HEALTHCARE FINANCING AND REVENUE SOURCES

Öz

Healthcare financing may be defined as the exchange or transfer of resources. The main objective of healthcare financing is to meet the healthcare expenditures of society. Healthcare services can be financed through taxation, social health insurance, private health insurance, community-based financing, medical savings accounts, out-of-pocket expenditures, as well as donations and grants. While taxation and social health insurance are considered public sources of financing, private health insurance, community-based financing, medical savings accounts, and out-of-pocket expenditures are classified as private sources. Donations and grants may originate from either public or private sources depending on the source of funding. Healthcare financing should rely on prepayment mechanisms and equitable contributions. Since public sources are more capable of fulfilling both of these conditions, public financing mechanisms are regarded as more appropriate methods for financing healthcare services. In contrast, out-of-pocket health expenditures represent the most problematic source of healthcare financing because they fail to satisfy either condition adequately. Out-of-pocket expenditures may prevent individuals from accessing the healthcare services they need or may result in catastrophic health expenditures.

Anahtar Kelimeler

• Revenue Collection Methods
• Equity
• Access to Healthcare
• Healthcare Financing.

Proje Numarası

Yok

SAĞLIK HİZMETLERİ FİNANSMANI VE GELİR KAYNAKLARI

Öz

Sağlık hizmetleri finansmanı, kaynakların değişimi ya da transferi olarak tanımlanabilmektedir. Sağlık hizmetleri finansmanının amacı, toplumun sağlık harcamalarını karşılamaktır. Sağlık hizmetleri finansmanı; vergiler, sosyal sağlık sigortası, özel sağlık sigortası, toplum temelli finansman, tıbbi tasarruf hesapları, cepten harcamalar ve bağış ve hibeler yoluyla karşılanabilmektedir. Vergiler ve sosyal sağlık sigortası kamusal nitelikli finansman kaynaklarıyken, özel sağlık sigortası, toplum temelli finansman, tıbbi tasarruf hesapları ve cepten harcamalar özel nitelikli kaynaklardır. Bağış ve hibeler sağlandığı kaynağa göre kamusal ya da özel kaynaklı olabilmektedir. Sağlık hizmetleri finansmanının ön ödemeli mekanizmalar ile hakkaniyetli katkılar ile finanse edilmesi gerekmektedir. Her iki koşulu da daha iyi düzeyde karşılamaları nedeniyle kamusal kaynaklar ile finansman sağlık hizmetleri için daha uygun yöntemlerdir. Buna karşın cepten sağlık harcamaları, her iki koşulu da sağlamamaları nedeniyle sağlık hizmetleri finansmanı açısından en sorunlu kaynaktır. Cepten sağlık harcamaları kişilerin ihtiyaç duydukları sağlık hizmetini alamamalarına ya da katastrofik sağlık harcamalarına neden olabilir.

Anahtar Kelimeler

• Gelir Toplama Yöntemleri
• Hakkaniyet
• Sağlık Hizmetlerine Erişim
• Sağlık Hizmetleri Finansmanı.

Destekleyen Kurum

Yok

Proje Numarası

Yok

Etik Beyan

Çalışmada veri kullanılmadığı için etik kurul iznine gerek bulunmamaktadır

Teşekkür

Yok

Kaynakça

1. Albreht, T., Kuhar, M., ve Prevolnik Rupel, V. (2022). Complementary health insurance in Slovenia. IntechOpen. doi: 10.5772/intechopen.105150.
2. Arab, M., Khosravi, B., Safari, H., Rahmani, H., Rajabi Vasokolaei, G., Mobinizadeh, M., ve Habibi, F. (2022). Reasons for informal payments from the perspective of health care providers and recipients: a qualitative study in Iran. Global Health Research and Policy, 7(1), 30.
3. Asante, A., Wasike, W. S. K., ve Ataguba, J. E. (2020). Health financing in Sub-Saharan Africa: from analytical frameworks to empirical evaluation. Applied Health Economics and Health Policy, 18(6), s.743–746. https://doi.org/10.1007/s40258-020-00618-0
4. Aslan, H. (2021). Sağlık hizmetleri finansmanı ve fonksiyonları. Aslan, H., Çetin Aslan, E. ve Top, M. (Ed.), Sağlık Ekonomisi içinde (311-325) Ankara: Siyasal Kitabevi.
5. Cashin, C. (2016). Health financing policy: the macroeconomic, fiscal and public finance context. A World Bank Study. s.47-52. http://dx.doi.org/10.1596/978-1-4648-0796-1
6. Chen, X., Guo, D., Tan, H., Zhang, Y., Liu, Y., Chen, X., ve Chen, Y. (2022). Can supplementary private health insurance further supplement health. Frontiers in Public Health, 10, 961019.
7. Chollet, D. J., & Lewis, M. (1997). Private insurance: principles and practise. Schieber, G. J. (Ed.), Innovations In Health Care Financing içinde (102-148) Washington. DC: The World Bank.
8. Cylus, J., Thomson, S., & Evetovits, T. (2018). Catastrophic health spending in Europe: Equity and policy implications of different calculation methods. Bulletin of the World Health Organization, 96(9), 599–609. https://doi.org/10.2471/BLT.18.209031

