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Sağlık Harcamalarındaki Artış ve Temel Bakım Hizmetleri

Year 2010, Volume: 1 Issue: 29, 173 - 192, 01.12.2010

Abstract

Dünyada son yıllarda sağlık harcamalarındaki artış önemli bir konu olmaya devam etmektedir. Sağlık sistemleri ile ilgili tatminsizlik de artmaktadır. Bu durum, sağlık hizmetleri sisteminde, performans ve finansman da dahil olmak üzere bazı önemli yeni düzenlemelerin yapılmasına neden olmuştur. 1978’deki Alma-Ata deklarasyonu, tüm ülkeler için kabul edilebilir, eşitlikçi, evrensel ve kapsamlı sağlık hizmetleri temin etmesi açısından, temel bakım hizmetlerini kabul etmiştir. Sağlık harcamalarındaki artışın arkasında sayılabilecek faktörler arasında, tıbbi teknoloji ve reçeteli ilaçlar, kronik hastalıklar ve nüfusun yaşlanması yer almaktadır. Sağlık sistemi ve ekonomik sistem birbirinden bağımsız değildir ve birçok yönden birbirleriyle bağlantılıdır. Ekonomik ve sosyal şartlar ve politikalar (gelir, eğitim, istihdam, sosyal destek, vergi ve transfer politikaları), sağlık üzerinde çok önemli sonuçlar ortaya çıkartmaktadır. Bu nedenle sağlık harcamalarını kontrol etmek, etkili ve verimli olmasını teşvik etmek için, tüm bakanlıkların (sağlık, ekonomi, çevre, tarım ve maliye) işbirliği içinde olmaları ve koordineli çalışmaları oldukça önemlidir

References

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  • Bilgili, Emine ve Eyyup Ecevit, “Sağlık Hizmetleri Piyasasında Asimetrik Bilgiye Bağlı Problemler ve Çözüm Önerileri”, Hacettepe Sağlık İdaresi Dergisi, Cilt: 11, Sayı: 2, 2008, ss: 201-228.
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  • Clevenger, Ernest, “How Primary Care, America’s Best- Kept Secret, Can Reduce Health Care Costs for Self-Funded Employers” HealthWatch, Issue: 59, 2008.
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  • Elmendorf, Douglas W. “Options for Controlling the Cost and Increasing the Efficiency of Health Care”, http://www.cbo.gov/ftpdocs/100xx/ doc10016/03-10-Health_Care.pdf, [ET. 22/04/2009], 2009.
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  • Gulliford, M.C., R.H. Jack, G. Adams, and O.C. Ukoumunne, “Avaliability and Structure of Primary Medical Care Services and Population Health Care Indicators in England”, BMC Health Services Research,Vol. 4, No: 12, 2004.
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  • Mechanic, David and David A. Rochefort “Comparative Medical Systems” Annual Review of Sociology, Vol. 22 (1996), pp. 239-270 http://www. jstor.org/stable/2083431 [ET: 08/06/2009]
  • Mohan, Ramesh and Sam Mirmirani, “An Assessment of OECD Health Care System Using Panel Data Analysis”, MPRA Paper, http://mpra.ub.unimuenchen.de/6122/, [ET. 22/04/2009], 2007.
  • Montefiori, M., “Patient Behavior in the Market for Hospital Services”,
  • NJAFP,http://www.njafp.org/documents/Cost%20Effective%20Delivery%20of%2 0Health%20Care_200 80604120234_20090120110514.pdf: [ET. 19/05/ 2009].
  • Sans-Corrales, Mireia, Enriqueta Pujol-Ribera, Joan Gene-Badia, Maria Isabel Pasarin-Rua, Begona Iglesias-Perez and Josep Casajuana-Brunet “Family Medicine attributes related to satisfaction, health and costs” Family Practice, Vol. 23, No. 3, 2006, pp: 308-316.
  • Shi, L., J. Macinko, B. Starfield, J. Wulu, J. Regan, and R. Politzer. ”The Relationship between Primary Sips, Fons, “A common basis for general practice/family medicine in EuropeEditorial”http://findarticles.com/p/articles/mi_m0689/is_n1_v41/ai_17376 310/[ET. 23/12/2008], 1995.
  • Sjonell, G., “Organised Family Medicine:The Key Issue To Cost-Effective Healthcare”, http://www.cfps.org.sg/sreenivasan/articles/1997.html, [ET. 22/04/2009], 1997.
  • Starfield, Barbara, Leiyu Shi, and James Macinko, “Contribution of Primary Care to Health Systems and Stewart, Moira “The Impact of Patient-Centered Care on Outcomes”, The Journal of Family Practice; Vol: 49, 2004, pp: 796-804.
  • WHO, “A Summary of the 2008 World Health Report : “Primary Health Care: Now More Than Ever”, http://www.who.int/whr/2008/summary.pdf, 2008.
  • WHO, Declaration of Alma-Ata, http://www.who.int/hpr/NPH/docs/ declaration_almaata.pdf
  • WHO, European Health Care Reforms: Analysis of Current Strategies Summary http://www.euro.who.int/document/obs/sumhecareform.pdf, [24/03/2009], 1996.
  • WHO, http://www.who.int/en/
  • WHO, What are the advantages and disadvantages of restructuring a health care system to be more focused on primary care services? http://www.euro.who.int/Document/E82997.pdf, [24/03/2009] Wong, Thomas, “A check for healthcare payment systems”, http://www.camagazine.com/4/6/6/1/0/index1.shtml, [ET. 24/03/2009], 2008. www.disefin.unige.it/finanza/WP%5Cn42003.pdf [ET.12.08.2006].
  • Zwanziger, Jack and Glenn A. Melnick, “Can Managed Care Plans Control Health Care Costs? Health Affairs, Vol. 15, No. 2, 1996, pp: 185-199.

