With the changing and developing world conditions, the needs and expectations of people have begun to differentiate. To keep up with this development and change, the states have started to take steps to realize some transformations to ensure sustainable development in the cities and to improve the health, comfort, and quality of life standards of the people living in the cities (Dhyani et al., 2018). The sustainability in question is not only about the health of the environment of cities but also about the health of people living in cities (Mason, 2022). In this context, Turkey has taken an important step that will directly affect the country’s health. It has put into operation the large and complex structures called the integrated health campuses (city hospitals), which were taken from England and built with the public-private partnership (PPP) model (Savas et al., 2020). Unlike public hospitals and training and research hospitals operating in Turkey, city hospitals are structured as large regional medical centers. The purpose of establishing these large health complexes is to meet the health needs of the people of the region with the latest technology, medical facilities, and qualified health personnel by having various health units (Atasever, 2018).
A New Strategic Change Application for Healthcare Systems: City Hospitals
City hospitals are defined as the integration of multi-part structures of health institutions in terms of management processes, which are built with the PPP model and strategic cooperation with health sector organizations and stakeholders (Ministry of Development, 2018; Kiviliene & Blazeviciene, 2019). These city hospitals, which serve in various regions in Turkey, have brought a new perspective to the country's health system and have begun to be implemented as a new reform (Kayral, 2019). This is the new and visible health policy action in Turkey, which has become one of the most controversial issues in the Turkish health system in recent years. The main purpose of putting city hospitals into operation is to combine small-capacity health facilities under larger campuses, to build more modern and functional health facilities, to provide high standards of service to increase the quality and effectiveness of health services, and to share the risks by reflecting the cost of health services to private sector entrepreneurs (World Bank, 2016; Uysal, 2020; Ministry of Health, 2022). In addition, the increase in the number of applications made to hospitals and the demand for health services over the years, as well as the increase in the need for the number of qualified health personnel to meet the demands, are also cited among the reasons for the implementation of this project (Ministry of Health, 2021). For this reason, in 2017, the first implementation of the city hospitals project, which undertakes the construction of large hospital complexes with the PPP model and will be operated in cooperation with the public sector for 25 years, have been implemented (Ministry of Health, 2021; Yılmaz & Aktas, 2021). In city hospitals, interdisciplinary working environments and multidisciplinary teamwork are prevalent. To provide high-quality patient care, these hospitals provide interdisciplinary, transdisciplinary, and effective collaborative practices (Ika et al., 2019; Okoh et al., 2020). Health policymakers need to understand the attitudes and intentions of health professionals regarding health system regulations so that they can design policies that improve the efficiency, effectiveness, and quality of health care (Rowe et al., 2018; Schot et al., 2020). For this reason, determining the opinions of certain occupational groups, such as specialist physicians, has critical importance for health policymakers to better respond to the needs in the health sector and to determine better policy practices.