Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-19T17:36:48.318Z Has data issue: false hasContentIssue false
  • English
  • Français

An Ethical Analysis of Performance-Based Supplementary Payment in Turkey’s Healthcare System

Published online by Cambridge University Press:  27 June 2016

FUNDA GULAY KADIOGLU
Get access Rights & Permissions [Opens in a new window]

Abstract:

In 2003 Turkey introduced the Health Transition Program to develop easily accessible, high-quality, and effective healthcare services for the population. This program, like other health reforms, has three primary goals: to improve health status, to enhance financial protection, and to ensure patients’ satisfaction. Although there is considerable literature on the anticipated positive results of such health reforms, little evidence exists on their current effectiveness. One of the main initiatives of this health reform is a performance-based supplementary payment system, an additional payment healthcare professionals receive each month in addition to their regular salaries. This system may cause some ethical problems. Physicians have an ethical duty to provide high-quality care to each patient; however, pay-for-performance and other programs that create strong incentives for high-quality care set up a potential conflict between this duty and the competing interest of complying with a performance measure.

Keywords

Health Transition Programperformance-based supplementary payment systemhealth reformpay for performance
Type
Special Section: Bioethics Beyond Borders
Information
Cambridge Quarterly of Healthcare Ethics , Volume 25 , Issue 3 , July 2016 , pp. 493 - 496
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Aran, M, Özçelik, EA. Turkey—Universal Health Coverage for Inclusive and Sustainable Development: Country Summary Report. Washington, DC: World Bank Group; 2014.Google Scholar

2. Ministry of Health, Republic of Turkey. Performance Management in Health: Performance Based Supplementary Payment System [report]. Ankara; 2008.

3. Ministry of Health, Republic of Turkey. Progress Report Health Transformation Program [report]. Ankara; 2009.

4. See note 3, Ministry of Health 2009.

5. OECD/The World Bank. OECD Reviews of Health Systems: Turkey 2008 [report]. OECD; 2009.

6. Meker T. Dynamic impacts of performance based payment system on public hospitals in Turkey [master’s thesis]. Istanbul: Boğaziçi University, the Institute of Sciences and Engineering; 2013.

7. See note 6, Meker 2013, at 3.

8. Yıldırım, HH, Yıldırım, T. Healthcare financing reform in Turkey: Context and salient features. Journal of European Social Policy 2011;21(2):178–93.CrossRefGoogle Scholar

9. Vujicic M, Susan S, Mollahaliloglu M. Health workforce policy in Turkey: Recent reforms and issues for the future; 2009; available at: https://openknowledge.worldbank.org/handle/10986/13784 (last accessed December 1, 2012).

10. Botje D, Klazinga NS, Wagner C. To what degree is the governance of Dutch hospitals orientated towards quality in care? Does this really affect performance? Health Policy 2013;134–41; available at http://dx.doi.org/10.1016/j.healthpol.2013.07.015 (last accessed February 6, 2014).

11. OECD. OECD Reviews of Health Care Quality: Turkey 2014: Raising Standards [report]. OECD; 2014.

12. Jadoo, SAA, Aljunid, SM, Sulku, SN, Nur, AM. Turkish health system reform from the people’s perspective: A cross sectional study. BMC Health Services Research 2014;14(1):30–8.CrossRefGoogle Scholar

13. Epstein, AM, Lee, TH, Hamel, MB. Paying physicians for high quality care. New England Journal of Medicine 2004;350(4):406–10.CrossRefGoogle ScholarPubMed

14. Turkish Medical Association Ethics Committee. Performance Based Supplementary Payment System: An Evaluation from Physicians’ Perspective [report]. Ankara; 2009. Turkish.

15. Turhan, E, Inandı, T, Ceylan, A, Gun, I, Oner, S. The effects of performance based supplementary payment on physician practice; a cross sectional questionnaire study. HealthMED 2011;5(4):837–45.Google Scholar

16. Turkish Dental Association Ethics Committee. Performance Based Supplementary Payment System: An Evaluation from Dentists’ Perspective [report]. Ankara; 2015. Turkish.

17. See note 14, Turkish Medical Association Ethics Committee 2009.

18. See note 16, Turkish Dental Association Ethics Committee 2014.

19. See note 15, Turhan et al. 2011.

20. See note 6, Meker 2013, at 5.

21. See note 1, Aran, Özçelik 2014, at 13.

22. See note 14, Turkish Medical Association Ethics Committee 2009.

23. See note 15, Turhan et al. 2011.

24. See note 16, Turkish Dental Association Ethics Committee 2014.

25. See note 14, Turkish Medical Association Ethics Committee 2009.

26. Turkish Bioethics Association. The effects of PBSP in healthcare on professional values and ethical questions [report]. TBA e-Bulletin 2011;21:21–8. Turkish.

27. Snyder, L, Neubauer, RL. Pay-for-performance principles that promote patient-centered care: An ethics manifesto. Annals of Internal Medicine 2007;147(11):792–4.CrossRefGoogle Scholar

28. Spooner, A, Chapple, A, Roland, M. What makes British general practitioners take part in a quality improvement scheme? Journal of Health Services Research & Policy 2001;6(3):145–50.CrossRefGoogle Scholar

29. Voinea-Griffin, A, Rindal, DB, Fellows, JL, Barasch, A, Gilbert, GH, Safford, MM. Pay-for-performance in dentistry: What we know. Journal for Healthcare Quality 2010;32(1):51–8.CrossRefGoogle ScholarPubMed

30. Golden, B, Sloan, F. Physician pay for performance: Alternative perspectives. In: Sloan, F, Kasper, H, eds. Incentives and Choice in Healthcare. Cambridge, MA: MIT Press; 2008.Google Scholar

31. Pope, GC. Overview of pay for performance models and issues. In: Cromwell, J, Trisolini, MG, Pope, GC, Mitchell, J.B., Greenwald, LM, eds. Pay for Performance in Healthcare: Methods and Approaches. Research Triangle Park, NC: RTI Press Book; 2011:33–76.Google Scholar