RISING HEALTH CARE COSTS AND PRİMARY HEALTH CARE

Year 2010, Volume: 1 Issue: 29, 173 - 192, 01.12.2010

Abstract

Rising health care costs over the last few decades have become an important issue in the world. Dissatisfaction with health care systems is also rising. That has caused some important reorganization in health care systems, including its funding and performance. The declaration of Alma-Ata (1978) formally adopted primary health care as the means for providing a comprehensive, universal, equitable and affordable health care service for all countries. Some of the major factors that are driving the growth in health care spending are medical technology and prescription drugs, chronic disease and aging of population. Health systems, health and economic systems are not independent. They are interrelated in several important ways. Economic and social conditions and policies (income, education, employment, social support, tax and transfer policies) have very important health consequences. In order to control health care expenditures and to promote efficient and effective care, coordination of policies and cooperation with all ministries (health, economics, environment, agricultural, finance,..) are very important

References

  • Austin, D. Andrew, Health Care and Markets, http://wikileaks.org/leak/crs/ RL33759.pdf, [ET.13/04/2009], 2007.
  • Bilgili, Emine ve Eyyup Ecevit, “Sağlık Hizmetleri Piyasasında Asimetrik Bilgiye Bağlı Problemler ve Çözüm Önerileri”, Hacettepe Sağlık İdaresi Dergisi, Cilt: 11, Sayı: 2, 2008, ss: 201-228.
  • Care, Income Inequal-ity, and Mortality in the United States, 1980-1995”. Journal of the American Board of Family Practice 16, 2003, pp. 412-22.
  • Clevenger, Ernest, “How Primary Care, America’s Best- Kept Secret, Can Reduce Health Care Costs for Self-Funded Employers” HealthWatch, Issue: 59, 2008.
  • Cylus, Jonathan and Gerard F. Anderson, “Multinational Comparisons of Health Systems Data”, 2006, “The Commonwealth Fund”, Vol.24. Department of Family and Preventive Medicine, 2007.
  • Elmendorf, Douglas W. “Options for Controlling the Cost and Increasing the Efficiency of Health Care”, http://www.cbo.gov/ftpdocs/100xx/ doc10016/03-10-Health_Care.pdf, [ET. 22/04/2009], 2009.
  • Gilliam, S., “The declaration of Alma Ata: still relevant after all these years?” Gulliford, M.C. “Avaliability of Primary Care Doctors and Population Health in England: Is There an Association?”, Journal of Public Health Medicine 24, 2002, pp: 252-4.
  • Gulliford, M.C., R.H. Jack, G. Adams, and O.C. Ukoumunne, “Avaliability and Structure of Primary Medical Care Services and Population Health Care Indicators in England”, BMC Health Services Research,Vol. 4, No: 12, 2004.
  • Gutierrez, Cecilia and Peter Scheid, “The History of Family Medicine and Its Impact in US Health Care Delivery” University of California San Diego in Developing Countries” Annals of Family Medicine_www. annfammed. org_Vol.2,Supplement2_May/June2004
  • Health” The Milbank Quarterly, Vol. 83, No. 3, pp. 457-502 http://www.jstor.org/stable/30045625 [ET.05/06/2009], 2005. http://www.15by15.org/wp-content/uploads/2008/03/declaration-of-almaata-stephen-gillam.pdf [ET. 22/04/2009], 2007.
