The Value of Socialized Medicine: The Impact of Universal Primary Healthcare Provision on Mortality Rates in Turkey
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 the 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.
|Date of creation:||Aug 2015|
|Note:||CH HC HE|
|Contact details of provider:|| Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.|
Web page: http://www.nber.org
More information through EDIRC
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Dow, William H. & Schmeer, Kammi K., 2003. "Health insurance and child mortality in Costa Rica," Social Science & Medicine, Elsevier, vol. 57(6), pages 975-986, September.
- 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.
- Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
- Gary S. Becker, 1981. "A Treatise on the Family," NBER Books, National Bureau of Economic Research, Inc, number beck81-1, December.
- Romero Rocha & Rodrigo R. Soares, 2010. "Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 126-158, September.
- Rocha, Romero & Soares, Rodrigo R., 2009. "Evaluating the Impact of Community-Based Health Interventions: Evidence from Brazil's Family Health Program," IZA Discussion Papers 4119, Institute for the Study of Labor (IZA).
- Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2014. "The Effects of Access to Health Insurance for Informally Employed Individuals in Peru," IZA Discussion Papers 8213, Institute for the Study of Labor (IZA).
- Kruk, Margaret Elizabeth & Porignon, Denis & Rockers, Peter C. & Van Lerberghe, Wim, 2010. "The contribution of primary care to health and health systems in low- and middle-income countries: A critical review of major primary care initiatives," Social Science & Medicine, Elsevier, vol. 70(6), pages 904-911, March.
- Jonathan Gruber & Nathaniel Hendren & Robert M. Townsend, 2014. "The Great Equalizer: Health Care Access and Infant Mortality in Thailand," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 91-107, January.
- Martin Ravallion & Shaohua Chen & Prem Sangraula, 2007. "New Evidence on the Urbanization of Global Poverty," Population and Development Review, The Population Council, Inc., vol. 33(4), pages 667-701.
- Ravallion, Martin & Chen, Shaohua & Sangraula, Prem, 2007. "New evidence on the urbanization of global poverty," Policy Research Working Paper Series 4199, The World Bank.
- Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
- Martha J. Bailey & Andrew Goodman-Bacon, 2014. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," NBER Working Papers 20653, National Bureau of Economic Research, Inc.
- Pfutze, Tobias, 2014. "The Effects of Mexico’s Seguro Popular Health Insurance on Infant Mortality: An Estimation with Selection on the Outcome Variable," World Development, Elsevier, vol. 59(C), pages 475-486.
- Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 25-46, July.
- Anthopolos, Rebecca & Becker, Charles M., 2010. "Global Infant Mortality: Correcting for Undercounting," World Development, Elsevier, vol. 38(4), pages 467-481, April.
- Fernando Ruiz & Liliana Amaya & Stella Venegas, 2007. "Progressive segmented health insurance: Colombian health reform and access to health services," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 3-18.
- Sosa-Rubí, Sandra G. & Galárraga, Omar & Harris, Jeffrey E., 2009. "Heterogeneous impact of the "Seguro Popular" program on the utilization of obstetrical services in Mexico, 2001-2006: A multinomial probit model with a discrete endogenous variable," Journal of Health Economics, Elsevier, vol. 28(1), pages 20-34, January.
- Sandra G. Sosa-Rubi & Omar Galarraga & Jeffrey E. Harris, 2007. "Heterogeneous Impact of the "Seguro Popular" Program on the Utilization of Obstetrical Services in Mexico, 2001-2006: A Multinomial Probit Model with a Discrete Endogenous Variable," NBER Working Papers 13498, National Bureau of Economic Research, Inc.
- Daniel Klepinger & Shelly Lundberg & Robert Plotnick, 1999. "How Does Adolescent Fertility Affect the Human Capital and Wages of Young Women?," Journal of Human Resources, University of Wisconsin Press, vol. 34(3), pages 421-448.
- D. Klepinger & S. Lundberg & R. Plotnick, "undated". "How Does Adolescent Fertility Affect the Human Capital and Wages of Young Women?," Institute for Research on Poverty Discussion Papers 1145-97, University of Wisconsin Institute for Research on Poverty.
- Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.
- Janet Currie & Patricia B. Reagan, 2003. "Distance to Hospital and Children's Use of Preventive Care: Is Being Closer Better, and for Whom?," Economic Inquiry, Western Economic Association International, vol. 41(3), pages 378-391, July.
- Likwang Chen & Winnie Yip & Ming-Cheng Chang & Hui-Sheng Lin & Shyh-Dye Lee & Ya-Ling Chiu & Yu-Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242.
- Mauricio Reis, 2014. "Public primary health care and children’s health in Brazil: evidence from siblings," Journal of Population Economics, Springer;European Society for Population Economics, vol. 27(2), pages 421-445, April.
- Adriana Camacho & Emily Conover, 2013. "Effects of Subsidized Health Insurance on Newborn Health in a Developing Country," Economic Development and Cultural Change, University of Chicago Press, vol. 61(3), pages 633-658.
- Carrin, Guy & Ron, Aviva & Hui, Yang & Hong, Wang & Tuohong, Zhang & Licheng, Zhang & Shuo, Zhang & Yide, Ye & Jiaying, Chen & Qicheng, Jiang & Zhaoyang, Zhang & Jun, Yu & Xuesheng, Li, 1999. "The reform of the rural cooperative medical system in the People's Republic of China: interim experience in 14 pilot counties," Social Science & Medicine, Elsevier, vol. 48(7), pages 961-972, April. Full references (including those not matched with items on IDEAS)