The Impact of Türkiye’s City Hospitals on Health Care Use and Health Outcomes

This study examines the impact of Türkiye’s city hospital reform on health care use and health outcomes. As part of a broader health care reform, the Turkish government established public-private partnerships to upgrade existing hospital infrastructure and build new high-capacity tertiary facilities across selected regions of the country. The first set of hospitals began operations in 2017. To estimate the effect of this reform, we employ a difference-in-differences approach, comparing changes in outcomes before and after 2017–18 in regions that opened city hospitals (treatment regions) with regions that did not open any city hospitals during the study period (control regions). We find that the reform led to a significant increase in inpatient utilization and improvements in self-reported health. Specifically, there is a 3.7 percentage point increase in the probability of using any inpatient care and 3.9 percentage point decrease in the probability of reporting bad or very bad health.