Department of Public Health, Faculty of Medicine, Ankara Yildirim Beyazit University, Turkey
Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Rural Remote Health. 2021 Apr;21(2):6478. doi: 10.22605/RRH6478. Epub 2021 Apr 7.
Turkey, which suffers from both undersupply of physicians, nurses and midwives and imbalanced distribution of healthcare personnel, has been developing and implementing various policies to solve these problems. The Ministry of Health launched the Health Transformation Program in 2003 for effective, efficient and fair provision of healthcare services for all people. This study aimed to take a closer look at the impact of policies implemented to reduce the imbalance of the distribution of human resources for health for the past 15 years in Turkey.
Data for the distributional imbalance obtained from Ministry of Health registries was analysed by using Lorenz curves and Gini coefficient for the years 2002, 2005, 2008, 2012 and 2016.
Geographical imbalances for healthcare professions decreased distinguishably during the 15 years. Gini coefficient was 0.33 for specialist distribution in 2002, and decreased gradually to 0.26 in 2008 and finally 0.21 in 2016. Similarly, Gini coefficients were 0.18, 0.20 and 0.25 for general practitioners, nurses and midwives, respectively, in 2002. In 2012, Gini coefficients for the same professionals were calculated as 0.09, 0.11 and 0.19, respectively.
The findings indicate that the policies targeting the distribution of healthcare personnel in Turkey have yielded positive results. Yet it is evident that these results are not due to a single action. It is essential to improve existing implementations, identify the instruments and factors that satisfy and motivate healthcare personnel, and continue developing and implementing comprehensive policies.
土耳其存在医生、护士和助产士数量不足以及医疗保健人员分布不均的问题，一直在制定和实施各种政策来解决这些问题。卫生部于 2003 年启动了卫生转型计划，旨在为所有人有效、高效和公平地提供医疗保健服务。本研究旨在更深入地了解过去 15 年为减少土耳其卫生人力资源分布不均而实施的政策的影响。
使用 Lorenz 曲线和基尼系数分析卫生部登记册中获得的分布不平衡数据，时间范围为 2002 年、2005 年、2008 年、2012 年和 2016 年。
在过去的 15 年中，医疗保健专业的地理不平衡明显减少。2002 年专家分布的基尼系数为 0.33，逐渐下降到 2008 年的 0.26，最终在 2016 年降至 0.21。同样，2002 年普通医生、护士和助产士的基尼系数分别为 0.18、0.20 和 0.25。2012 年，同样专业的基尼系数分别计算为 0.09、0.11 和 0.19。
研究结果表明，土耳其医疗保健人员分配政策取得了积极成果。然而，很明显，这些结果不是单一行动的结果。改进现有实施情况，确定满足和激励医疗保健人员的工具和因素，以及继续制定和实施全面政策是至关重要的。
