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Sağlık Hizmetleri Finansmanında İnformal Ödemeler

Informal Payments in Health Services Financing

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Abstract (2. Language): 
Informal payments as a component of out-of-pocket health expenditures have been part of health financing in many countries at varying extent. The issue also appears to exist in Turkey, with a considerable portion of health expenditures. The common feature of these countries is that informal payments stem mainly from supply-related problems and become an inherent part of cultural normsover time. Informal payments have the potential to perversely affect the health system in general and health care users in particular. However, realization of undesired impacts of informal payments and becoming a policy issue in a country depend on certain criteria. Informal payments that have a long-lasting history in Turkey are an issue demanding policy intervention. Available research in Turkey indicated that informal payments are driven mainly by supply-related problems. Policy changes that are both in effect and planned have implications for informal payments.This article delineatesdefinition and types of informal payment, its extent in a variety of countries including Turkey, and its implications for health policy.
Abstract (Original Language): 
Cepten sağlık harcamalarının bir unsuruolan informal ödemeler birçok ülkede, değişen boyutlarda sağlık finansmanının bir parçasıdır. Türkiye’de de informal ödemelerinsağlık harcamaları içinde önemli bir yer tuttuğu öngörülmektedir. Bu ülkelerin ortak özelliği, informal ödemelerin temelde sağlık sisteminin arzyapısıyla ilgili sorunlardan kaynaklanması ve zaman içinde informal ödemelerin kültürel bir norm haline gelmesidir. İnformal ödemeler sağlık hizmeti kullanıcıları ve sağlık sistemi açısından olumsuz etkiler yaratma potansiyeline sahiptir. Ancak,bir ülkede informal ödemelerin olumsuz etkilerinin görülebilmesi ve bir politika konusu olabilmesi bazı koşullara bağlıdır. Türkiye sağlık sektöründe uzun yıllardır süregelen informal ödemelerin yarattığı olumsuzluklar nedeniyle politika müdahalesinigerektiren bir sorunolduğu düşünülmektedir. Mevcut araştırma bulguları Türkiye’de informal ödemelerde temel rol oynayan faktörlerin arz ile ilgili olduğunu göstermektedir. Mevcut durumda uygulanan ve uygulanması planlanan politika değişikliklerinin informal ödemeler açısından etkileri vardır.Bu makalede informal ödemenin tanımı ve türleri, çeşitli ülkelerde ve Türkiye’de boyutları ve sağlık politikaları ile etkileşimi ele alınmaktadır.
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