Target Markets – Country Analyses | Türkiye
The central challenge for Türkiye’s health system in the coming period is to turn rising expenditure into lasting health gains. To achieve this, we need to assess financing, service use, clinical outcomes and the health workforce within a common management framework. We already have strong quantitative indicators showing how much care is delivered. These indicators must also explain how far patients’ health improves and whether care will remain affordable in the future. Health tourism should be positioned within this wider picture.
Explaining expenditure growth is the first step towards sustainability
According to TurkStat, total health expenditure increased by 89.6% in 2024, reaching approximately TRY 2.359 trillion. Per capita expenditure also rose by 89.2%. The increase in total spending therefore cannot be explained by population growth alone. Health expenditure as a share of GDP rose from 4.6% to 5.3% over the same period, an increase of 0.7 percentage points. [1]
Wages and input prices, service volumes, disease severity, technology use and models of care should be examined separately. A nominal increase of 89.6% is not an increase in the real volume of services. General inflation and changes in healthcare-specific costs should not be treated as identical either. For example, the initial cost of a treatment may rise while complications and readmissions fall, reducing the overall cost of care. Conversely, an inexpensive treatment that requires repeat procedures may ultimately cost more. Assessment should therefore extend beyond the consultation or surgical bill to the total cost and outcome of the care pathway, from diagnosis through follow-up.
What needs are being met by the rise in consultations
The Ministry of Health’s 2024 statistical yearbook shows that physician consultations per capita rose from 11.4 in 2023 to 12.2 in 2024. Calculated from these rounded figures, the increase is approximately 7%. This rise confirms that total demand has an intensity-of-use dimension beyond the size of the population. [2]
From a sustainability perspective, we need to ask which health needs these additional contacts address. Better access and necessary follow-up for chronic conditions are positive explanations. However, visits to different providers for the same complaint, unresolved treatment or weak continuity of care may indicate different management problems. To understand which factors are driving the increase, consultations must be linked to diagnoses, unique patients, tests, prescriptions and subsequent clinical outcomes.
The number of annual consultations for a person with diabetes is not, on its own, a good indicator of effective follow-up. Appropriate disease control, monitoring for complications affecting organs such as the kidneys and eyes, and potentially avoidable emergency visits are more meaningful measures. Similarly, in cancer care, we should assess not only the number of tests but also the stage at diagnosis and the time to treatment. This approach connects family medicine with hospital services as parts of the same care pathway.
Capacity and workforce planning must go together
In 2024, the national hospital bed occupancy rate was 59.8%. It stood at 62.0% in Ministry of Health hospitals, 65.0% in university hospitals and 48.9% in private hospitals. These differences show why a single national average is insufficient for investment decisions. As the figures are not adjusted for case mix, specialty or region, they also cannot establish a ranking of sector efficiency. [2]
When deciding on investment in new beds, we must understand where demand arises, which staff are available to operate existing beds and which services patients cannot access. A waiting list in one specialty does not mean that every hospital needs additional capacity in that specialty. Appropriate referral, allocation of responsibilities and regional planning should also be examined. Capacity needed for disasters and sudden surges in demand must be preserved separately.
In the comparison presented in the OECD’s 2025 report, Türkiye has 2.4 practising doctors and 2.9 practising nurses per 1,000 people, compared with OECD averages of 3.9 and 9.2. This gap supports the case for linking physical investment with workforce planning; it does not, by itself, show that every institution faces the same degree of staff shortage. [3]
Education, staff retention and regional distribution should therefore be considered together across the public, private and university sectors. A university hospital’s research responsibilities and complex case mix, a private hospital’s investment and operating responsibilities, and the public sector’s obligation to provide broad access do not produce identical cost structures. Reimbursement and performance assessment should reflect these responsibilities and patient characteristics.
Quality data must form part of economic assessment
The OECD’s country note reports a breast cancer screening indicator of 37% for Türkiye, compared with an OECD average of 55%. Taking account of the age groups and reference periods covered, this gap of 18 percentage points points to a need to improve access to screening. The same note states that comparable data on avoidable hospital admissions are not available for Türkiye. This does not mean that no records are kept nationally; it identifies a limitation in the international comparability of published data. [3]
These two findings matter because they shift the discussion from activity volumes to health outcomes. A large number of consultations does not, in itself, demonstrate that preventive services adequately reach all target groups. Disease prevention, early diagnosis and reducing the need for hospital admission are measures of system performance alongside successful hospital treatment.
