Herkes için Sağlık? Türkiye'de Sağlık Hizmetleri Kullanımında Eşitlik Üzerine Bir Araştırma

Abstract

Sağlık hizmetleri kullanımında eşitsizlikler gelir temelli, mesleki veya bölgesel faktörlerden kaynaklanabilir. Bu eşitsizlikler, önlenebilir ve haksız nedenlerle sağlık hizmetlerinin kullanımını engellediğinde politika yapıcılar tarafından müdahale gerektirir. 2003 yılında başlatılan Sağlıkta Dönüşüm Programı bu nitelikte bir politika müdahalesi olarak kabul edilebilir. Bu program sağlık hizmetlerinin etkinliğini, verimliliğini ve eşitliğini sağlamayı amaçlamaktadır. Ancak bu politika değişikliğinden kaynaklanan refah düzeyinin analiz edilmesi gerekmektedir. Çalışma, literatürdeki bu boşluğa odaklanmayı amaçlamaktadır. Çalışma, Sağlıkta Dönüşüm Programı’ndan sonra sağlık hizmetleri kullanımında eşitlik ilkesinin sağlanıp sağlanamadığını incelemektedir. Çalışmanın bu amacı için Türkiye Sağlık Araştırması veri seti analiz edilecektir. Probit modeli tahminlerinin sonuçları, Türkiye’de gelir temelli eşitsizliğe ek olarak sağlık hizmetleri kullanımında bölgesel eşitsizliğin de olduğunu göstermektedir. Ayrıca, belirli meslek grupları arasında eşitsizlik kanıtları gözlemlenmiştir. Türkiye’de sağlık hizmetlerinin kullanımındaki eşitsizleri gidermek için politikaların daha hassas bir şekilde uygulanması zorunludur. Sağlık politikalarının, özellikle gelir, servet ve istihdam politikaları ile desteklenmesi gerekir.

Keywords

• Sağlık hizmetleri kullanımı
• eşitlik
• sağlıkta eşitsizlik

Supporting Institution

Çalışma, kamusal, özel, ticari nitelikte ya da kar amacı gütmeyen herhangi bir kurumdan destek alınmadan hazırlanmıştır.

Ethical Statement

Bu çalışmanın hazırlanma sürecinde bilimsel ve etik ilkelere uyulduğu ve yararlanılan tüm çalışmaların kaynakçada belirtildiği beyan olunur.

Health for All? A Study on Equity in Health Services Utilization in Turkey

Abstract

Inequities in the utilization of health services may stem from income-related, occupational, or region-based factors. These inequities require intervention by policymakers when they prevent individuals from utilizing health services for avoidable and unjust reasons. The Health Transformation Program, initiated in 2003, can be regarded as a policy intervention of this nature. This program aims to enhance the effectiveness, efficiency, and equity of health services. However, the level of prosperity resulting from this policy change still needs to be analyzed. This study addresses this gap in the literature. It examines whether the principle of equity in health service utilization has been achieved after the Health Transformation Program. For this purpose, data from the Turkey Health Survey were analyzed. The probit model estimates show that, in addition to income-related inequity, region-based inequities exist in health service utilization in Turkey. Furthermore, evidence of inequity was observed among specific occupational groups. In order to address inequities in the utilization of health services in Turkey, it is essential that policies are implemented with greater precision. It is especially important that health policies are supported by income, wealth, and employment policies..

Keywords

• Health services utilization
• equity
• inequity in health

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical Statement

It is declared that scientific and ethical principles have been followed while carrying out and writing this study and that all the sources used have been properly cited.

References

1. Acar, İ. A., & Kitapcı, İ. (2008). Sosyal Güvenliğin Demografik Boyutu: Türkiye’deki Emeklilik Sistemindeki Değişim. Maliye Dergisi(154), s. 77-98.
2. Aday, L. A., & Andersen, R. M. (1974). A Framework for the Study of Access to Medical Care. Health Services Research, 9(3), s. 208-220.
3. Aday, L. A., Andersen, R. M., & Fleming, G. V. (1980). Health Care in the U.S.: Equitable for Whom? Beverly Hills, CA: Sage.
4. Agartan, T. I. (2015). Health Workforce Policy and Turkey’s Health Care Reform. Health Policy, 119(12), s. 1621-1626.
5. Akkaya, Y. (2000). Sosyal Güvenlik Tarihi Üzerine Notlar. Toplum ve Hekim, 15(2), s. 82-91.
6. Andersen, R. M. (1968). A Behavioral Model of Families’ Use of Health Services. University of Chicago Press.
7. Andersen, R. M. (1995). Revisiting the Behavioral Model and Access to Medical Care: Does it Matter? Journal of Health and Social Behavior, 36(1), pp. 1-10.
8. Andersen, R. M., & Newman, J. F. (1973). Societal and Individual Determinants of Medical Care Utilization in the United States. The Milbank Memorial Fund Quarterly: Health and Society, 51(1), s. 95–124.

