IDEAS home Printed from https://ideas.repec.org/p/erg/wpaper/544.html
   My bibliography  Save this paper

Impact of Healthcare Reforms on Out-of-Pocket Health Expenditures in Turkey for Public Insurees

Author

Listed:
  • Burçay Erus

    (Department of Economics, Bogaziçi University)

Abstract

The Turkish health care system has been subject to major reform during the last five years. During the reform process, access to private and public providers was eased for public insurees. Despite the importance of the reform, there is no rigorous study of the reform’s impact on health expenditures and access. This study analyzes a rich dataset on healthcare expenditures to look into the presence and size of out-of-pocket (OOP) health expenditures. The study uses Household Budget Surveys from 2003 to 2006, which provide a range of individual and household level data, as well as aggregate and detailed health care expenditures. Using econometric methods we analyze the presence of health expenditures, the share of health expenditures in total monthly expenditures and the level of health expenditures. Results show that the ratio of households with non-zero OOP expenditure has increased with the reforms, but the share and level of OOP expenditures have decreased. In addition, the impact is different across income levels. The results of a semi-parametric analysis show that wealthier individuals have benefited more in terms of the decrease in OOP health expenditures.

Suggested Citation

  • Burçay Erus, 2010. "Impact of Healthcare Reforms on Out-of-Pocket Health Expenditures in Turkey for Public Insurees," Working Papers 544, Economic Research Forum, revised 09 Jan 2010.
    • Handle: RePEc:erg:wpaper:544
    as