This is where quality and financing should be connected. The resource implications of complications, hospital-acquired infections, unplanned readmissions and repeated tests should be assessed alongside their clinical consequences. Fair comparisons between institutions require adjustment for age, disease severity and comorbidities. Payment models that preserve access to necessary care and support measurable improvement should gradually be considered in place of payment based on activity counts without outcome assessment.
Moving from recording data to data-driven management
Türkiye needs to connect systems in which indicators are tracked in separate tables through shared definitions. Patients’ needs, the care they receive, clinical outcomes and costs should be visible within the same chain of assessment. Consultations, unique individuals, admissions, procedures and invoices are different units. Using them interchangeably distorts both capacity calculations and interpretations of efficiency.
I propose a shared data dictionary and a system of verifiable records across institutions. Each indicator should have an explicit numerator, denominator, scope, reference year and person or unit responsible for updates. Clinical and payment records should be checked for consistency, while incomplete, duplicate and unusual records should be investigated with the source institution. An unusual value should trigger investigation rather than an immediate judgement of poor practice. Artificial intelligence can support this work, but should not replace clinical judgement and audit.
Keeping data under control does not mean allowing unrestricted circulation of patient information. Purpose-limited access, access logs, secure record linkage and aggregate reporting should be core design principles. Managers should be able to identify problems in quality or resource use while protecting patient privacy.
The value of this system should not be measured by the number of reports it produces. For example, if a clinic has a high rate of unplanned readmission, the causes should be investigated, discharge and follow-up processes redesigned, and outcomes measured again. If overall costs fall while outcomes are maintained in a comparable patient group, we can identify an efficiency gain. If access or outcomes deteriorate as costs fall, that cannot be reported as success.
Ageing and patients’ ability to pay belong in the same plan
At the end of 2025, Türkiye’s population was approximately 86.1 million, with people aged 65 and over accounting for 11.1%. The older population increased by 20.5% between 2020 and 2025. This demographic shift raises questions not only about future bed requirements but also about how long-term care will be financed. [4, 5]
Without continuity between rehabilitation, home healthcare, palliative care and social support, hospitals may also take on needs that could be met in other settings. Health planning should therefore consider family structures, the burden on carers and regional access. Mental health, oral and dental health, maternal and child health, and the needs of people with disabilities are also part of sustainability.
In 2024, government financed 76.1% of total health expenditure, demonstrating the central role of public funding. Household out-of-pocket payments amounted to TRY 442.4 billion, or 18.8% of the total. [1] Tracking this share only as a national average is insufficient. The financial burden and postponement of treatment among households with chronic illness, low incomes or continuing care needs should be examined separately. Savings in the public budget achieved by shifting costs onto patients do not constitute sustainability for the system as a whole.
What should we measure beyond health tourism volumes
Health tourism is an important part of this discussion of financing and capacity. USHAŞ’s 2025 Annual Report records 1,506,442 health visitors and approximately USD 3.023 billion in revenue for 2024, and 1,398,580 visitors and approximately USD 3.022 billion for 2025. The calculations below use the series presented in that report. [6]
| Indicator | 2024 | 2025 | Change |
|---|---|---|---|
| Health visitors | 1,506,442 | 1,398,580 | 7.2% decrease |
| Revenue USD million | 3,022.957 | 3,022.452 | Approximately unchanged |
| Revenue per visitor USD | 2,007 | 2,161 | 7.7% increase |
Source and calculation: USHAŞ 2025 Annual Report, p. 9. Exact revenue figures are USD 3,022,957,000 and USD 3,022,452,000 respectively, a change of approximately −0.02%. Revenue per visitor is calculated as total revenue divided by visitor numbers and rounded. [6]
The table shows that calculated revenue per person can increase while visitor numbers fall. It does not establish whether the increase reflects higher quality, higher prices or a different treatment mix. Revenue is not net earnings either. Economic contribution cannot be assessed without knowing patient acquisition, intermediary, staffing, consumables and post-treatment follow-up costs. A growth strategy focused solely on attracting more visitors is therefore incomplete.
