How the government intervention affects the distribution of physicians in Turkey between 1965 and 2000.
How the government intervention affects the distribution of physicians in Turkey between 1965 and 2000.
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DOI：
10.1186/s12939-014-0131-1
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发表时间：
2015-01-08
影响因子：
4.8
通讯作者：
Ünal E
中科院分区：
文献类型：
--
作者：
Ünal E
土耳其卫生系统的主要弱点之一是医生分布不均。在1960年代初，地理区域之间的差异是巨大的。20世纪80年代以后，对新毕业的医生实行两年义务服务，对所有国家来说都是一个有趣和具体的经验。本研究的目的是分析1965 - 2000年间医生、全科医生和专科医生的分布以及15年（1981 - 1995）严格的政府干预的效率。本研究使用的数据包括卫生部和国家统计局1965 - 2000年公布的数据。覆盖35年的医生，全科医生和专家，基尼系数计算，以观察分布的变化。为了衡量政府干预的有效性，本文还对义务兵役制实施前15年（第一阶段--1965至1980年）和1981年后15年（第二阶段）的基尼系数进行了分析，并进行了统计检验。1965年，医生总人数的基尼系数相当高（0.47），2000年大幅下降（0.20）。1965年，全科医生和专科医生的基尼系数分别为0.44和0.52，2000年，这两个数值分别下降到0.13和0.28。据观察，由于政府的这种干预，多样性水平在2000年之前急剧下降。在回归方面，第二阶段全科医生的基尼指数下降率高于专科医生。全科医生与专科医生之间的分布不平等存在显著差异，专科医生的分布不平等高于全科医生。由市场机制产生的医生分配不平等的改善表明了一个长期的过程，当它被自己的设备所取代时。结果表明，强制服务政策是有效的，医生分布得到了显著改善。政府干预使GP分布得到更快的改善。
One of the main weaknesses of the health system in Turkey is the uneven distribution of physicians. The diversity among geographical districts was huge in the beginning of the 1960s. After the 1980s, the implementation of a two-year compulsory service for newly graduated physicians is an interesting and specific experience for all countries. The aim of this study is to analyse the distribution of physicians, GPs and specialists between the years 1965-2000 and the efficiency of the strict 15 year government intervention (1981-1995). The data used in this study includes the published data by the Ministry of Health and The State Institute of Statistics between the years 1965–2000. Covering 35 years for total physicians, GPs and specialists, Gini coefficients are calculated so as to observe the change in the distribution. In order to measure the efficiency of government intervention, Gini index belonging to the previous 15 years (first period-1965 to 1980) and the last 15 years (second period) of 1981 when the compulsory service was enacted is also analysed including the statistical tests. In 1965, the Gini for total physician is quite high (0.47), and in 2000 it decreases considerably (0.20). In 1965, the Gini for GPs and the Gini for specialists is 0.44 and 0.52, respectively and in 2000 these values decrease to 0.13 and 0.28, respectively. It is observed that, with this government intervention, the level of diversity has decreased dramatically up to 2000. Regarding to regression, the rate of decrease in Gini index in the second period is higher for the GPs than that of the specialists. The inequalities in the distribution between GPs and specialists are significantly different; inequality of specialist distribution is higher than the GP. The improvement of the inequality in the physician distribution produced by the market mechanism shows a long period when it is left to its own devices. It is seen that the compulsory service policy is efficient since the physician distribution has improved significantly. The government intervention provides a faster improvement in the GP distribution.
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影响因子：
4.5
作者：
Sasaki H;Otsubo T;Imanaka Y
通讯作者：
Imanaka Y
影响因子：
4.9
作者：
Feeley, TH
通讯作者：
Feeley, TH
影响因子：
168.9
作者：
Kanchanachitra, Churnrurtai;Lindelow, Magnus;dela Rosa, Jennifer Frances
通讯作者：
dela Rosa, Jennifer Frances
影响因子：
5.4
作者：
Meliala, Andreasta;Hort, Krishna;Trisnantoro, Laksono
通讯作者：
Trisnantoro, Laksono
DOI：
10.2307/3003469
发表时间：
1982-01-01
期刊：
BELL JOURNAL OF ECONOMICS
影响因子：
--
作者：
NEWHOUSE, JP;WILLIAMS, AP;SCHWARTZ, WB
通讯作者：
SCHWARTZ, WB