9. Domapielle, M. K., Sumankuuro, J., ve Bebelleh, F. Der. (2022). Revisiting the debate on health financing in Low and Middle-income countries: an integrative review of selected models. International Journal of Health Planning and Management, 37(6), 3061–3074. https://doi.org/10.1002/HPM.3566
10. Evans, R. G. (2002). Financing health care: taxation and the alternatives. Mossialos E., Dixon, A., Figueras, J. ve Kutzin, J. (Ed), Funding Health Care: Options for Europe içinde (31-58) Philadelphia: Open University Press.
11. Ezat Wan Puteh, S., ve Almualm, Y. (2017). Catastrophic health expenditure among developing countries. Health Systems and Policy Research, 04(01), s.1–5. https://doi.org/10.21767/2254-9137.100069
12. Fenny, A. P., Yates, R., ve Thompson, R. (2021). Strategies for financing social health insurance schemes for providing universal health care: a comparative analysis of five countries. Global Health Action, 14(1). https://doi.org/10.1080/16549716.2020.1868054
13. Getzen, T. E. (2012). Health Economics and Financing (5th ed.). Hoboken: John Wiley and Sons Inc.
14. Gottret, P. ve Schieber, G. (2006). Health Financing Revisited: A Practioner’s Guide. Washington DC. doi: 10.1596/978-0-8213-6585-4.
15. Gözlü, K. (2022). Sağlık sigortacılığının tarihsel gelişimi. Şantaş, F. ve Şantaş, G. (Ed.), Sağlık Sigortacılığı içinde (45-60) Ankara: Atlas Akademik Basım Yayın Dağıtım Tic. Ltd. Şti.
16. Jakab, M., ve Krishnan, C. (2004). Review of the strengths and weaknesses of community financing. Preker, A. S. ve Carrin, G. (Ed.), Health Financing for Poor People: Resource Mobilization and Risk Sharing içinde (53-118) Washington, D.C.: The World Bank.
17. Kutzin, J. (2001). A descriptive framework for country-level analysis of health care financing arrangements. Health Policy, 56(3), 171-204.
18. Lieberman, S., Gottret, P., Yeh, E., de Beyer, J., Oelrichs, R., ve Zewdie, D. (2009). International health financing and the response to AIDS. JAIDS Journal of Acquired Immune Deficiency Syndromes, 52, 38-44.
19. Maynard, A. ve Dixon, A. (2002). Private health insurance and medical savings accounts: theory and experience. Mossialos E., Dixon, A., Figueras, J. ve Kutzin, J. (Ed.), Funding Health Care: Options for Europe içinde (110-127) Philadelphia: Open University Press.
20. McIntyre, D. (2007). Learning from experience: health care financing in low- and middle-income countries. Global Forum for Health Research, Health Economics Unit, University of Cape Town, South Africa.
21. Mossialos, E. ve Dixon, A. (2002). Funding health care: an introduction. Mossialos E., Dixon, A., Figueras, J. ve Kutzin, J. (Ed.), Funding Health Care: Options for Europe içinde (1-30) Philadelphia: Open University Press.
22. Mpofu, F. Y., & Chilunjika, S. R. (2026). Rethinking Health Financing: An Analysis of Innovative Tax Models in Sub-Saharan African Contexts. Economies, 14(5), 153.
23. Murray, C. J. L., ve Frenk, J. (2000). A framework for assessing the performance of health systems. Bulletin of the World Health Organization, 78(6), 717-731. PMID: 10916909; PMCID: PMC2560787.
24. Navarro-Scherer, G. I., ve Lievens, T. (2012). Health financing: trends in sub-Saharan Africa. CABRI Dialogue on ‘Value for Money in the Health Sector: Health Financing and Expenditure Management for Allocative and Technical Efficiency, Oxford Policy Management Limited, 3.
25. Normand, C. ve Busse, R. (2002). Social health insurance financing. Mossialos E., Dixon, A., Figueras, J. ve Kutzin, J. (Ed.), Funding Health Care: Options for Europe içinde (59-79) Philadelphia: Open University Press.
26. Normand, C. ve Thomas, S. (2008). Health care financing and the health system. International Encyclopedia of Public Health, s.160-174.
