Distributive Pattern of Health Services Utilization under Public Health Reform and Promotion in Turkey

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Çinaroğlu S., Çalişkan Z.

Value in Health Regional Issues, vol.1, no.1, pp.1-9, 2022 (Scopus)

  • Publication Type: Article / Article
  • Volume: 1 Issue: 1
  • Publication Date: 2022
  • Journal Name: Value in Health Regional Issues
  • Journal Indexes: Scopus, ASSIA, EMBASE, MEDLINE
  • Page Numbers: pp.1-9
  • Hacettepe University Affiliated: Yes


Inclusive health policies and health promotion to ensure strong primary health care systems are main tenets of health reforms in developing countries, such as Turkey. However, there has been a lack of interest regarding the assessment of equity in health services utilization under public health reform and promotion of primary care. This study aims to analyze equity by measuring deviations from proportionality in the relationship between the utilization of health services and income using indices and curve approaches. A cross-sectional national Turkey Health Survey used for the years 2008, 2010, 2012, and 2014. Gini and Kakwani indices and Concentration curves were estimated and the degree of regressivity was analyzed to understand the sources of equity in health services utilization. Health services utilization for inpatients and outpatient services, family medicine/general practitioner services were regressive between the years 2008 and 2014. The most regressive pattern was observed in the year 2014 regarding medicine usage (Kakwani index = –0.1808904). Differences in the utilization of health services have increased, hurting the poorest during the health reform in Turkey. Policies focused on health promotion to strengthen the primary health system, as well as continuous monitoring of health services utilization by vulnerable groups are essential for ensuring a fairer health service usage in developing countries.