APPENDIX REPUBLIC OF TURKEY MINISTRY OF HEALTH DIRECTORATE GENERAL OF HEALTH SERVICES

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1 APPENDIX REPUBLIC OF TURKEY MINISTRY OF HEALTH DIRECTORATE GENERAL OF HEALTH SERVICES DEPARTMENT OF H T MEDICAL T ACTIVITY REPORT

2 ÖZET SUMMARY Bakanlığımız, sağlık turizmi sektörünün paralel Our Ministrydünyadaki carries out its activities in parallel with gelişimine the developments in olarak Health çalışmalarını Tourism sector yürütmektedir. Bu kapsamda gerekli mevzuat çalışmaları olup, son ikiare yılda throughout the world. In this context, necessary legislative works yürütülmekte are going on and following the aşağıdaki çalışmaları works carried out in theyapılmıştır. last two years: 1. Sağlık Turizmi Daire Başkanlığı: 1. Department of Health Tourism: Yeni teşkilat yasamızla sağlık turizmi ileitilgili vetask işlemleri yapmak ve ilgili kurumlardaworks arathanks to our new organizational law, hasişthe to carry out health-tourism-related sındaki koordinasyonu sağlamak görevini Bu kapsamda sağlık hizmetleri genel and operations and to ensure coordination with üstlenmiştir. the relevant institutions. In this context, the department müdürlüğü bünyesinde sağlık turizmi within daire the başkanlığı kurulmuştur. of Health Tourism has been established directorate general of health services. 2. Çalışma Alanı: 2. Field of Activity: Sağlık çalışmalarımız turizm, yaşlı under ve engelli turizmi olaraktourism, geniş Our turizmi Health Tourism activities tıp areturizmi, carried termal out comprehensively the titles of medical kapsamlı olarakand değerlendirilmektedir. gelenwithin yıllık 32 turiste deofacil thermal Tourism elderly and disabledayrıca, Tourism.ülkemize Furthermore, the milyon scope of health the sağlık olarak turistin sağlığı kapsamında verilmekte denetlenmektedir. tourist,hizmeti we are providing and supervising emergencyhizmet health service to 32ve million tourists annually who are coming to Turkey. 3. İstatistikler ve Web Kaydı: Kamu, özel ve and üniversite hastanelerine gelen yabancı uyruklu hastalar düzenli olarak 3. Statistics Web Registration: web tabanlı bir programla kayıt edilip toplanmaktadır. Bununhospitals, neticesinde elde edilen ve-a Foreign patients, who admit to the public, private and university are registered through riler bu raporda kapsamlı değerlendirilmektedir da web-based program regularly.olarak The data obtained as a result areörneğin, handled in2008 de this study74.093, comprehensively , 2010 da , 2011 de ve 2012 de yabancı Türkiye de ücfor example, in ,093, in ,961, in ,678, in 2011 hasta 156,176 and in 2012 retli olarak tedavi görmüştür. Kayıt sistemimizden illere, branşlara, hastanelere göre 210,000 foreign patients received medical treatment ülkelere, in Turkey against remuneration. We are able to istatistiksel rapor alınmaktadır. get statistical reports from our registration by country, province, branch and hospital. 4. Yurtdışı Çağrı Merkezi: 4. International Call Center: 7/24 saat dört dilde Rusça ve Almanca) ülkemize gelen tüm7/24 yabancı In health sector, all (İngilizce, the foreign Arapça, patients and tourists are given interpretation service hours hastalara ve turistlere sağlık alanında tercümanlık destek Turistler, acil in four languages (English, Arabic, Russian and German). Thehizmeti tourists verilmektedir. can dial 112 for emergency durumlarda ve and şikayet durumlarında 184 service telefoninnumaralarından kendiin situations and bilgi for edinme information complaints and receive their mother tongues. anadillerinde alabilmektedir. merkezimizde 21 kişi vardiyalı olarakin our call center konuşarak 21 persons hizmet are working in shifts and Çağrı they answer average 700 calls in a month. çalışmakta olup aylık 700 çağrıya Bunun yanı sıraisbirçok yaaddition, translation andortalama interpretation support iscevap given. verilmektedir. In 2013, monthly call number targeted to zılı de ve toplantılara daincluded tercüman olarak destek verilmektedir yılında aylık be çevirilere Persian and French will be in this service. 5. Website: 5. Web Sitesi: bearing information on the Health Tourism potentials in four languages has been Our website, Ülkemizdeki turizmi potansiyelleri anlatan ve 4 dilde yayın bir web sitemiz kuestablished andsağlık is constantly updated ((www.saglikturizmi.gov.tr / yapan rulmuş sürekli güncellenmektedir. (www.saglikturizmi.gov.tr Througholup this website, the health system and Health Tourism potential in/ our country are announced trto) whole Bu siteyle ülkemizin sağlık sistemi ve sağlık potansiyeli 4 dilde tüm dünyaya tanıtılworld in 4 languages. Everybody can turizmi reach the statistics on Health Tourism through this maktadır. bu webthe sitesinden turizmi was ile ilgili istatistik bilgilere ulaşabilmektedir. website. AtHerkes the beginning, number ofsağlık daily visitors Başlangıçta ziyaretçi sayısı günlük civarındadır. 6. Our Activities on Health Free Zone 6. Sağlık Bölgesi (SSB) It is nowserbest possible in Article 49 Çalışmalarımız: of the 663 Law Decree to establish a Health Free Zone and our 663with sayılı oluşturulabilmesinin açılmışis olup Ekonomi baworks thekkk nin Ministry49. of Maddesinde Economy on thessb preparation of necessaryönü legislation continuing. In 2013 kanlığı ile gerekli çalışmalarımız yılı içinde kadar bu çalışthese works will bemevzuat completed. There is more devam detailedetmektedir. information in2013 the report. malarımız tamamlanacaktır. Raporun içinde daha detaylı bilgi mevcuttur. 7. Legislation Works: 7. Mevzuat Çalışmalarımız: In line with the development in health sector, sub-regulatory works started to avoid potential problems in applications and toparalel ensure olarak the sustainability of the çıkabilecek sector. Naturally, international Sağlık turizminin gelişimine uygulamalarda aksaklıkları önleagreements on health and Tourism and laws in this regard form the basis of our works. mek, sektörün sürdürülebilirliğini sağlamak için bu konuyla ilgili alt mevzuat çalışmaları yapıl-