    Download full text from publisher

    File URL: http://erf.org.eg/wp-content/uploads/2014/08/544.pdf
    Download Restriction: no
    File URL: http://bit.ly/2mXNcOx
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Alan, Sule & Crossley, Thomas F. & Grootendorst, Paul & Veall, Michael R., 2002. "The effects of drug subsidies on out-of-pocket prescription drug expenditures by seniors: regional evidence from Canada," Journal of Health Economics, Elsevier, vol. 21(5), pages 805-826, September.
    2. Ardeshir Sepehri & Sisira Sarma & Wayne Simpson, 2006. "Does non‐profit health insurance reduce financial burden? Evidence from the Vietnam living standards survey panel," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 603-616, June.
    3. Sulku, Seher Nur & Bernard, Didem M., 2009. "Financial burden of health care expenditures in Turkey: 2002-2003," MPRA Paper 28968, University Library of Munich, Germany.
    4. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    5. Borissov, Vesselin & Rathwell, Tom, 1996. "Health care reforms in Bulgaria: An initial appraisal," Social Science & Medicine, Elsevier, vol. 42(11), pages 1501-1510, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Brown, Sarah & Hole, Arne Risa & Kilic, Dilek, 2014. "Out-of-pocket health care expenditure in Turkey: Analysis of the 2003–2008 Household Budget Surveys," Economic Modelling, Elsevier, vol. 41(C), pages 211-218.
    2. Songul Cinaroglu, 2017. "A Fresh Look at Out-of-Pocket Health Expenditures after More than a Decade Health Reform Experience in Turkey: A Data Mining Application," International Journal of Economics and Financial Issues, Econjournals, vol. 7(5), pages 33-40.
    3. Kim, Sujin & Kwon, Soonman, 2015. "Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea," Social Science & Medicine, Elsevier, vol. 138(C), pages 241-247.
    4. Abdullah TİRGİL & Fatih Cemil ÖZBUĞDAY, 2020. "Does Public Health Insurance Provide Financial Protection Against Out-Of-Pocket Health Payments? Evidence from TurkeyAbstract: Turkey hasinitiated comprehensive reformsto increase equity among its cit," Sosyoekonomi Journal, Sosyoekonomi Society, issue 28(45).
    5. Esra N. Kilci, 2021. "A study on financial sustainability of healthcare indicators for Turkey under the health transformation program," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(4), pages 1287-1307, July.
    6. Burcay Erus, 2020. "Out of pocket health expenditures in Turkey following introduction of co‐payments along with improved primary care services," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(2), pages 433-440, March.
    7. repec:jet:dpaper:dpaper391 is not listed on IDEAS
    8. Burcay Erus, 2016. "Out of Pocket Health Expenditures in Turkey in the Aftermath of the Reforms: Impact of Co-payments on Expenditures and Use of Health Services," Working Papers 1070, Economic Research Forum, revised 12 Jun 2016.
    9. Eleftherios Giovanis & Oznur Ozdamar, 2016. "Who Pays More: Public, Private, Both or None? The Effects of Health Insurance Schemes and Health Reforms on Out-of-Pocket and Catastrophic Health Expenditures in Turkey," Working Papers 1058, Economic Research Forum, revised 10 2016.
    10. Ozdamar, Oznur & Giovanis, Eleftherios, 2017. "The causal effects of survivors’ benefits on health status and poverty of widows in Turkey: Evidence from Bayesian Networks," Economic Analysis and Policy, Elsevier, vol. 53(C), pages 46-61.
    11. Reham Rizk & Hala Abou-Ali, 2016. "Out of Pocket Health Expenditure and Household Budget: Evidence from Arab Countries," Working Papers 1065, Economic Research Forum, revised 12 Jan 2016.
    12. Emrah Konuralp & Sermin Bicer, 2021. "Putting the Neoliberal Transformation of Turkish Healthcare System and Its Problems into a Historical Perspective," Review of Radical Political Economics, Union for Radical Political Economics, vol. 53(4), pages 654-674, December.
    13. Dilek Basar & Sarah Brown & Arne Risa Hole, 2012. "Out-of-Pocket Health Care Expenditure in Turkey: Analysis of the Household Budget Surveys 2002-2008," Working Papers 2012020, The University of Sheffield, Department of Economics.
    14. Erus, Burcay & Hatipoglu, Ozan, 2017. "Physician payment schemes and physician productivity: Analysis of Turkish healthcare reforms," Health Policy, Elsevier, vol. 121(5), pages 553-557.
    15. Giovanis, Eleftherios & Ozdamar, Oznur, 2017. "The Effects of the 2008 Health Reform on Out-of-Pocket Health Expenditures in Turkey," MPRA Paper 95837, University Library of Munich, Germany.
    16. Hasan Tekguc & Z. Nurdan Atalay-Gunes, 2011. "Health Consequences of an Eclectic Social Security Regime: The Case of Turkey," Working Papers 2011-05, Mardin Artuklu Univeristy, Department of Economics.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dilek Basar & Sarah Brown & Arne Risa Hole, 2012. "Out-of-Pocket Health Care Expenditure in Turkey: Analysis of the Household Budget Surveys 2002-2008," Working Papers 2012020, The University of Sheffield, Department of Economics.
    2. Brown, Sarah & Hole, Arne Risa & Kilic, Dilek, 2014. "Out-of-pocket health care expenditure in Turkey: Analysis of the 2003–2008 Household Budget Surveys," Economic Modelling, Elsevier, vol. 41(C), pages 211-218.
    3. Adam Wagstaff, 2010. "Estimating health insurance impacts under unobserved heterogeneity: the case of Vietnam's health care fund for the poor," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 189-208, February.
    4. Acharya, Arnab & Vellakkal, Sukumar & Taylor Fiona & Masset Edoardo & Satija, Ambika & Burke, Margaret & Ebrahim, Shah, 2013. "The impact of health insurance schemes for the informal sector in low- and middle-income countries : a systematic review," Policy Research Working Paper Series 6324, The World Bank.
    5. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    6. Lingguo Cheng & Hong Liu & Ye Zhang & Ke Shen & Yi Zeng, 2015. "The Impact of Health Insurance on Health Outcomes and Spending of the Elderly: Evidence from China's New Cooperative Medical Scheme," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 672-691, June.
    7. He, Huajing & Nolen, Patrick J., 2019. "The effect of health insurance reform: Evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 168-179.
    8. Budi Aji & Manuela De Allegri & Aurelia Souares & Rainer Sauerborn, 2013. "The Impact of Health Insurance Programs on Out-of-Pocket Expenditures in Indonesia: An Increase or a Decrease?," IJERPH, MDPI, vol. 10(7), pages 1-19, July.
    9. Sheikh Aftaab Ul Maroof & Mohi-ud-Din Sangmi, 2021. "Assessing financial impact of a health intervention program and controlling spillover effects," DECISION: Official Journal of the Indian Institute of Management Calcutta, Springer;Indian Institute of Management Calcutta, vol. 48(1), pages 15-25, March.
    10. Ali, Shehzad & Cookson, Richard & Dusheiko, Mark, 2017. "Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure," Social Science & Medicine, Elsevier, vol. 177(C), pages 127-140.
    11. McBain, Florence, 2014. "Health insurance and health environment: India’s subsidized health insurance in a context of limited water and sanitation services," Working Papers 179200, University of Bonn, Center for Development Research (ZEF).
    12. Hai Zhong, 2011. "Effect of patient reimbursement method on health‐care utilization: evidence from China," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1312-1329, November.
    13. Macha, Raphael Rasiel, 2015. "Community Based Health Insurance Schemes and Protection of the Rural Poor: Empirical evidence from Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 3(2), July.
    14. Lan Thi Thu Phan & Yusuke Jinnai, 2018. "Does health insurance matter in the hospital? New evidence from patient-level medical records in Vietnam," Working Papers EMS_2018_01, Research Institute, International University of Japan.
    15. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    16. Kuangnan Fang & BenChang Shia & Shuangge Ma, 2012. "Health Insurance Coverage and Impact: A Survey in Three Cities in China," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-8, June.
    17. Magnezi, Racheli & Weiss, Yossi & Cohen, Yossi & Shmueli, Amir, 2007. "Development of a capitation scale for IDF career soldiers in Israel," Health Policy, Elsevier, vol. 80(3), pages 459-464, March.
    18. Phuong Huu Khiem & Yu-Chen Kuo, 2022. "Health insurance reform impact on children’s educational attainment: evidence from Vietnam," Review of Economics of the Household, Springer, vol. 20(4), pages 1255-1285, December.
    19. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    20. Jing You & Katsushi S. Imai & Raghav Gaiha, 2014. "Decoding the Growth-Nutrition Nexus in China: Inequality, Uncertainty and Food Insecurity," Discussion Paper Series DP2014-28, Research Institute for Economics & Business Administration, Kobe University, revised Dec 2014.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:erg:wpaper:544. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sherine Ghoneim (email available below). General contact details of provider: https://edirc.repec.org/data/erfaceg.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.