • I0 - Health, Education, and Welfare - - General
    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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