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Search for Solution For SustainableHealthcareTurkish Report 2014
S.Haluk OZSARI, Assoc. Prof.Dr.President Turkey Committee
June 6, 2014/Brussels
“SEARCH FOR SOLUTION FOR SUSTAINABLE HEALTHCARE TURKISH REPORT, 2014”MAY 12, 2014/ISTANBUL
HOSTED BY ISTANBUL UNIVERSITY WITH THE HONORABLE PRESENCE OF MINISTER OF HEALTH OF THE REPUBLIC OF TURKEY MR. MEHMET MÜEZZİNOĞLU
CONTENTS
Foreword; Written by Minister of Health of the Republic of Turkey,
Project; Goal, Scope, Process, 5 Critical Questions, Principles
Turkish Report; 4 of 31 Local Best Practices Examples
“…The Ministry of Health pays importance to support the main streaming of best practices in the countries covered by the project and the integration of examples of projects described in the Turkey Reports into the programs for the fight against chronic diseases in the public sector. ... “
Dr. MEHMET MÜEZZİNOĞLU MINISTER OF HEALTH, REPUBLIC OF TURKEY
“SEEKING SOLUTIONS FOR SUSTAINABLE HEALTHCARETURKISH REPORT 2014”
FOREWORD
Sustainable Healthcare ProjectGoal
in order to reduce the burden of chronic diseases on the health system,
secondary and tertiary prevention measures to be taken,
to improve patient outcomes.
Sustainable Healthcare ProjectScope
19 Countries;
Austria, Belgium, Canada, Denmark,
England, Finland, France, Germany,
Greece, Hungary, Iceland, Ireland,
Israel, Italy, Norway, Spain, Sweden,
Switzerland and Turkey
Sustainable Healthcare PlanProcess
April 2013 : Project Work Plan / Turkey
May 2013 : Project Opening Meeting / Brussels
1st Meeting: August 21, 2013, Scope of Report Contents/Turkey
2nd Meeting:October 31, 2013, Gathering of Example Projects/Turkey
3rd Meeting: December 18, 2013, Presentation of Draft Report/Turkey
May 2014: Presentation of Turkish Report / Istanbul
June 2014: Presentation of Turkish Report, as the one of 5 chosen Countries / Brussels
March 2015: Presentation of 19 Country Reports / Brussels
1st Project Meeting, August 21, 2013,
Hosted by the Social Security Institution
2nd Project Meeting, October 31, 2013,
Hosted by the Ministry of Development
3rd Project Meeting, December 18, 2013,
Hosted by the Ministry of Health
Project Presentation Meeting, May 12, 2014,
Hosted by the Istanbul University
Sustainable Healthcare Project5 Critical Questions Common to All Country Reports
1. The role of the stakeholder in chronic diseases
2. In the current economic climate, allocation of funds be improved to optimize secondary and tertiary preventation
3. Pathways be optimized to drive earlier diagnosis&intervention
4. Measurement of return on investment (ROI)
5. Clinical practice evolve to support active, engaged and healthy citizens
Sustainable Healthcare ProjectCommon Principles in the Country Reports
Country Examples which:
are concrete and applicable,
may be repeated (replicable)
expandable,
scalable,
together with stakeholders.