9. Arıcı, K. (2015). Genel Sağlık Sigortasında Gelir Testi Meselesi ve Çözümü. SİCİL İş Hukuku Dergisi(34), s. 27-40.
10. Arıcı, K. (2019). Sosyal Güvenlikte Eşitlik Meselesi. Ankara Hacı Bayram Veli Üniversitesi Hukuk Fakültesi Dergisi, 23(1), s. 3-23.
11. Arnault, D. S. (2009). Cultural Determinants of Healp Seeking: A Model for Research and Practice. Research and Theory for Nursing Practice, 23(4), s. 259-278.
12. Arnault, D. S. (2018). Defining and Theorizing About Culture: The Evolution of the Cultural Determinants of Help-Seeking, Revised. Nursing Research, 67(2), s. 161-168.
13. Asada, Y., & Kephart, G. (2011). Understanding Different Methodological Approaches to Measuring Inequity in Health Care. International Journal of Health services, 41(2), s. 195-207.
14. Babitsch, B., Bormann, C., Gohl, D., & Ciupitu-Plath, C. C. (2014). Gender and Utilization of Health Care. In C. Janssen, E. Swart, & T. v. Lengerke (Eds.), Health Care Utilization in Germany: Theory, Methodology, and Results (pp. 101–116). New York: Springer.
15. Başar, D., Öztürk, S., & Cakmak, İ. (2021). An Application of the Behavioral Model to the Utilization of Health Care Services in Turkey: A Focus on Equity. Panoeconomicus, 68(1), pp. 129-146.
16. Başol, E., & Işık, A. (2015). Türkiye'de sağlık Politikalarında Güncel Gelişmeler: ağlıkta Dönüşüm Programından Günümüze Bazı Değerlendirme ve Öneriler. International Anatolia Academic Online Journal, 2(2), s. 1-26.
17. Baum, A. (2023). Bridge or Barrier? The Impact of Network Capital on the Receipt of Long-Term Care Services in Germany. Journal of Aging and Health, 35(1-2), pp. 23-41.
18. Bayri, O. (2013). Türkiye’de Sosyal Güvenlik Sisteminin Kurum ve Kapsam Olarak Gelişimi ve Sosyal Güvenlik Adaleti. Sosyal Güvenlik Dergisi, 3(2), s. 18-60.
19. Bertakis, K. D., Azari, R., Helms, L. J., Callahan, E. J., & Robbins, J. (2000). Gender Differences in the Utilization of Health Care Services. The Journal of Family Practice, 49(2), pp. 147–152.
20. Blackwell, D. L., Martinez, M. E., Gentleman, J. F., Sanmartin, C., & Berthelot, J.-M. (2009). Socioeconomic Status and Utilization of Health Care Services in Canada and the United States: Findings from a Binational Health Survey. Medical Care, 47(11), pp. 1136-1146.
21. Bostancı, Y. (2008). Sosyal Güvenlik Hukukunda Genel Sağlık Sigortası. Selçuk Üniversitesi Hukuk Fakültesi Dergisi, 16(1), s. 145-173.
22. Braveman, P. A. (2006). Health Disparities and Health Equity: Concepts and Measurement. Annual Review of Public Health, 27(1), s. 167-194.
23. Braveman, P. A. (2010). Social Conditions, Health Equity, and Human Rights. Health and Human Rights, 12(2), s. 31-48.
24. Braveman, P. A. (2022). Defining Health Equity. Journal of the National Medical Association, 114(6), s. 593-600.
25. Braveman, P. A., & Gruskin, S. (2003). Defining equity in health. J Epidemiol Community Health, 57(4), s. 254-258.
26. Cameron, A. C., & Trivedi, P. K. (2005). Microeconometrics: Methods and Applications. Cambridge University Press.
27. Cameron, A. C., & Trivedi, P. K. (2022). Microeconometrics Using Stata Volume II: Nonlinear Models and Causal Inference Methods (2. ed.). Stata Press Publication.
28. Carrillo, J. E., Carrillo, V. A., Perez, H. R., Salas-Lopez, D., Natale-Pereira, A., & Byron, A. T. (2011). Defining and Targeting Health Care Access Barriers. Journal of Health Care for the Poor and Underserved, 22(2), pp. 562-575.
29. Carter-Pokras, O., & Baquet, C. (2002). What is a "Health Disparity"? Public Health Reports, 117(5), s. 426-434.
