SAĞLIK HİZMETLERİNDE KÜRESEL REFORM YAKLAŞIMLARI

Yıl 2011, Sayı: 60, 323 - 365, 25.01.2012

Davuthan Günaydın

Öz

Sağlık hizmetlerinde gerçekleştirilmeye çalışılan reformlar genel olarak iki grupta değerlendirilmektedir. Bunlardan ilki, DB ve IMF tarafından desteklenen “piyasa temelli” sağlık reformudur. Bu modelde sağlık hizmetleri, piyasa ekonomisi ile  ilişkilendirilmektedir. İkincisi ise, DSÖ ve UNICEF tarafından desteklenen “sosyal model”dir. Bu model, sağlık hizmetlerini insan ihtiyacı temelinde değerlendirir. Ayrıca, bu iki modele ilave olarak, her iki modelin birlikte kullanıldığı, “yaklaşımların işbirliği” olarak adlandırılabilecek üçüncü bir modelden de söz etmek mümkündür.

 

The reforms that are planned to be realized in the future will be
evaluated in two groups. The first one of them is “the market based”, which is supported by WB and IMF. In this model, health care services are related with the market economics. The second one is “the social model”, which is supported by WHO and UNICEF. This model treats health care services at a base that health care is a commodity for human beings. It is also possible to think of a third model that can be named
“cooperation of approaches” which represent a model where these two approaches given above are combined together.

