Transcript Turkish Report 2014

Search for Solution
For Sustainable
Healthcare
Turkish 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
“SEEKING SOLUTIONS FOR SUSTAINABLE HEALTHCARE
TURKISH REPORT 2014”
FOREWORD
“…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
Sustainable Healthcare Project
Goal
 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 Project
Scope
19 Countries;
Austria, Belgium, Canada, Denmark,
England, Finland, France, Germany,
Greece, Hungary, Iceland, Ireland,
Israel, Italy, Norway, Spain, Sweden,
Switzerland and Turkey
Sustainable Healthcare Plan
Process
 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:
 May 2014:
 June 2014:
December 18, 2013, Presentation of Draft Report/Turkey
Presentation of Turkish Report / Istanbul
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 Project
5 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 Project
Common Principles in the Country Reports
Country Examples which:
 are concrete and applicable,
 may be repeated (replicable)
 expandable,
 scalable,
 together with stakeholders.
Sustainable Healthcare Project
Turkish 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 Project
Turkish 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 Project
Turkish Project Example List
Stakeholder Role
Rational Use of Drug Project
(Ministry of Health)
Earlier Diagnosis and Intervention
Gaziantep 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 Project
Turkish 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 Project
Turkish 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 Project
Turkish 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 Project
Turkish Project Examples; Clinical Practice
Istanbul University Turkcell TeleDiab Project
(Istanbul Medical Faculty)
Justification
The 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 Project
Conclusions
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 expenses
for healthcare, and
will earn less.
Sustainable Healthcare Project
Conclusions
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 Dollars
10% = 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
Search for Solution
For Sustainable
Healthcare
Turkish Report 2014
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