30. Cheng, Q., Fattah, R., Susilo, D., Satrya, A., Haemmerli, M., Kosen, S., . . . Wiseman, V. (2025). Determinants of healthcare utilization under the Indonesian national health insurance system – a cross-sectional study. BMC Health Services Research, 25(48), pp. 1-15.
31. Chrisman, N. J. (1977). The Health Seeking Process: An Approach to the Natural History of Illness. Culture, Medicine and Psyhchiarty, 1(4), s. 351-377.
32. Copeland, V. C., & Butler, J. (2007). Reconceptualizing Access A Cultural Competence Approach to Improving the Mental Health of African American Women. Social Work in Public Health, 23(2-3), pp. 35-58.
33. Culyer, A., & Wagstaff, A. (1993). Equity and equality in health and health care. Journal of Health Economics, 12(4), s. 431-457.
34. Demir, E., & Kılıç, G. (2021). Pandemide Sosyal Güvenlik. In O. Elbek, & K. Pala, PAndeminin Düşürdüğü Maskeler: COVID-19 Salgınının Muhasebesi (1. ed., pp. 177-194). İstanbul: İletişim Yayınları.
35. Dertli, N. (2015). Genel Sağlık Sigortası ve Gelir Testi: Statü Eşitsizliğinden Gelir Eşitsizliğine. Mülkiye Dergisi, 39(3), s. 271-304.
36. Devaux, M. (2015). Income-related Inequalities and Inequities in Health Care Services Utilisation in 18 Selected OECD Countries. European Journal of Health Economics, 16(1), s. 21-33.
37. Doorslaer, E. v., Masseria, C., & Koolman, X. (2006). Inequalities in Access to Medical Care by Income in Developed Countries. Canadian Medical Association Journal, 174(2), pp. 177-183.
38. Dover, D. C., & Belon, P. (2019). The Health Equity Measurement Framework: A Comprehensive Model to Measure Social Inequities in Health. International Journal for Equity in Health, 18(36).
39. Egede, L. E., Walker, R. J., & Williams, J. S. (2024). Addressing Structural Inequalities, Structural Racism, and Social Determinants of Health: a Vision for the Future. Journal of General Internal Medicine, 39, pp. 487-491.
40. Geitona, M., Zavras, D., & Kyriopoulos, J. (2007). Determinants of Healthcare Utilization in Greece: Implications for Decision-Making. European Journal of General Practice, 13(3), pp. 144-150.
41. Gliedt, J. A., Spector, A. L., Schneider, M. J., Williams, J., & Young, S. (2023). A Description of Theoretical Models for Health Serrvice Utilization: A Scoping Review of the Literature. The Journal of Health Care Organization, Provision, and Financing, 60, pp. 1-17.
42. Godoy, A., & Huitfeldt, I. (2020). Regional Variation in Health Care Utilization and Mortality. Journal of Health Economics, 71.
43. Gould, W., Pitblado, J., & Poi, B. (2010). Maximum Likelihood Estimation with Stata (4. ed.). Stata Press Publication.
44. Gökbayrak, Ş. (2010). Türkiye’de Sosyal Güvenliğin Dönüşümü. Çalışma ve Toplum, 2(25), s. 141-162.
45. Greene, W. H. (2009). Discrete Choice Modeling. In T. C. Mills, & K. Patterson (Eds.), Palgrave Handbook of Econometrics Volume 2: Applied Econometrics (pp. 473-556). Palgrave Macmillan.
46. Greene, W. H. (2012). Econometric Analysis (7. ed.). Pearson.
47. Guallar-Castillón, Á. R.-S., Banegas, J. R., & Rodríguez-Artalejo, F. (2006). Gender Differences in the Utilization of Health-Care Services among the Older Adult Population of Spain. BMC Public Health, 6(155).
48. Güvercin, C. H. (2004). Sosyal Güvenlik Kavramı ve Türkiye'de Sosyal Güvenliğin Tarihçesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 57(2), s. 89-95.
49. Güzel, A. (2005). Türk sosyal Güvenlik Sisteminde Öngörülen Reform Mevcut Sorunlara Çözüm Mü? Çalışma ve Toplum, 4(7), s. 61 - 76.