Sustainable Healthcare ProjectTurkish Report
FOREWORD
EXECUTIVE SUMMARY
CHAPTER-I Content of the Project
CHAPTER-II Process of the Turkey Project
CHAPTER-III Analysis of the Current Situation in the Perspective of the Project
CHAPTER-IV Analysis of Local Best Practices
CHAPTER-V General Evaluation and Conclusion
BIBLIOGRAPHY
CONTRIBUTORS
Sustainable Healthcare ProjectTurkish Report
The Overview of Local Best Practices Examples (31)
TREASURY AND SOCIAL SECURITY INSTITUTION (1)
MINISTRY OF DEVELOPMENT (1)
MINISTRY OF FINANCE (1)
MINISTRY OF HEALTH (14)
SOCIAL SECURITY INSTITUTION (10)
UNIVERSITY, SECTOR AND NGO PROJECTS (4)
Sustainable Healthcare ProjectTurkish Project Example List
Stakeholder RoleRational Use of Drug Project
(Ministry of Health)
Earlier Diagnosis and InterventionGaziantep Rheumatology Early Arthritis Screening Project
(Gaziantep University + Ministry of Health)
Measuring Return on Investment (ROI), Public Hospitals Organization Performance Evaluation Program
(Ministry of Health)
Clinical Practice Istanbul University Turkcell TeleDiab Project
(Istanbul Medical Faculty)
Sustainable Healthcare ProjectTurkish Project Examples; Stakeholder Role
Rational Use of Drug Project (Ministry of Health)
Justification increase in morbidity and mortality rate, increased risk of drug side effects, inefficient use of resources leads to decrease in availability of even basic
drugs, possible development of resistance to emergency and basic drugs, increased financial and social cost of treatment,
Process As a result of an evaluation study of knowledge and attitude of doctors and
the public;is not rational drug use by 50 percent
Results The National Action Plan of Rational Use of Drug 2013-17 , The Establishment of The Prescription Information System
Sustainable Healthcare ProjectTurkish Project Examples; Earlier Diagnosis and Intervention
Gaziantep Rheumatology Early Arthritis Screening Project(Ministry of Health and Gaziantep University)
Justification Lack of relevant specialists primary care physicians relevant knowledge/skill levels need to be supported The need for a different General Practitioner’s system to direct arthritis and
rheumatoid arthritis patients to rheumatology centers in a timely manner,
Process From March 2011, preliminary diagnosis training of 581 family physicians in 3
different Province (Gaziantep, Adıyaman, Kilis) General Practitioners visit and send e-mail regularly, Decreased patients admission to tertiary health services,
Results For the first time in Turkey, the creation of an “Early Arthritis Clinic” model, resulting
in 34% correct diagnoses and referrals for 581 referred patients, Long-term goals: a decrease in the diagnosis period, and increase in correct diagnoses
Sustainable Healthcare ProjectTurkish Project Examples; Measuring Return on Investment
Public Hospitals Organization Performance Evaluation System(Ministry of Health)
Justification To facilitate monitoring and accountability of activity results, The creation of a measurement, monitoring and evaluation concept,
Process Productivity Report Model structure,
Results Measurement and comparison of resource and project success by
administrations revealed increases of; 6% and 1% respectively in the “Medical and Administrative” category with 9 indicators 52% in the “Financial” category with 9 indicators 12% in the “Quality” category with 8 indicators 6% in overall scoring wıth 45 indicators.
“Continuous Improvement-Kaizen”; the triggering of a series of projects about the strategic work load and return on investment
Sustainable Healthcare ProjectTurkish Project Examples; Clinical Practice
Istanbul University Turkcell TeleDiab Project (Istanbul Medical Faculty)
JustificationThe need for remote monitoring of parameters such as blood sugar levels, complications and accompanying diseases in diabetes patients
Process In a total of 182 experimental and control patients;
Electronic transmission of capillary blood glucose and blood pressure measurements, Synchronized video-conferences, secure messaging, Reminders of routine followup tests and examinations, provision of web-based educational
material
Results With remote monitoring, even the results for the first 6 months showed a
reduction in fasting blood glucose levels from 167.5 to 149.1; and of HbA1c levels from 8.04 to 7.48,
It was shown that guidance via remote monitoring technology could achieve significant improvement expecially in chronic diseases.
Sustainable Healthcare ProjectConclusions
In view of the unpredictable increase in health expenditures together with chronic diseases;
A process that affects all countries equally in terms of sustainability in health systems:
The person living with chronic disease and facing a change in quality of life:
will retire earlier,will work less, will face a greater risk of unemployment, may be forced to pay more out-of-pocket expensesfor healthcare, andwill earn less.
Sustainable Healthcare ProjectConclusions
Transformation in Health in Turkey: Opportunities Brought by the 21st Century, 2012* Non-communicable diseases cause more than 70% of deaths The loss of 6.5 million disability-adjusted life years (DALY) The consequent damages corresponding to nearly 8-10% of the
yearly GDP
Resulting proposed expenses:For a Medium-Term Development Program in Turkey
Projected Turkish Gross Domestic Product for 2014:867 Billion US Dollars10% = 86 Billion US Dollars
*Prof. Dr. David Taylor, Prof. Dr. Mehtap Tatar , Dr. Panos Kanavos
Not the ones speaking the same language, but the ones sharing
the same feeling understand each other.
Rumi