In the same report, USHAŞ states that an HTS code has been developed for unique patient tracking and that work on integration with e-Nabız has begun. [6] This direction of infrastructure development is important. The next step is for unique records to show which treatments are delivered, at what cost and with what outcomes. The start of this work should not be interpreted as proof that all data are already fully integrated.
We should diversify statistics along three dimensions. Patient and service data should cover country of residence, purpose of travel, specialty, treatment type, provider, repeat visits and duration of care. Quality data should cover complications, unplanned repeat procedures, patient experience and follow-up after returning home. Economic data should cover revenue collected, the total cost of care and net contribution. Waiting times for domestic patients and staff workloads should also be included. This would reveal both the contribution of international services and the capacity pressures they create.
People travelling for planned treatment, tourists receiving healthcare during a holiday and citizens living abroad should be distinguished through clear definitions. Nationality, country of residence and purpose of travel are not the same variable. A person receiving services from several providers should not inflate the count of individuals. When definitions or coverage change, the effect on comparisons with the historical series should also be explained.
Different dimensions of health require different measures of value
Medical treatment, rehabilitation, thermal services, wellness programmes and care for older people do not have identical purposes or outcome structures. Functional improvement is central to rehabilitation; independence and quality of life to long-term care; and condition-specific outcomes to medical treatment. Combining these services into a single total of patients and revenue obscures investment priorities. The primary purpose of travel and additional services should be recorded separately, without counting people more than once when they use several services.
Türkiye’s international health potential extends further. Pharmaceutical and medical device production, clinical research, professional education, digital health and hospital management partnerships make distinct economic contributions. They should be reported within their own definitions rather than simply added to health tourism revenue. Device investment should be assessed through maintenance and lifetime costs; medicines through appropriate use and treatment outcomes; and digital projects through their contribution to continuity of care. Energy, water and waste management in health facilities should also be measurable components of resource sustainability.
A practical direction for management in Türkiye
The first step is to assess the definitions and quality of existing data across the Ministry, the Social Security Institution (SGK), universities and the private sector. Outcome and cost linkage could then be piloted in comparable areas of care, such as diabetes follow-up, hip and knee surgery or selected oncology pathways. For international patients, data on travel purpose, country and post-treatment follow-up could be added to the same clinical quality framework. This is a proposal for implementation, not a description of a system that is already fully operational.
The success of pilots should be assessed against baseline performance, patient characteristics and, where possible, comparable groups. Approaches shown to improve outcomes should be expanded; those that do not should be redesigned. Reimbursement, investment and promotion decisions could then be linked to measurable health gains and economic contribution.
The choice facing Türkiye goes beyond whether to spend more. We should make decisions knowing which needs resources address, who cannot access care and which approaches produce better outcomes. Sustainability in health means not only accounting for a growing budget, but also demonstrating what that budget changes in population health. Lasting value in health tourism can be generated through the same approach to management.
Sources and calculation notes
[1] TurkStat. Health Expenditure Statistics 2024. 4 December 2025.
https://veriportali.tuik.gov.tr/tr/press/54188 (opens in a new tab)
[2] Republic of Türkiye Ministry of Health. Health Statistics Yearbook 2024. Consultations per capita: Figure 8.2, p. 167; bed occupancy by sector: Table 8.25, p. 203.
https://www.saglik.gov.tr/TR-114952/saglik-istatistikleri-yilligi-2024.html (opens in a new tab)
[3] OECD. Health at a Glance 2025: Türkiye. 13 November 2025. Comparisons concerning workforce, screening and avoidable admissions.
[4] TurkStat. Address Based Population Registration System Results 2025. 9 February 2026.
[5] TurkStat. Statistics on Older Persons 2025. 12 March 2026.
https://veriportali.tuik.gov.tr/tr/press/58231 (opens in a new tab)
[6] USHAŞ. Annual Report 2025. Health tourism series, p. 9; HTS code and e-Nabız integration, p. 10.
Data checked on 25 October 2026. Health expenditure and hospital use refer to 2024; population and health tourism figures refer to 2025. OECD indicators relate to the different reference periods used in the report. Data from different years have not been treated as a single-year snapshot. Percentage changes are calculated as (new value/old value − 1) × 100. Numerical findings are distinguished in the text from the author’s interpretations and recommendations.
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