An Evaluation of Oral and Dental Health Services in Turkey and in the Member States of the EU in Terms of Economy

An Evaluation of Oral and Dental Health Services in Turkey and in the Member States of the EU in Terms of Economy

Abdülkadir Işık (Namık Kemal University, Turkey), Seda Suat (Sevgi Dental Clinic, Turkey), Özge Selvi Yavuz (Namık Kemal University, Turkey), Gamze Yıldız Şeren (Namık Kemal University, Turkey) and Berkay Habiboğlu (Thrace Development Agency, Turkey)
DOI: 10.4018/978-1-5225-1903-4.ch013
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Dental health expenditures are a big part of general health expenditures. In Turkey, oral health services are provided by both private practitioners and government sections. In 2012, approximately 7 million fillings were made by government clinics. According to Turkish Dental Association data, in the same year, the number of fillings that Turkish citizens needed was 247 million. Even if the entire budget of the Health Ministry of Turkey were spent for these fillings, it is impossible to handle this demand. In 2012, in the European Union with 24 member countries, dental health spending was close to 74 billion Euro. Because of this financial burden, Turkey and the other countries are trying to find cost-effective methods to minimize dental health spending. This chapter emphasizes dental health conditions of both Turkey and European Union, firstly, and then successful and cost-effective strategies are discussed.
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Cost Items In Oral And Dental Health Services

Calculating properly the cost of a service plays a role not only in the control and audit of the costs, but also in the efficient allocation of resources. Various cost centers appear in health care units and this issue prevents to calculate the costs exactly. Therefore, the classification method started to be used in determining the cost of health care. Generally costs are divided into three groups as follows: direct costs, indirect costs and immaterial costs (Elliott& Payne 2008):

  • Immaterial Costs: Immaterial costs are the most difficult ones to express monetarily. Costs of pain due to tooth decay take part in immaterial costs.

  • Indirect Costs: Indirect costs occur because of the loss of work force of the patient or of the person who takes care of the patient.

  • Direct Costs: Direct costs are the costs related to the medical care services and can be calculated at market prices. Direct costs are divided into two groups, direct medical costs and direct non-medical costs. This separation can be made in oral and dental health services as follows: Direct dental costs and direct non-dental costs.

    • o

      Direct Non-Dental Costs: These costs include foods, drinks, transportations and accommodations.

    • o

      Direct Dental Costs: Direct dental costs are divided into three groups:

  • Fixed Costs: The building where the service is provided, building-related expenses and service investments are included in this group. Dental units, all equipment, instruments and systems are included in this group.

  • Semi Fixed Costs: Personal expenses are included in this group.

  • Variable Costs: Drugs and consumables used for treatment are included in this group.


Oral And Dental Health Profile Of Turkey

In Turkey, oral and dental health problems are among the most important health problems. Oral diseases affect 96% of the individuals and the losses suffered by the country's economy is quite large.

According to Turkish Dental Association’s report published in 2011, there are 24.203 dentists working actively. Turkish population was 74.724.269 in 2011. So in 2011 there were 3087 patients per dentist. The distribution of the dentists actively employed is, 60% of them work in private clinics, 29% of them work for the Ministry of Health, 10% of them work at faculties, and 1% for other institutions (Table 1).

Figure 1.

The distribution of dentists who are actively employed


We can see the current situation below in terms of the number of treatments provided and the number of treatments needed. But considering the number of treatments needed in our country, these numbers seem very low (Figure 1).

Table 1.
The number of treatments provided by dentists working for the Ministry of Health in 2010
Name of TreatmentNumber
Root canal operation752.206
Tooth extraction6.369.715
Removable denture944.276
Fixed partial denture3.043.235

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