50. Hanratty, B., Zhang, T., & Whitehead, M. (2007). How Close Have Universal Health Systems Come to Achieving Equity in Use of Curative Services? A Systematic Review. International Journal of Health Service, 37(1), pp. 89-109.
51. Hensher, D. A., Rose, J. M., & Greene, W. H. (2015). Applied Choice Analysis (2. ed.). Cambridge University Press.
52. Heymann, J., Cassola, A., Raub, A., & Mishra, L. (2013). Constitutional Rights to Health, Public Health and Medical Care: The Status of Health Protections in 191 Countries. Global Public Health, 8(6), pp. 639-653.
53. Hochhausen, L., Le, H.-N., & Perry, D. F. (2011). Community-based Mental Health Service Utilization among Low-Income Latina Immigrants. Community Mental Health Journal, 47, pp. 14-23.
54. Insaf, T. Z., Jurkowski, J. M., & Alomar, L. (2010). Sociocultural factors influencing delay in seeking routine health care among Latinas: a community-based participatory research study. Ethnicity & Disease, 20(2), pp. 148-154.
55. Iwashyna, T. J., & Christakis, N. A. (2003). Marriage, Widowhood, and Health-Care Use. Social Science & Medicine, 57(11), pp. 2137-2147.
56. İzgi, B. B. (2008). Türk Sosyal Güvenlik Sisteminde Son Gelişmeler. Çalışma ve Toplum, 1(16), s. 85-107.
57. Joung, I. M., Meer, J. B., & Mackenbach, J. P. (1995). Marital Status and Health Care Utilization. International Journal of Epidemiology, 24(3), pp. 569-575.
58. Karabulut, A. (2017). Sosyal Güvenlik Hakkı ve 1982 Anayasası'na Yansımaları. İş ve Hayat, 2(3), s. 187 - 208.
59. Kim, J.-H., Lee, K. S., Lee, Y., & Park, E.-C. (2017). Association of Occupational Class with Healthcare Utilization among Economically Active Korean Adults from 2006 to 2014: A Repeated Cross-Sectional Study of Koreans Aged 19 Years and Older. Korean Journal of Family Medicine, 38(6), pp. 365-371.
60. Kim, J.-H., Lee, K. S., Lee, Y., & Park, E.-C. (2017). Association of Occupational Class with Healthcare Utilization among Economically Active Korean Adults from 2006 to 2014: A Repeated Cross-Sectional Study of Koreans Aged 19 Years and Older. Korean Journal of Family Medicine, 38(6), pp. 365-371.
61. Kisa, A., Yilmaz, F., Younis, M. Z., Kavuncubasi, S., Ersoy, K., & Rivers, P. A. (2009). Delayed use of Healthcare services among the Urban Poor in Turkey. Education, Business and Society: Contemporary Middle Eastern Issues, 2(3), pp. 232-240.
62. Koopmans, G. T., & Lamers, L. M. (2007). Gender and Health Care Utilization: The Role of Mental Distress and Help-Seeking Propensity. Social Science & Medicine, 64(6), pp. 1216-1230.
63. Kriegger, N. (1999). Embodying inequality: a review of concepts, measures, and methods for studying health consequences of discrimination. International Journal of Health Services, 29(2), s. 295-352.
64. Lahana, E., Pappa, E., & Niakas, D. (2011). Do Place of Residence and Ethnicity Affect Health Services Utilization? Evidence from Greece. International Journal for Equity in Health, 10(16).
65. Leary, V. A. (1994). The Right to Health in International Human Rights Law. Health and Human Rights, 1(1), s. 24-56.
66. Lee, C., Ayers, S. L., & Kronenfeld, J. J. (2009). The Association between Perceived Provider Discrimination, Health Care Utilization, and Health Status in Racial and Ethnic Minorities. Ethnicity & Disease, 19(3), pp. 330–337.
67. Lengerke, T. v., Gohl, D., & Babitsch, B. (2014). Re-revisiting the Behavioral Model of Health Care Utilization by Andersen: A Review on Theoretical Advancecs and Perspectives. In C. Janssen, E. Swart, & T. v. Lengerke (Eds.), Health Care Utilization in Germany: Theory, Methodology, and Results (pp. 11-28). New York: Springer.