Anahtar Kelimeler

Sağlık Hizmetleri Reformu, Sağlık Hizmetleri

Kaynakça

• Ağartan, Tuba. “Sağlıkta Reform Salgını”, Avrupa’da ve Türkiye’de Sağlık Politikaları, Reformlar, Sorunlar, Tartışmalar, 1. Baskı, İstanbul, İletişim Yayınları, 2007.
• Annear, Peter Lesli. Healthy Markets–Healthy People? Reforming Health Care in Cambodia, School of Health Sciences, Darkin University, Burwood, 2001.
• Aktan, Coşkun Can, Kadir Işık. Sağlık Hizmetlerinin Finansmanı ve Alternatif Tanımlar, http://www.canaktan.org/ekonomi/saglik–degisim– caginda/pdf–aktan/finansman–alternatif.pdf, (25.08.2010).
• Ashton, Toni, Jacqueline Cumming, Janet McLean. “Contracting for Health Services in a Public Health System: the New Zealand Experience”, Health Policy, 69, 2004.
• Balkenhol, Bernd, Craig Churchill. From Microfinance to Micro Health Insurance, Social Reinsurance A New Approach to Sustainable Community Health Financing, World Bank and Internatıonal Labour Offıce, 2002, http://www–wds.worldbank.org/servlet/WDSContent Server/WDSP/IB/2003/08/27/000012009_20030827151353/Rendered/P DF/265280PAPER0Social0reinsurance.pdf, (Erişm: 15.09.2010).
• Bennett, Sara. The Role Of Community–Based Health Insurance within the Health Care Financing System: A Framework for Analysis, Health Policy And Planning; 19(3): Oxford University Press, 2004.
• Bhat, Ramesh. Public–Private Partnerships: Lessons and Implications from Three Case Studies Managing Contracting Arrangements to Strengthen the Reproductive and Child Health Programme in India, World Health Organization, Geneva, 2007.
• BMA. Commissioning and the Impact of the Purchaser–Provider Split on the NHS uploads/commissionign–and–purchaser–provider–split–with–links– 03062.pdf, (Erişim: 02.10.2010).
• Breyer, Friedrich, Andreas Haufler. “Health Care Reform: Separating Insurance from Income Redistribution”, International Tax and Public Finance, 7, 445–461, Kluwer Academic Publishers, Netherlands, 2000.
• Busse, Reinhard, Jonas Schreyögg, Christian Gericke. Analyzing Changes in Health Financing Arrangements in High–Income Countries, a Comprehensive Framework Approach, Health, Nutrition and Population (HNP) Discussion Paper, Washington, 2007.
• Bosanquet, Nick. ” Public/Private Partnership: Change For Today’s Patients– not Tomorrow’s”, Eurohealth, Vol 6 No 2, London, 2000.
• Carin, Guy. Community Based Health İnsurance Schemes in Devoloping Countries: Facts, Problems and Perspectivies, WHO Discussion Paper, Number 1, Department Health System Financing Expenditure and Resource, Geneva, 2003.
• Ciccone, Dana Karen. “Arguing for a Centralized Coordination Solution to the Public–Private Partnership Explosion in Global Health”, Global Health Promotion, 17: 48, 2010.
• Duran, Antonio, Igor Sheiman, Markus Schneider, John Overtveit. Purchasers, Providers and Contracts, Purchasing to Improve Health Systems Performance, Europen Observatory on Health Systems and Policies Series, First Published, Glasgow, Open University Press, 2005.
• Ekman, Björn. “Community–Based Health Insurance in Low–Income Countries: A Systematic Review of the Evidence”, Health Policy and Planning, 19(5), Oxford University Press, 2004.
• Figueras, Josep, Ray Robinson, Elke Jakubowski (ed.), Purchasing to Improve Health Systems Performance, Europen Observatory on Health Systems and Policies Series, First Published, Glasgow, Open University PreSs,
• Gerdtham U. G., Rehnberg, C., Tambour, M., The Impact of Internal Markets on Health Care Efficiency: Evidence From Health Care Reforms in Sweden, Working Paper Series in Economics and Finance, No 170, http://swopec.hhs.se/hastef/papers/hastef0170.pdf, (Erişim: 11.05.2010)
• Glinos,Irene A. Rita Baeten, Hans Maarse. “Purchasing Health Services Abroad: Practices of Cross–Border Contracting and Patient Mobility in Six European Countries”, Health Policy, 95, 2010.
• Ham, Chris. Healty Care Reform: Learning From International Experience, Open University Press, Birmingham, 1997.
• Harding, April, Alexander S. Preker. Private Participationin Health Services, World Bank Health, Nutrition, and Population Series, Washington, 2003.
• Hjertqvist,Johan, The Purchaser–Provider Split, Swedish Health–Care Reform, from Public Monopolies to Market Services, Frontier Centre for Public Policy, 201–63.
• Jacobs, Maryam Bigdeli, Mautris van Pelt, Por Ir, Cedric Salze. “Bridging Community Based Health Insurance on Social Protection for Health Care–a Step in the Direction for Health Care”, Tropical Medicine and International Health, Volume 13, No 2, Blakwell Publishing, 2008.
• Kankaanpa, Eila, Ismo Linnosmaa, Hannu Valtonen. “Public Health Care Providers and Market Competition: the Case of Finnish Occupational Health Services”, Europen Jurnal of Health Economics, Springer, Verlag, 2010.
• Kerschbaumer, Katja. “Public Private Partnership in Eastern Europe: Case Studies from Lithuania, Republika Srpska and Albania”, Eurohealth, Vol 13 No 2, London, 2007.
• Langenbrunner,Jhon C. Eva Orosz, Joe Kutzin, Mirian M. Wiley. “Purchasing and Paying Providers”, Purchasing to Improve Health Systems Performance, Josep Figueras, Ray Robinson, Elke Jakubowski (ed.), Europen Observatory on Health Systems and Policies Series, First Published, Glasgow, Open University Press, 2005.
• Libby, Anne M. “Contracting Between Public and Private Providers: A Survey of Mental Health Services in California”, Administration and Policy in Mental Health, Vol. 24, No. 4, 1997.
