Access to Healthcare: The Issue of Unmet Needs

Öz

Although the main objective of health care is to improve and maintain the health of individuals and communities, it is estimated that there are still many people who can not access health services due to social, cultural or economic reasons. In this context, the aim of this study is to determine the level of unmet needs of individuals having a health problem longer than six months in Turkey and to make recommendations to solve this problem. To achieve the objectives of this study, Turkey Health Survey conducted in 2016 by Turkey Statistical Institute was used. It has been found that the level of unmet needs is 13.2% in Turkey and it is more among women than men. Also, the level of unmet needs decreases when education level higher. It is expected that the results of this study will provide evidence-based information to policymakers and managers.

Anahtar Kelimeler

• access to healthcare,equity,unmet needs

Sağlık Hizmetlerine Erişim: Karşılanmamış İhtiyaçlar Sorunu

Öz

Sağlık hizmetlerinin temel amacı, birey ve toplum sağlığını geliştirmek ve devamlılığını sağlamak olsa da halen dünya genelinde sosyal, kültürel ya da ekonomik nedenlerden dolayı ihtiyaç duydukları sağlık hizmetlerine erişemeyen çok sayıda insanın yaşadığı tahmin edilmektedir. Bu nedenle, bu çalışmanın amacı, Türkiye’de altı aydan uzun süre belirli bir sağlık sorunu yaşayan bireylerin ödeme güçlüğü nedeni ile karşılanamayan sağlık ihtiyaçları düzeyini belirlemek ve sağlık hizmetlerine erişimi artırmak için çözüm önerilerinde bulunmaktır. Çalışmanın amaçlarına ulaşabilmek için Türkiye İstatistik Kurumu tarafından 2016 yılında yapılan Türkiye Sağlık Araştırmaları veri seti kullanılmıştır. Çalışma kapsamında, tanımlayıcı istatistiklerden ve Ki-Kare testlerinden yararlanılmıştır. Çalışmanın sonuçları incelendiğinde; Türkiye’de karşılanamayan sağlık ihtiyaçları düzeyinin %13,2 seviyelerinde olduğu görülmektedir. Ayrıca kadınlarda ve daha düşük eğitim ve gelir düzeyindeki hastalarda karşılanamayan sağlık ihtiyaçlarının daha fazla olduğu tespit edilmiştir. Bu çalışma sonunda elde edilen sonuçların, politika belirleyicileri ve yöneticilere kanıta dayalı bilgiler sunacağı düşünülmektedir.

Anahtar Kelimeler

• Sağlık Hizmetlerine Erişim,Hakkaniyet,Karşılanamayan İhtiyaçlar

Kaynakça

1. Allin, S. and Masseria, C. (2009). Unmet need as an indicator of health care access. Eurohealth, 15(3), 7.
2. Allin, S., Grignon, M., Le Grand, J. (2010). Subjective unmet need and utilization of health care services in Canada: what are the equity implications?. Social science medicine, 70(3), 465-472.
3. Alonso, J., Codony, M., Kovess, V., Angermeyer, M. C., Katz, S. J., Haro, J. M., ... Almansa, J. (2007). Population level of unmet need for mental healthcare in Europe. The British journal of psychiatry, 190(4), 299-306.
4. Assari, S. and Hani, N. (2018). Household income and children’s unmet dental care need; Blacks’ diminished return. Dentistry journal, 6(2), 17.
5. Berlin, A. (2010). Cultural competence in primary child health care services: Interaction between primary child health care nurses parents of foreign origin and their children. Institutionen för neurobiologi, vårdvetenskap och samhälle/Department of Neurobiology, Care Sciences and Society.
6. Celik, Y. and Hotchkiss, D. R. (2000). The socio-economic determinants of maternal health care utilization in Turkey. Social science medicine, 50(12), 1797-1806.
7. Chaupain-Guillot, S. and Guillot, O. (2015). Health system characteristics and unmet care needs in Europe: an analysis based on EU-SILC data. The European Journal of Health Economics, 16(7), 781-796.
8. Chen J, and Hou F. Unmet needs for health care. Health Rep 2002;13: 23–33.