68. Link, B. G., García, S. J., Firat, R., Scalla, S. L., & Phelan, J. C. (2024). Socioeconomic-Status-Based Disrespect, Discrimination, Exclusion, and Shaming: A Potential Source of Health Inequalities? Journal of Health and Social Behavior, 65(4), pp. 558-576.
69. Lui, M., Zhang, Q., Lu, M., Kwon, C.-S., & Quan, H. (2007). Rural and Urban Disparity in Health Services Utilization in China. Medical Care, 45(8), pp. 767-774.
70. Macinko, J. A., & Starfield, B. (2002). Annotated Bibliography on Equity in Health, 1980-2001. International Journal of Equity Health, 1(1).
71. Magi, M., & Allander, E. (1981). Towards a Theory of Perceived and Medically Defined Need. Sociology of Health & Illness, 3(1), pp. 49-71.
72. Makas, R. (2004). Sosyal Güvenlik Kurumlarının Yeniden Yapılanması Üzerine. Çalışma ve Toplum, 1(1), s. 67-79.
73. Maral, I. (1995). Yeşil Kart. Toplum ve Hekim, 10(69-70), s. 125-128.
74. Marschak, J. (1959). Binary-Choice Constraints on Random Utility Indicators. Cowles Foundation Discussion Papers. 297.
75. McCaughrin, W. C. (1984). Dollars and Sense: The Economics of Personal Health Decision-Making. Health Policy, 4(2), s. 101-116.
76. Miller, S., Rhodes, E., Bartik, A. W., Broockman, D. E., Krause, P. K., & Vivalt, E. (2024). Does Income Affect Health? Evidence from a Randomized Controlled Trial of a Guaranteed Income. NBER Working Paper Series: Working Paper 32711.
77. Ministry of Health. (2003). Transformation in Health.
78. Ministry of Health. (2009). Health Transformation Program in Turkey.
79. Morris, S., Sutton, M., & Gravelle, H. (2005). Inequity and Inequality in the Use of Health Care in England: An Empirical Investigation. Social Science & Medicine, 60(6).
80. Newbold, K. B., Eyles, J., & Birch, S. (1995). Equity in Health Care: Methodological Contributions to the Analysis of Hospital Utilization within Canada. Social Science & Medicine, 40(9), pp. 1181-1192.
81. O’Donnell, O., Doorslaer, E. v., Wagstaff, A., & Lindelow, M. (2008). Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation. The World Bank.
82. OECD. (2008). OECD Reviews of Health Systems: Turkey.
83. Öztek, Z. (2021). Temel Sağlık Hizmetleri: Sorular ve Yanıtlar. Toplum ve Hekim, 36(1), s. 52-60.
84. Paasche-Orlow, M., & Wolf, M. (2007). The Causal Pathways Linking Health Literacy to Health Outcomes. American Journal of Health Behavior, 31(1), s. 19-26.
85. Pala, K. (2021a). Türkiye'de Sağlık Alanında Eşitsizlikler. İstanPol, Friedrich-Ebert-Stiftung Derneği.
86. Pala, K. (2021b). Dönüşen Sağlıkta Pandemi. In O. Elbek, & K. Pala, Pandeminin Düşürdüğü Maskeler: COVID-19 Salgınının Muhasebesi (1. ed., pp. 119-150). İstanbul: İletişim Yayınları.
87. Parslow, R., Jorm, A., Christensen, H., & Jacomb, P. (2002). Factors Associated with Young Adults' Obtaining General Practitioner Services. Australian Health Review, 25(6), pp. 109-118.
88. Pekten, A. (2006). Genel Sağlık Sigortası Sistemi ve Getirdiği Yenilikler. Sayıştay Dergisi(61), s. 119-138.
89. Pulok, M. H., Gool, K. v., & Hall, J. (2020). Horizontal Inequity in the Utilisation of Healthcare Services in Australia. Health Policy, 124(11), pp. 1263-1271.
90. Qian, D., Pong, R. W., Yin, A., Nagarajan, K. V., & Meng, Q. (2009). Determinants of Health Care Demand in Poor, Rural China: The Case of Gansu Province. Health Policy and Planning, 24(5), pp. 324–334.
