Details of the Turkish Success Story

Many macro policies have been implemented in Turkey's health sector over the last 2 decades, but there is still much potential for further structural transformation. Each policy can bring important changes and innovative modifications to the sector. In this context, the most important challenge we face today is to develop an accreditation system on a national basis, which is to be built according to principles of the International Society for Quality in Healthcare (ISQua) for generating quality service and creating a culture of patient safety. This system should conform to international standards, and as such will require major transformations at both micro and macro levels, incorporating changes both practical and theoretical. The development of such infrastructure changes in response to quality, and accreditation concerns within the health sector will prove beneficial to all tributaries of the system.

There are 866 public, 556 private, and 69 university hospitals in Turkey. Total beds number 206,836, and total operating rooms number 5682. Under this structure, 644 million patient admissions occurred during 2014. According to the Organisation for Economic Co-operation and Development's (OECD, 2015b) health data, the average of doctor admissions is above the OECD average. At any one time, an average of 70% of hospital beds are occupied. Health staff consists of 760,000 employees, 135,000 of whom are medical doctors. Maintaining qualified healthcare services on such a large scale requires systematic efforts to ensure the success of the whole system (Ministry of Health [Turkey], 2015c).

Improvements to the Turkish healthcare system began with the issuing of 100 quality standards by the MoH in 2005 (Ministry of Health [Turkey], 2011). Over the following years, the standards have undergone modifications in both quantity and extent, increasing to 150 in 2007, 354 in 2008, 388 in 2009, and to 621 standards with the final revision in 2011. The common point of all the issued standard sets was to develop and maintain a quality culture at a basic level in all healthcare facilities, and to ensure systematic improvement. It is now mandatory to implement these standards in every hospital within the borders of the country.

These efforts were designed to produce a high level of quality within healthcare institutions. As a result of these improvements, healthcare is now designed in accordance with the national accreditation system and, since 2012, conforms with international guidelines. Since 2013, a series of studies have taken place, culminating in the issuing of ISQua-endorsed Standards of Accreditation in Health-Hospital by MoH. Some hospitals, accredited by ISQua since 2014, have also established ISQua-accredited Surveyor Training Programs. Between 2014 and 2016, a number of other accreditation initiatives were also launched; these include setting standards for dental health, dialysis, and medical laboratories (Ministry of Health [Turkey], 2015a).

 
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