9. Chiri, G. and Warfield, M. E. (2012). Unmet need and problems accessing core health care services for children with autism spectrum disorder. Maternal and child health journal, 16(5), 1081-1091.
10. Çakmak, A., Ertem, M., Karazeybek, H. (2007). Diyarbakır Çocuk Hastanesine yatırılan çocukların annelerinin sağlık hizmetlerine erişimi. Turkiye Klinikleri Journal of Pediatrics, 16(2), 82-89.
11. Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J., … Kikkawa, T. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Jama, 291(21), 2581-2590.
12. Diamant, A. L., Hays, R. D., Morales, L. S., Ford, W., Calmes, D., Asch, S., ... Sumner, G. (2004). Delays and unmet need for health care among adult primary care patients in a restructured urban public health system. American journal of public health, 94(5), 783-789.
13. Donabedian, A. (1972). Models for organizing the delivery of personal health services and criteria for evaluating them. The Milbank Memorial Fund Quarterly, 50(4), 103-154.
14. Erol, N., Simsek, Z., Münir, K. (2010). Mental health of adolescents reared in institutional care in Turkey: challenges and hope in the twenty-first century. European child adolescent psychiatry, 19(2), 113-124.
15. Gözlü, M. ve Tatlıdil, H. (2015). Türkiye’deki 81 ilin kamu tarafından sunulan sağlık hizmetlerine erişim durumları. SGD-Sosyal Güvenlik Dergisi, 5(2), 145-165.
16. Gu, D., Zhang, Z., Zeng, Y. (2009). Access to healthcare services makes a difference in healthy longevity among older Chinese adults. Social Science Medicine, 68(2), 210-219.
17. Juškevičius, J. and Balsienė, J. (2010). Human rights in healthcare: some remarks on the limits of the right to healthcare. Jurisprudencija, 4(122), 95-110.
18. Karanikolos, M. and Kentikelenis, A. (2016). Health inequalities after austerity in Greece. International journal for equity in health, 15(1), 83.
19. Kataoka, S. H., Zhang, L., Wells, K. B. (2002). Unmet need for mental health care among US children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159(9), 1548-1555.
20. Kayral, İ. H. (2014). Perceived Service Quality İn Healthcare Organizations And A Research İn Ankara By Hospital Type. Ankara Araştırmaları Dergisi, 2(1): 22-34.
21. Ko, H. (2016). Unmet healthcare needs and health status: panel evidence from Korea. Health Policy, 120(6), 646-653.
22. Levesque, J. F., Harris, M. F., Russell, G. (2013). Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International journal for equity in health, 12(1), 18.
23. Marşap, A., Akalp, G., Yeniman, E. (2010). Sağlık işletmelerinde insan kaynağının kurumsal bilgi güvenliği kültürü gelişimi. Bilişim Teknolojileri Dergisi, 3(1).
24. Mayer, M. L., Skinner, A. C., Slifkin, R. T. (2004). Unmet need for routine and specialty care: data from the National Survey of Children With Special Health Care Needs. Pediatrics, 113(2), e109-e115.
25. Neutens, T. (2015). Accessibility, equity and health care: review and research directions for transport geographers. Journal of Transport Geography, 43, 14-27.
26. Newacheck, P. W., Hughes, D. C., Hung, Y. Y., Wong, S., Stoddard, J. J. (2000). The unmet health needs of America's children. Pediatrics, 105(Supplement 3), 989-997.
27. Norredam, M. L., Nielsen, A. S., Krasnik, A. (2007). Migrants’ access to healthcare. Dan Med Bull, 54(1), 48-9.
28. OECD. (2015). Health at a Glance 2011. OECD Indicators, OECD Publishing, Paris DOI: https://doi org/101787/health_glance-2015-en Accessed February, 15, 2016.
29. Pagán, J. A. and Pauly, M. V. (2006). Community‐level uninsurance and the unmet medical needs of insured and uninsured adults. Health services research, 41(3p1), 788-803.
30. Patil, B. Y. (2018). A Study To Evaluate The Effectıveness Of Structured Teachıng Programme On Knowldege And Attıtude On Tuberculosıs Among Tuberculosıs Patıents In Bangalore Urban Dıstrıct.
31. Pekcici, B., Gürsoy, T. R., Balcı, Ö., Çelik, P., Sucaklı, İ. A., Ertem, İ. (2015). Üçüncü Basamak Sağlık Hizmeti Veren Bir Merkezde İzlenen Prematüre Bebeklerin Sağlık, Eğitim, Rehabilitasyon ve Sosyal Alanlardaki Karşılanmamış Gereksinimleri. Türkiye Çocuk Hastalıkları Dergisi, 10(1), 13-21.
32. Purwanto, R., Prihantara, A., Syafirullah, L. (2018, October). Design of Information System Immunized Care Services Based on Mobile (Case Study: Puskesmas Maos Cilacap). In 2018 International Conference on Applied Science and Technology (iCAST) (pp. 470-476). IEEE.
33. Sachs, J. D. (2012). Achieving universal health coverage in low-income settings. The Lancet, 380(9845), 944-947.
34. Sanmartin, C., Gendron, F., Berthelot, J. M., Murphy, K. (2004). Access to health care services in Canada, 2003. Ottawa: Statistics Canada.
35. Sheppard, R., Deane, F. P., Ciarrochi, J. (2018). Unmet need for professional mental health care among adolescents with high psychological distress. Australian New Zealand Journal of Psychiatry, 52(1), 59-67.
36. Smith, P. C., Mossialos, E., Leatherman, S., Papanicolas, I. (Eds.). (2009). Performance measurement for health system improvement: experiences, challenges and prospects. Cambridge University Press.
37. Subica, A. M., Aitaoto, N., Link, B. G., Yamada, A. M., Henwood, B. F., Sullivan, G. (2019). Mental health status, need, and unmet need for mental health services among US Pacific Islanders. Psychiatric services, appi-ps.
38. U. N. (1948). Universal declaration of human rights. UN General Assembly, 302(2).
39. Wagstaff, A., Van Doorslaer, E. (2000). Equity in health care finance and delivery. Handbook of health economics, 1, 1803-1862.
40. Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., ... Haro, J. M. (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet, 370(9590), 841-850.
41. Yardim, M. S., Uner, S. (2018). Equity in access to care in the era of health system reforms in Turkey. Health Policy, 122(6), 645-651.