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Today, health systems are one of the largest sectors in the world economy. The total spending for the healthcare sector in 1997 was about $ 2985 billion. This amounts to almost 8% of the world’s gross national product. The numerical size of this thousands of years ago, family members, religious organizations, professional treatment offered by a person or sometimes a healer, a simple and special relationship between disease, expanding in the past two centuries and are getting into the health care system is covered by a complex network of reflect how.

The creation of Modern health systems involves the differentiation and specialization of capabilities and activities, but also involves huge changes in the economic burden of diseases. Until recently, most such loads were treated as a form of efficiency loss. Because people were dying young, getting sick, and being crippled in a way that would interfere with their work. The cost of health care was calculated as only a small part of the economic loss. Although productivity losses are still significant, especially in poor countries, extending life and reducing disability mean greater responsibility for health systems. The additional burden caused by the increase in resources used by Health Systems is compensated by preventing economic damage caused by disease and premature death.

The two most important problems facing the health systems of almost all countries of the world are the very unfair distribution of resources allocated to the health system and the distribution of health problems.

Health Systems Performance Measurement and World Health Organization approach 5 no allocation is made. Low-and middle-income countries generate only 18% of the world’s income and account for 11% of global health spending ($250 billion, or 4% of gross national product in these countries). 84% of the world’s population lives in these countries and they carry 93% of the world’s disease burden. These countries face great challenges in meeting the health needs of their people, ensuring adequate funding in a fair and achievable way, and finding a solution for insufficient resources.


Before addressing health system performance, it is necessary to define and draw the boundaries of the health system as a basis for developing performance criteria. In today’s complex world, it is difficult to say exactly what a health system is, what it consists of, and where it starts and ends. The World Health Organization (who) 2000 report defined the health system to include all activities whose main purpose is to improve, renew and maintain health (WHO 2000; Murray, Frank 2000; WHO 2001; Murray, Frank 2001; IHSD 2000a; WHO 2000a).

In the World Health Report 2000, a number of definitions that can be used for the boundaries of health systems are included: (1) the narrowest definition outlines the boundaries of the health system to include activities under the direct control of the Ministry of Health. Many activities aimed specifically at improving health (for example, taxes aimed at reducing the use of tobacco and alcohol products) fall outside these limits. In some countries, this limit also excludes most personal health services offered by other government departments, missionaries, associations and foundations outside state control, or the private sector. (2) the second definition is slightly more comprehensive. In this definition, the system is defined in a way that includes personal medical services and non-personal health services, but does not cover intersectoral activities aimed at improving health. Traditional public health interventions such as mosquito spraying or health information transfer are included, while intersectoral activities such as clean water and hygiene programs are not included. (3) the third definition is even more comprehensive, and every activity whose main purpose is to improve health is considered part of the health system. This definition is medical and personal it includes non-health services, as well as inter-sectoral activities such as regulations to reduce deaths from road accidents. (4) the final definition covers all activities that contribute to improving health. Almost all areas of human activity-such as education, industrial development, the environment – affect health. There is no operational distinction between education and health systems or health and agriculture systems in this definition.

Which of the definitions given briefly above is the most appropriate definition of the health system? In fact, the third definition, which includes both medical and impersonal Health Services, whose main purpose is to improve health, and inter-sectoral activities, is the most appropriate definition. This definition allows health policymakers to think beyond personal medical services about how to advocate and support community health improvement in areas such as nutrition, tobacco consumption, or changes in road safety regulations.

A recognition that everyone can use can only be achieved with a thought about what a health activity is. A health activity can be defined as a group of activities that have the main goal of maintaining and improving health. A health system, on the other hand, includes resources, decision makers and organizations related to the financing, regulation and presentation of health activities. (Murray, Frank 2000; Murray, Frank 2000a). The World Health report 2000, health systems aim to improve the health of all the basic resources, organizations, groups, and individuals, including a broad definition of groups and personal health services and health contained in interventions being offered to the community as a way to reduce traffic accidents is made for Security Studies, the dietary habits are changing includes national policies. But many factors outside the health system can also determine health standards and inequalities…

Even if a clear definition is used for the health system, the answer to what a health activity is is debatable. For example, what is the main purpose of food delivery programs? Improving health by reducing malnutrition or regulating income inequalities? In the case of uncertain situations, quick decisions should be made on the identification of health systems, especially in water and nutrition areas. Clear boundaries of Health Systems Health Systems Performance Measurement and World Health Organization approach 7 determination of the figure is necessary for studies such as performance evaluation and National Health accounts.

So what are the tasks of the health system that are trying to scratch the boundaries above? Whether in rich or poor countries, health needs today vary widely, 100 or even 50 years ago. As patients, people only come into contact with the health system once or twice a year. Most of these relationships occur as consumers of prescription drugs and as recipients of health-related information and advice. People encounter the system as participants who pay into the system; they always knowingly purchase services that are not covered or pay insurance premiums and Social Security contributions, and unwittingly pay taxes to fund health care. How the system will meet the needs of society, how it will increase its income to meet its expenses, and how much protection it will provide to protect them from financial risk are very important issues. People, in particular, have the expectation that the health care system will treat themselves by protecting their individual dignity. As far as possible, their needs should be dealt with urgently, without long delays in waiting for diagnosis and treatment, and this should be done not only to achieve healthier outcomes, but also to reduce people’s concerns and respect their time. Patients often expect privacy as well and also want to participate in decisions about their own health and choices about where and who they will take care of. Patients should not always be passively expected to receive Services determined by a service provider.

In summary, health systems have a responsibility not only to improve people’s health, but also to protect them from the financial risks of disease and treat them with dignity. Health systems will thus have three important goals. These:

* Improving the health of the population served;

* Responding to people’s expectations;

* Provide financial protection against the costs of illness or health.


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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.


Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.


Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.


Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.
Medically Reviewed by Professor Doctor Alper Demirbaş
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