Public to Private, Paper to Digital: Thirty Years of Turkish Healthcare System

• In Event: 30421 - Section on Global and Transnational Sociology Roundtables
  In Refereed Roundtable (60 minute): Table 4. Transformative Global Logics and their Platforms

Abstract

Turkey's healthcare system is undergoing significant digital transformation, supported by investments from the World Bank and European Bank for Reconstruction and Development. The government's "Digital Hospitals" initiative has positioned Turkey as Europe's leader in hospitals accredited by the Electronic Medical Record Adoption Model—a measure indicating how digital technologies enhance organizational efficiency in healthcare institutions. This context raises an important and unanswered question: What is the relationship between privatization and digitalization? How do these two phenomena extend each other's reach in providing healthcare in Turkey influenced by global actors? Furthermore, what practices, measures, incentives, policies, and actors does each necessitate? To what extent are these respective assemblages (of practices, measures, incentives, policies, and actors) enabling and constraining one another?
The research employs multi-sited qualitative methods, including interviews with physicians, nurses, administrators, and government officials, alongside observation at Istanbul's City Hospital. It examines three key areas: global and local actors driving digital transformation, interactions between digital technologies and care workers, and the relationships among patients, technologies, and care providers.
First, while existing literature typically frames digitalization as a consequence of privatization, this research reveals a bidirectional relationship. Based on interviews with healthcare professionals and government officials, the study finds that digitalization also reinforces privatization by enabling new institutional models like family health centers, which were designed according to available digital infrastructure rather than preceding it.
Second, digitalization has also restructured healthcare financing. The consolidation of insurance schemes under the Social Security Institution required digital infrastructure to manage information and billing, allowing more private actors to integrate into the national healthcare system.
Third, this study uniquely demonstrates how digitalization serves as a vehicle for private enterprises to become embedded in healthcare services in the country through standardized platforms and regulatory frameworks that intensify competition among private companies.

Author

• Seray Bircan, University of Illinois at Urbana-Champaign