  • Macinko, J., B. Starfield, and L. Shi. 2003. “The Contribution of Pri-mary Care Systems to Health Outcomes within Organization for Economic Cooperation and Development (OECD) Countries, 1970- 1998”. Health Services Research3 8, 2003, pp: 831-65.
  • Mechanic, David and David A. Rochefort “Comparative Medical Systems” Annual Review of Sociology, Vol. 22 (1996), pp. 239-270 http://www. jstor.org/stable/2083431 [ET: 08/06/2009]
  • Mohan, Ramesh and Sam Mirmirani, “An Assessment of OECD Health Care System Using Panel Data Analysis”, MPRA Paper, http://mpra.ub.unimuenchen.de/6122/, [ET. 22/04/2009], 2007.
  • Montefiori, M., “Patient Behavior in the Market for Hospital Services”,
  • NJAFP,http://www.njafp.org/documents/Cost%20Effective%20Delivery%20of%2 0Health%20Care_200 80604120234_20090120110514.pdf: [ET. 19/05/ 2009].
  • Sans-Corrales, Mireia, Enriqueta Pujol-Ribera, Joan Gene-Badia, Maria Isabel Pasarin-Rua, Begona Iglesias-Perez and Josep Casajuana-Brunet “Family Medicine attributes related to satisfaction, health and costs” Family Practice, Vol. 23, No. 3, 2006, pp: 308-316.
  • Shi, L., J. Macinko, B. Starfield, J. Wulu, J. Regan, and R. Politzer. ”The Relationship between Primary Sips, Fons, “A common basis for general practice/family medicine in EuropeEditorial”http://findarticles.com/p/articles/mi_m0689/is_n1_v41/ai_17376 310/[ET. 23/12/2008], 1995.
  • Sjonell, G., “Organised Family Medicine:The Key Issue To Cost-Effective Healthcare”, http://www.cfps.org.sg/sreenivasan/articles/1997.html, [ET. 22/04/2009], 1997.
  • Starfield, Barbara, Leiyu Shi, and James Macinko, “Contribution of Primary Care to Health Systems and Stewart, Moira “The Impact of Patient-Centered Care on Outcomes”, The Journal of Family Practice; Vol: 49, 2004, pp: 796-804.
  • WHO, “A Summary of the 2008 World Health Report : “Primary Health Care: Now More Than Ever”, http://www.who.int/whr/2008/summary.pdf, 2008.
  • WHO, Declaration of Alma-Ata, http://www.who.int/hpr/NPH/docs/ declaration_almaata.pdf
  • WHO, European Health Care Reforms: Analysis of Current Strategies Summary http://www.euro.who.int/document/obs/sumhecareform.pdf, [24/03/2009], 1996.
  • WHO, http://www.who.int/en/
  • WHO, What are the advantages and disadvantages of restructuring a health care system to be more focused on primary care services? http://www.euro.who.int/Document/E82997.pdf, [24/03/2009] Wong, Thomas, “A check for healthcare payment systems”, http://www.camagazine.com/4/6/6/1/0/index1.shtml, [ET. 24/03/2009], 2008. www.disefin.unige.it/finanza/WP%5Cn42003.pdf [ET.12.08.2006].
  • Zwanziger, Jack and Glenn A. Melnick, “Can Managed Care Plans Control Health Care Costs? Health Affairs, Vol. 15, No. 2, 1996, pp: 185-199.
There are 25 citations in total.

Details

Other ID JA78EJ35TA
Journal Section Makaleler / Articles
Authors

Emine Kılavuz This is me

Publication Date December 1, 2010
Submission Date December 1, 2010
Published in Issue Year 2010 Volume: 1 Issue: 29

Cite

APA Kılavuz, E. (2010). Sağlık Harcamalarındaki Artış ve Temel Bakım Hizmetleri. Erciyes Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 1(29), 173-192.

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