91. Ravesteijn, B., Kippersluis, H. v., & Doorslaer, E. v. (2013). The Contribution of Occupation to Health Inequality. In Research on Economic Inequality Volume 21: Health and Inequality (Vol. 21, pp. 311–332). Emerald Group Publishing Limited.
92. Scheppers, E., Dongen, E. v., Dekker, J., Geertzen, J., & Dekker, J. (2006). Potential Barriers to the Use of Health Services among Ethnic Minorities: A Review. Family Practice, 23(3), pp. 325–348.
93. Sebastián, M. S., Mosquera, P. A., Ng, N., & Gustafsson, P. E. (2017). Health Care on Equal Terms? Assessing Horizontal Equity in Health Care Use in Northern Sweden. European Journal of Public Health, 27(4), pp. 637-643.
94. Siddiqi, A., Zuberi, D., & Nguyen, Q. C. (2009). The Role of Health Insurance in Explaining Immigrant versus Non-Immigrant Disparities in Access to Health Care: Comparing the United States to Canada. Social Science & Medicine, 69(10), pp. 1452–1459.
95. Söyler, S., & Çavmak, D. (2019). Sağlıkta Bölgesel Eşitsizlikler: Türkiye Açısından Bir Değerlendirme. In H. Eriş, & F. Bucak (Eds.), Sağlık Bilimlerinde Yeni Gelişmeler (pp. 385 - 435). IKSAD Publishing House.
96. Sözmen, K., & Ünal, B. (2016). Explaining Inequalities in Health Care Utilization amongTurkish Adults: Findings from Health Survey 2008. Health Policy, 120(1), pp. 100-110.
97. Starfield, B. (2001). Improving Equity in Health: A Research Agenda. International Journal of Social Determinants of Health and Health Services, 31(3), s. 545-566.
98. Stockdale, S. E., Tang, L., Zhang, L., Belin, T. R., & Wells, K. B. (2007). The Effects of Health Sector Market Factors and Vulnerable Group Membership on Access to Alcohol, Drug, and Mental Health Care. Health Services Research, 42(3p1), pp. 1020-1041.
99. Tatar, M., Mollahaliloğlu, S., Şahin, B., Aydın, S., Maresso, A., & Hernández-Quevedo, C. (2011). Turkey: Health system review. Health Systems in Transition, 13(6), pp. 1-186.
100. Thurstone, L. L. (1927). A Law of Comparative Judgment. Psychological Review, 34(4), s. 273-286.
101. Train, K. (2003). Discrete Choice Methods with Simulation. Cambridge University Press.
102. TURKSTAT. (2017). Turkey Health Survet Report.
103. TURKSTAT. (2020). Turkey Health Survey Report.
104. TURKSTAT. (2023). Turkey Health Survey Report.
105. Uğur, Z. B., & Durak, A. (2024). The Impact of COVID-19 on Healthcare Utilization in Turkey. Value in Health Regional Issues, 43.
106. UN. (1948, December 10). Universal Declaration of Human Rights. Paris: United Nations General Assembly. United Nations Committee on Economic. (2000, August 11). Social and Cultural Rights. CESCR General Comment No. 14: The Right to the Highest Attainable (Art. 12). Geneva: UN.
107. Wagstaff, A., & Doorslaer, E. v. (2000). Measuring and Testing for Inequity in the Delivery of Health Care. The Journal of Human Resources, 35(4), s. 716-733.
108. Wagstaff, A., Paci, P., & Doorslaer, E. v. (1991). On the Measurement of Inequalities in Health. Social Science & Medicine, 33(5), pp. 545-557.
109. Waters, H. R. (2000). Measuring Equity in Access to Health Care. Social Science & Medicine, 51(4), s. 599-612.
110. Whitehead, M. (1992). The Concepts and Principles of Equity and Health. International Journal of Health Services, 22(3), pp. 429-445.
111. WHO. (1946). Constitution of the World Health Organization. International Health Conference. New York.
112. WHO. (2012). Successful Health System Reforms: The Case of Turkey.
113. Yardim, M. S., & Uner, S. (2018). Equity in Access to Care in the Era of Health System Reforms in Turkey. Health Policy, 122(6), s. 645-651.