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


  • Burçay Erus

    () (Department of Economics, Bogaziçi University)


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.

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  • 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

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    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.
    3. 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.
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