Türkiye’de Sağlık Personeli Eşitsizliği: Theil ve Gini ile Zaman Analizi

Abstract

Sağlık işgücü eşitsizliği, dünya genelinde sağlık hizmetlerine adil erişimi olumsuz etkilemektedir. Türkiye, 2000’li yıllarda hekim dağılımındaki bölgesel farklılıkları gidermek amacıyla Sağlıkta Dönüşüm Programı (SDP) kapsamında kapsamlı sağlık sistemi reformları uygulamıştır. Amaç: 2002 ile 2023 yılları arasında Türkiye’nin 81 ilinde sağlık personeli eşitsizliğinin zaman içindeki eğilimlerini hekim dağılımı çerçevesinde incelemektir. Yöntem: TÜİK tarafından sağlanan ve tüm illere ait hekim sayıları ile nüfus verilerini içeren resmi veriler analiz edilmiştir. Eşitsizlikteki değişimi nicel olarak ölçmek amacıyla her yıl Gini katsayısı ve Theil endeksi hesaplanmıştır. Her iki ölçüt başlangıçta gelir eşitsizliğini değerlendirmek amacıyla geliştirilmiş olsa da, sağlık hizmetlerinin dağılımındaki eşitsizlikleri etkin şekilde yansıtmaktadır. Bulgular: Her iki endeks de, 2000’li yıllarda SDP reformlarıyla uyumlu olarak, hekim dağılımında önemli ölçüde iyileşme göstermiştir. Gini katsayısı 2002 yılında 0,253 iken 2019’da 0,146’ya; Theil endeksi ise 0,103’ten 0,034’e gerilemiştir. 2019 sonrasında ise her iki göstergede de ılımlı artışlar gözlenmiş; 2023 itibarıyla Gini katsayısı 0,174’e, Theil endeksi ise 0,048’e yükselmiştir. Sonuç: Türkiye, hedefe yönelik politika müdahaleleri sayesinde bölgesel hekim eşitsizliğini azaltmada önemli ilerleme kaydetmiştir. Son dönem eğilimleri, sağlık hizmetlerindeki eşitliği korumak adına sürekli izleme ve uyarlanabilir stratejilerin gerekliliğine işaret etmektedir.

Keywords

• Sağlık Eşitsizliği
• Gini Katsayısı
• Theil Endeksi
• Sağlık Politikası
• Türkiye

Health Personnel Inequality Trends in Turkey: Theil Index and Gini Analysis

Abstract

Health workforce inequality affects equitable access to healthcare worldwide. Turkey implemented major health system reforms in the 2000s through the Health Transformation Program (HTP) to address regional disparities in physician distribution. Aim: To examine temporal trends in health personnel inequality across Turkey's 81 provinces between 2002 and 2023, focusing on medical doctor distribution patterns. Methods: Official data from the Turkish Statistical Institute (TÜİK) on physician counts and population figures for all provinces were analyzed. The Gini coefficient and Theil index were calculated annually to quantify changes in inequality. Although originally developed to measure income inequality, both metrics effectively capture disparities in the distribution of healthcare resources. Results: Both indices showed major improvements in physician distribution equity during the 2000s, corresponding with HTP healthcare reforms. The Gini coefficient fell from 0.253 in 2002 to 0.146 in 2019, while the Theil index dropped from 0.103 to 0.034. After 2019, both measures showed modest increases, with 2023 values reaching 0.174 (Gini) and 0.048 (Theil). Conclusion: Turkey achieved substantial progress in reducing regional physician inequality through targeted policy interventions. Recent trends suggest the need for continued monitoring and adaptive strategies to maintain healthcare equity gains.

Keywords

• Health Inequality
• Gini Coefficient
• Theil Index
• Healthcare Policy
• Turkey

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