27. Odeyemi, I. A. (2014). Community-based health insurance programmes and the national health insurance scheme of Nigeria: challenges to uptake and integration. International Journal for Equity in Health, 13(1), 20.
28. OECD. (2025). Health at a Glance 2025: OECD Indicators. Paris: OECD Publishing. https://doi.org/10.1787/8f9e3f98-en
29. OECD/European Commission. (2024). Health at a Glance: Europe 2024: State of Health in the EU Cycle. Paris: OECD Publishing.
30. Oğuzhan, G., & Kurnaz, M. (2018). Katastrofik sağlık harcamaları: Düşük gelirli ülke örnekleri. Samsun Sağlık Bilimleri Dergisi, 3(2), 25-32.
31. Olsen, J. A. (2009). Principles in Health Economics and Policy (1st ed.). New York: Oxford University Press.
32. Özer, Ö., Gözlü, M., Karsavuran, S., ve Gözlü, K. (2014). Türkiye sağlık finansmanında yeni bir alternatif: Tamamlayıcı sağlık sigortası. Akademik Bakış Uluslararası Hakemli Sosyal Bilimler Dergisi, (42).
33. Özgen, H. (2007). Sağlık hizmetleri finansmanında cepten harcama: Nedir? Neden önemlidir? Hacettepe Sağlık İdaresi Dergisi, 10(2), s.201-228.
34. Özkan, O. (2021). Sağlık hizmetleri finansman yöntemleri. Aslan, H., Çetin Aslan, E. ve Top, M. (Ed.), Sağlık Ekonomisi içinde (333-345) Ankara: Siyasal Kitabevi.
35. Ranson, M. K. (2002). Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges. Bulletin of the World Health Organization, 80, s.613-621.
36. Roberts, M. J., Hsiao, W., Berman, P., & Reich, M. R. (2004). Getting Health Reform Right: A Guide to Improving Performance and Equity. New York: Oxford University Press.
37. Sagan, A. ve Thomson, S. (2016). Voluntary health insurance in Europe: Role and regulation. Observatory on Health Systems and Policies, Copenhagen.
38. Smith, P. C. ve Witter, S. N. (2004). Risk pooling in health care financing: The implications for health system performance. Health, Nutrition and Population (HNP) Discussion Paper, Washington, DC.
39. Sosyal Güvenlik Kurumu Sağlık Uygulama Tebliği. (2013). 24 Mart 2013 tarih ve 28597 sayılı Resmî Gazete.
40. Tatar, M. (2011). Sağlık hizmetleri finansman modelleri: Sosyal sağlık sigortasının Türkiye’de gelişimi. Sosyal Güvenlik Dergisi, 1(1), 103-133.
41. Thomson, S., Foubister, T., ve Mossialos, E. (2009). Financing health care in the European Union: Challenges and policy responses. World Health Organization.
42. Uğurluoğlu, E. ve Özgen, H. (2008). Sağlık hizmetleri finansmanı ve hakkaniyet. Hacettepe Sağlık İdaresi Dergisi, 11(2), s.133-160.
43. Wagstaff, A. ve Doorslaer, E. V. (2000). Equity in Health Care Finance and Delivery. Culyer, A. J. ve Newhouse, J. P. (Ed.), Handbook of Health Economics içinde (Cilt 1, s. 1803-1861). Elsevier Science, Amsterdam.
44. Wasem, J., Greb, S., ve Okma, K. G. H. (2004). The role of private health insurance in social health insurance countries. Saltman, R. B., Busse, R. ve Figueras, J. (Ed.), Social Health Insurance Systems in Western Europe içinde (227-248) McGraw-Hill Education (UK).
45. World Health Organization. (2000). The World Health Report: Health systems: Improving performance. Geneva, World Health Organization. Erişim Tarihi: 15.12.2025. https://www.who.int/publications/i/item/924156198X
46. World Health Organization. (2010). The World Health Report: Health systems financing: The path to universal coverage. Geneva, World Health Organization. Erişim Tarihi: 05.01.2026. https://www.who.int/publications/i/item/9789241564021
47. Wouters, O., Cylus, J., Yang, W., Thomson, S. ve McKee, M. (2016). Medical savings accounts: Assessing their impact on efficiency, equity and financial protection in health care. Health Economics, Policy and Law, 11(3), 321-335.
48. Yang, O., Yong, J., & Zhang, Y. (2024). Effects of private health insurance on waiting time in public hospitals. Health Economics (United Kingdom), 33(6), 1192–1210.
49. Yaşar, G. Y. (2013). Türkiye’nin sağlık finansman politikasının değerlendirilmesi. Memleket Siyaset Yönetimi, 8(19-20), s.97-139.