Comparison of the SSK (governmental social insurance organization ) and private health insurance from the point of the health spendings and the usage of health services in private health insurance

12 ABSTRACT Title of the Study Comparision of the SSK (Governmental Social Insurance Organization ) and Private Health Insurance from the point of the health spendings and the usage of Health Services in "Private Health Insurance". Name of the Investigator Dr. Ruhsan Gezgin Brief Summary Introduction : It is being informed that the two main problems of the health care systems in the world are 1) the continuous increase of the costs and difficulties in preparing a budget consequently, 2) the organizational inadequacy and malfunction in the health service system. One of the main points which is being planned to be implemented as part of the health reform in our country is the privatisation of the health services. It is proposed that the private health insurance should be supported and put forward, and this way it would be possible to give a more efficient and more effective health service. With this research, it is planned to compare the public health insurance and the private health insurance from the point of health spendings for the curative health care. Method : Curative health care spendings of SSK (governmental public social health security) registered patients realized during January and July,2001 at SSK Tepecik Eğitim Hastanesi ( SSK Tepecik Training Hospital) is compared with the spendings of the private health insured patients in the same period in the city of Izmir. This work took place in the periods of November-December 2002 and January-February 2003. The independent variables are medical exam, symptom methods, receipts, the number of hospitalized patients and the spendings per capita. Additionally, in October-November 2002, a survey to a population of 352 people is done about the usage of the health services by private health insured people.The software used for analyses of chi-square is EPI INFO 2000 Statcalc.13 Results : The health spendings per capita for out and hospitalized SSK registered patients' curative services are 2,696,625 TL in January,2001 and 3,002,328 TL in July,2001. The same sort of spendings for private health insured patients are 31,476,812 TL in January,2001 and 26,158,780 TL in July,2001. From the population who took part in the survey, the percentage of the private health insured patients who had health problems within the last 15 days is 18.2%. Again 11.1% of the population of the private insured people who took part in the survey is recommended to be hospitalized. Conclusion and Discussion : As the conclusion of this study, the health expenditure and usage of health services per capita is more in private health insurances compared to the ones in SSK. It is thought that the being private health insuranced has an active role in increasing the usage of the health services and the health spendings. Key words: Private Health Insurance, SSK (Public Social Insurance Organization), Health Spendings, Usage of Health Services