EXAMINING THE CAPACITY EXPANSION OF HOSPITALS IN THE TRANSFORMED TURKISH HEALTH SYSTEM

Öz

This article empirically analyzes the determinants of capacity expansion in the local hospital markets in Türkiye. The aim of the paper is to explain changes in bed capacities of privately- and publicly-owned hospitals in local districts of Türkiye over the late stages of health reforms under the Health Transformation Program (2003-2013). The empirical analyses rely on the yearly countrywide data on hospitals, demand conditions, and local market characteristics over the period of 2010-2014. The estimation results did not show evidence for the presence of local market competitive pressure on the growth in hospital bed capacity of local districts in Türkiye. Thus, based on the findings of the article, it cannot be concluded that the local competition among hospitals led to a rivalry to expand their bed capacities. It appears more appropriate to interpret the capacity expansion of private hospitals as a consequence of the increased inclusion of the private sector in healthcare provision within the publicly-funded universal health insurance system and favorable market environment thanks to the health reforms.

Anahtar Kelimeler

• hospital capacity growth
• competition
• hospital ownership
• health reforms

DÖNÜŞEN TÜRKİYE SAĞLIK SİSTEMİNDE HASTANELERİN KAPASİTE ARTIŞININ İNCELENMESİ

Öz

Bu makale, Türkiye yerel hastane piyasalarındaki kapasite artışının belirleyicilerini ampirik olarak analiz etmektedir. Makalenin amacı, Sağlıkta Dönüşüm Programı (2003-2013) kapsamındaki sağlık reformlarının son aşamalarında Türkiye'nin yerel ilçelerindeki özel ve kamu hastanelerinin yatak kapasitelerindeki değişiklikleri açıklamaktır. Ampirik analizler, 2010-2014 döneminde hastaneler, talep koşulları ve yerel pazar özellikleriyle ilgili yıllık ülke çapındaki verilere dayanmaktadır. Tahminleme sonuçları Türkiye'nin yerel ilçelerinin hastane yatak kapasitesindeki büyüme üzerinde yerel piyasadaki rekabet baskısının varlığına dair kanıt göstermemektedir. Dolayısıyla, makalenin bulgularına dayanarak hastaneler arasındaki yerel rekabetin yatak kapasitelerini artırma yarışına yol açtığı söylenememektedir. Özel hastanelerin kapasite artışının, kamu tarafından finanse edilen genel sağlık sigortası sistemi kapsamında özel sektörün sağlık hizmetleri sunumuna daha fazla dâhil edilmesinin ve sağlık reformları sayesinde elverişli piyasa ortamının bir neticesi olarak yorumlanması daha uygun görünmektedir.

Anahtar Kelimeler

• sağlık reformları
• hastane kapasite büyümesi
• piyasa yapısı
• hastane sahipliği

Kaynakça

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