• Liu, Xingzhu, David R. Hotchkiss, Sujata Bose, “The Effectiveness of Contracting–Out Primary Health Care Services in Developing Countries: A Review Of The Evidence”, Health Policy and Planning, 23, 2008.
• Lincoln, Thomas, John R. Miles, Steve Scheibel. Community Health and Public Health Collaborations, Public Health Behind Bars, Springer, New York, 2007.
• Litvack, Jennie, Jessica Seddon, Decentralization Briefing Notes, World Bank Instute Resourse/wbi37142.pdf, (Erişim: 19.04.2009).
• http//siteresourse.worldbank.org/WBI/
• Loevinsohn, Benjamin, April Harding. “Buying Results? Contracting for Health Service Delivery in Developing Countries”, Lancet, Vol 366, 2005.
• Maarse, Haans, Thomas A. Rathwell, Tamas Evetovits, Alexander S. Preker, Elke Jakuboski. “Responding to Purchasing Provider Perspectives”, Purchasing to Improve Health Systems Performance, Josep Figueras, Ray Robinson, Elke Jakubowski (ed.), Europen Observatory on Health Systems and Policies Series, First Published, Glasgow, Open University Press, 2005.
• Maynard, Alan Anna Dixon. “Private Health Insurance And Medical Savings Accounts: Theory and Experience”, Funding Health Care: Options for Europe, Elias Mossialos, Anna Dixon, Josep Figueras, Joe Kutzin (ed.), First Published, Buckingham, Open University Press, 2002.
• Mera, Jarge A. “A Review of the Welfare State and Alternative Ways of Delivering Health Care”, İnternational Journal for Quality in Health Care, Volume 14, Oxford University Pres, 2002.
• Mc Quaid, Ronald W. “The Theory of Partnership”, Public Private Partnership, Theory and Practice in International Perspective, Stephen P. Osborne (ed.), First Published, London, Routledge, 2000.
• Mills, Anne Jonathan Broomberg, Experiences of Contracting Health Services: An Overview of the Literature, HEFP Working Paper 01/98, LSHTM, 1998.
• Molyneux,Catherine, Beryl Hutchison, Jane Chuma, Lucy Gilson. “The Role of Community–Based Organizations in Household Ability to Pay for Health Care in Kilifi District, Kenya”, Health Policy and Planning, 2007.
• Munthe, Christian. “The Goals of Public Health: An Integrated, Multidimensional Model”, Public Health Ethics, Volume 1, Number 1,
• Njau, R.J.A, F.W. Mosha, D. De Savigny. “Case Studies in Public–Private– Partnership in Health With the Focus of Enhancing the Accessibility of Health İnterventions”, Tanzania Journal of Health Research, Vol. 11, No. 4, 2009.
• Nikolic,Irina A., Harald Maikisch. Public–Private Partnerships and Collaboration in the Health Sector, An Overview with Case Studies from Recent European Experience, World Bank, Health, Nutrition and Population Discussion Paper, Washington, 2006.
• Nishtar, Sania. “The Mixed Health System Syndrome”, Bulletin of the World Health Organanization, Vol.88(1), 2010 January.
• Nyonator, Frank K., J. Koku Awoonor–Williams, James F Pillips, Tanya C Jones, Robert A Miller. “The Ghana Community–Based Health Planning and Services Initiative for Scaling up Service Delivery Inovation”, Health Policy And Planning, 20(1), Oxford University Press, 2005.
• Reich, Michael R. “Public–Private Partnerships for Public Health”, Nature Medicine, Volume 6, Number 6, 2000.
• Rosen, James E. Contracting for Reproductive Health Care: A Guide, World Bank, Health, Nutrition and Population Discussion Paper, Washington, 2000.
• Saltman, R.B. J.Figüeras. “Avrupa ülkelerindeki Sağlık Reform Stratejilerinin Değerlendirilmesi”, Toplum ve Hekim, Cilt 14, Sayı 5, 1999.
• Saltman, R.B. J.Figüeras. Avrupa Sağlık Reformu: Mevcut Stratejilerin Analizi, Sağlık Bakanlığı Sağlık Projesi Genel Koordinatörlüğü Ankara, 1998.
• Schreyögg,Jonas, Oliver Tiemann, Reinhard Busse. “The DRG Reimbursement System in Germany”, Euro Observer, Winter 2005, Volume 7, Number 4, C. Çetin Değer (çev.), Makro Bakış, Sayı 5, 2007.
• Türk Dil Kurumu Sözlüğü, 4.Akşam Sanat Okulu Matbaası, 10.Basım, Ankara, 2005
• Taylor, James Stacey. “Market Incentives and Health Care Reform”, Journal of Medicine and Philosophy: 33, 2008.
• Taylor, Robert J. ”Contracting for Health Services”, Private Participationin Health Services, April Harding, Alexander S. Preker (ed.), World Bank Health, Nutrition, and Population Series, Washington, 2003.
• Taylor Robert J. “Contracting for Health Services”, Private Participationin Health Services, April Harding, Alexander S. Preker (edt.), World Bank Health, Nutrition, and Population Series, Washington, 2003.
• T. Plochg, N. S. Klazingo. “Community–Based Integrated Care: Myth or Must?”, International Journal for Quality in Health Care, Volume 14 Number 2, Oxford University Pres, 2002. The Bamako Initiative. panel_2_5.pdf, (Erişim: 02.08.2010).
• Wynand P. M. M. Van De Ven. “Market–Oriented Health Care Reform: Trends and Future Options”, Soc. Sci. Bird. Vol. 43, No. 5, 1996.
• WHO. World Health Report 2008, Primary Health Care Now More Than Ever, Switzerland 2008.
• WHO. Consultation on Strategic Contracting in Health Systems Synthesis of the Meeting Geneva, 2008.
• WHO. Frequently Asked Questions About Community–Based Initiatives, Community–Based http://whqlibdoc.who.int/emro/2003/WHO– EM_CBI_017_E_G_eng.pdf, (Erişim: 18.10.2009). 8, Cairo, 2003,
• Widdus, Roy. “Public–Private Partnerships for Health: Their Main Targets, Their Diversity, and Their Future Directions”, Bulletin of the World Health Organization, 79 (8), 2001.