Türkiye'de Sağlıkta Dönüşüm Üzerine Tarihsel Bakış

Yıl 2022, Cilt: 12 Sayı: 1, 188 - 193, 14.01.2022

Nurşen Aydın

https://doi.org/10.33631/sabd.1055675

Cited By: 2

Öz

Türkiye, sağlık sistemini ve sağlık sonuçlarını dönüştürmek ve iyileştirmek için 2003 yılından bu yana büyük reformlar gerçekleştirmiştir. Bu tarihsel değerlendirme, Türkiye’nin Sağlıkta Dönüşüm Programı’ndan (SDP) elde edilen deneyimleri akademisyenler, politika yapıcılar ve halkla paylaşmayı amaçlamaktadır. Türkiye Cumhuriyeti'nin kuruluşundan bugüne kadar sağlık hizmetlerinin iyileştirilmesine yönelik yasal düzenlemeler ve uygulamalar anlatılmış ve tarihsel bir bakış açısıyla değerlendirilmiştir. İncelememiz, SDP'nin genel sağlık sigortası, aile hekimliği, sağlık hizmetlerine erişim ve hizmet kalitesi için hedeflere ulaşan bir model oluşturduğunu göstermektedir. SDP sağlık hizmetlerine erişimi artırdı ve hizmet kalitesini etkiledi. Ancak, ikinci ve üçüncü basamak sağlık hizmeti sunan kurumların adem-î merkeziyetçiliği tam olarak sağlanamamıştır. Kamu Hastane Birlikleri ve Halk Sağlığı Müdürlükleri, İl Sağlık Müdürlüğü bünyesinde yeniden birleştirilmiştir. Bunda, yönetimde üç farklı organın olması, atanan yöneticilerin yetkinliği ile ilgili sorunlar, kararsız organizasyon yapısı, birden fazla yöneticinin atanması ve sık sık görev değişikliği, sağlık çalışanlarının memnuniyetsizliği, koordinasyon sorunları gibi faktörlerin etkili olduğu belirtilmiştir. Reform yapmak isteyen ülkelerin, adem-î merkeziyetçiliği kendi koşullarına göre uygulamaları daha verimli olabilir.
Anahtar Kelimeler: Sağlık politikaları; sağlık reformu; kamu politikası.

Anahtar Kelimeler

Sağlık politikaları, sağlık reformu, kamu politikası

Historical Perspective on the Health Transformation in Turkey

Öz

Turkey has undertaken major reforms since 2003 to transform and improve its healthcare system and health outcomes. This historical evaluation aims to shares experiences gained from Turkey’s Health Transformation Program (HTP) with scholars, policymakers, and the public. Until today from the establishment of the Republic of Turkey, the legal regulations and practices for improving health services have been explained, and the results have been evaluated from a historical perspective. Our review shows that HTP has created a model that achieved goals for universal health insurance, family medicine, access to health services, and service quality. HTP increased access to health services and affected service quality. However, it has not achieved full decentralization of secondary and tertiary healthcare providers. Public hospital associations and public health directorates were reunited under the Provincial Health Directorate. It is stated that various factors such as having three different bodies in administration, problems with the competence of appointed managers, unsettled organizational structure, more than one managers being appointed and frequent changes in office, dissatisfaction of healthcare workers, and problems in communication and coordination. Countries wishing to reform may be more productive in implementing decentralization considering in their own circumstances.

Anahtar Kelimeler

Health policy, health care reform, public policy

Kaynakça

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