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Search for Solution For Sustainable Healthcare Turkish Report 2014

This report highlights the need for sustainable healthcare and explores best practices in Turkey and other countries. It discusses the role of stakeholders, allocation of funds, early diagnosis and intervention, measuring ROI, and evolving clinical practices.

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Search for Solution For Sustainable Healthcare Turkish Report 2014

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  1. Search for Solution For Sustainable Healthcare Turkish Report 2014 S.Haluk OZSARI, Assoc. Prof.Dr. President Turkey Committee June 6, 2014/Brussels

  2. “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

  3. CONTENTSForeword; Written by Minister of Health of the Republic of Turkey, Project; Goal, Scope, Process, 5 Critical Questions, PrinciplesTurkish Report; 4 of 31 Local Best Practices Examples

  4. “SEEKING SOLUTIONS FOR SUSTAINABLE HEALTHCARETURKISH 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

  5. 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.

  6. 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

  7. 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

  8. 1st Project Meeting, August 21, 2013, Hosted by the Social Security Institution

  9. 2nd Project Meeting, October 31, 2013, Hosted by the Ministry of Development

  10. 3rd Project Meeting, December 18, 2013, Hosted by the Ministry of Health

  11. Project Presentation Meeting, May 12, 2014, Hosted by the Istanbul University

  12. Sustainable Healthcare Project5 Critical Questions Common to All Country Reports • Therole of thestakeholder in chronicdiseases • Inthecurrenteconomicclimate, allocation of funds be improved to optimize secondaryandtertiarypreventation • Pathways be optimizedtodriveearlierdiagnosis&intervention • Measurement of return on investment (ROI) • Clinicalpracticeevolvetosupportactive, engagedandhealthycitizens

  13. Sustainable Healthcare ProjectCommon Principles in the Country Reports Country Exampleswhich: • areconcreteandapplicable, • may be repeated (replicable) • expandable, • scalable, • togetherwithstakeholders.

  14. 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

  15. 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)

  16. Sustainable Healthcare ProjectTurkish Project Example List Stakeholder Role Rational Use ofDrug 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)

  17. 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 rationaldrug use by 50 percent Results • The National Action Plan of Rational Use of Drug 2013-17 , • The Establishment of The Prescription Information System

  18. 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

  19. 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

  20. Sustainable Healthcare ProjectTurkish 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.

  21. 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 expenses for healthcare, and will earn less.

  22. 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 Dollars 10% = 86 Billion US Dollars *Prof. Dr. David Taylor, Prof. Dr. Mehtap Tatar , Dr. Panos Kanavos

  23. Not the ones speaking the same language, but the ones sharing the same feeling understand each other. Rumi

  24. Search for Solution For Sustainable Healthcare Turkish Report 2014 THANK YOU hozsari@istanbul.edu.tr

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