Overwhelming health expenditures among the poor in a transition economy: A case study from Turkey.

A primary goal of modern health systems is to protect citizens from catastrophic health expenditures. Today, health care spending is a significant cause of poverty and the poor are more vulnerable to catastrophic payments. Similar to other countries, Turkey is facing problems of poverty due recent economic crises and it has developed poverty alleviation programs with the support of international organizations such as the World Bank. In the literature, no studies have identified and measured catastrophic health expenditures among poor people in Turkey. This study included 92 households in the Etimesgut region of Ankara, with these households being in the priority group for assistance identified by the Social Risk Mitigation Project of the Social Solidarity Fund (SYDTF). In the study, households' socio-demographic characteristics, living standards, health status and situations regarding catastrophic health expenditures were examined via face-to-face interviews. The results of the study indicate that poverty, households' socio-demographic characteristics and living standards are strongly related. The poverty rate of female-headed households (61.33%) was greater than that of male-headed households (32.8%). Moreover, 125 household members (34.3%) had at least one chronic illness and/or disability, and 14 households (15.2%) were facing catastrophic health expenditures that constituted an average of 62.3% of their non-food expenditures. One conclusion of the study is that particularly in poor households, people can be protected from catastrophic health expenditures by reducing the health system's reliance on out-of-pocket payments and by providing more financial risk protection. If the poor are not protected, their increased health risks will create further financial and social burdens at both the community and government levels. [ABSTRACT FROM AUTHOR]