Turkey underwent a very ambitious reform programme in 2003, the so-called "Health Transformation Programme". Access to healthcare in Turkey has greatly increased with the attainment of Universal Health Coverage, as also demonstrated by improvement in health outcomes, most notably around maternal and child health and infectious diseases. However, despite these significant achievements, Turkey has a significant way to travel to deliver high-quality health services to its population. Governance of the health system is highly centralised and typified by directive control from the Ministry of Health, and information collected in different part of the system is not always fully exploited.
The OECD Review of Health Care Quality in Turkey recommends a number of changes to address these shortcomings. The key recommendations are that: i) Turkey needs to develop robust systems to standardise and monitor the quality of care, encourage continuous professional development and incorporate patient views; ii) some loosening of the governance structure would be welcome, to allow regions greater flexibility to assess and respond to local health needs and to continue to provide health workers with incentives for improve quality; iii) data on health sector activity and outcomes need to be made more available and more usable for individual patients and clinicians, while greater effort is needed to increase the robustness of Turkey’s information systems at national level and harmonise performance measures to OECD and other international comparators.
English, PDF, 478kb
This country profile describes in details the Canadian pharmaceutical system, including decision-making processes for regulatory approval, reimbursement and pricing; assessment guidelines; institution and stakeholders involved and specific policies for new high cost drugs, when available.
English, PDF, 527kb
This country profile describes in details the Australian pharmaceutical system, including decision-making processes for regulatory approval, reimbursement and pricing; assessment guidelines; institution and stakeholders involved and specific policies for new high cost drugs, when available.
The detailed analysis of these 10 case studies together with the rest of the analytical text highlight the realities of P4P programs and their potential impact on the performance of health systems in a diversity of settings. This book provides critical insights into the experience to date with P4P and how this tool may be better leveraged to improve health system performance and accountability.
L’utilisation des soins de santé varie d’un pays à l’autre mais peut aussi varier tout autant, voire plus, au sein même des pays. Les gouvernements devraient redoubler d’efforts pour améliorer leurs systèmes de santé afin d’éviter les interventions superflues, et pour que chacun, où qu’il vive, ait le même accès à des soins de santé de qualité, selon un nouveau rapport de l’OCDE.
Variations in health care use within a country are complicated. In some cases they may reflect differences in health needs, in patient preferences or in the diffusion of a therapeutic innovation; in others they may not. There is evidence that some of the observed variations are unwarranted, signalling under- or over-provision of health services, or both. This study documents geographic variations for high-cost and high-volume procedures in select OECD countries. It finds that there are wide variations not only across countries, but within them as well. A mix of patient preferences and physician practice styles likely play an important part in this, but what part of the observed variations reflects over-provision, or whether there are unmet needs, remain largely unexplained. This report helps policy makers better understand the issues and challenges around geographic variations in health care provision and considers the policy options.
Français, PDF, 391kb
Selon un rapport de l'OCDE, les variations dans le recours à différents types de services de santé entre les zones géographiques à l’intérieur des pays est une source de préoccupation. Ces variations indiquent que la probabilité de recevoir un service de santé dépend fortement du lieu de résidence du patient dans le pays.
Rapports techniques sur la santé
Despite the enormous burden that mental ill-health imposes on individuals, their families, society, health systems and the economy, mental health care remains a neglected area of health policy in too many countries. Mental disorders represent a considerable disease burden, and have a significant impact on the lives of the OECD population, and account for considerable direct and indirect costs. This report argues that even in those OECD countries with a long history of deinstitutionalisation, there is still a long way to go to make community-based mental health care that achieves good outcomes for people with severe mental illness a reality. The disproportionate focus on severe mental illness has meant that mild-to-moderate mental illnesses, which makes up the largest burden of disease, have remained overwhelmingly neglected. This book addresses the high cost of mental illness, weaknesses and innovative developments in the organisation of care, changes and future directions for the mental health workforce, the need to develop better indicators for mental health care and quality, and tools for better governance of the mental health system. The high burden of mental ill health and the accompanying costs in terms of reduced quality of life, loss of productivity, and premature mortality, mean that making mental health count for all OECD countries is a priority.
The USA has exceptional levels of health-care expenditure, but growth slowed dramatically in recent years, amidst major efforts to close the coverage gap with other OECD countries.