3 7.1.Done so far: a) By the amendments in the Regulation on Private Hospitals and Outpatient Diagnosis and Treatment of Private Health Institutions, establishment and operation of health units at the hotels (for emergency situations), establishment and operation of health facilities at the accommodation facilities (for Health Tourism services), b) The health care and rehabilitation services at the spas, c) The procedures and principles of remunerating the health services that will be provided to the foreign patients at the public hospitals have been identified. d) By the organizational law, the labor division and mission definitions regarding the follow-up of the Health Tourism at the center and field have been fixed. (in provinces health services will be followed up by the branch directorates). e) Promotion and informing in Health Tourism have been expanded Ongoing Legislation Efforts: a) Regulations on Health Free Zone b) Regulations on intermediary organizations and Health Tourism procedures c) Curing and rehabilitation services legislation and medical SPA legislation d) Finally, general regulation determining the procedures and principles of Health Tourism generally and broadly 7.3. Other Relevant Legislations: a) With notification no. 2012/4 to the Ministry of Economy, financial support to the promotion of Health Tourism abroad has been provided. b) Article 9 of Law no. 6322, issued by Ministry of Finance, 50 % income tax relief from the Health Tourism has been obtained. Works on issuing notification on the procedures and principles of this law are to be concluded. c) Works by the Ministry of Culture and Tourism regarding promotion and thermal Tourism investments 8. Meetings and Trainings Relevant ministries, institutions, and representatives of the sector are constantly meeting and making consultations regarding the legislation work on Health Tourism. In addition, regulations related to the Health Tourism and the field meetings, are explained to the concerned parties and the participants. International meetings are participated in to monitor developments throughout the world and to tell about the potentials our country has. 9. Ultimate Goals: Turkey aims at being a leader in the world in terms of Health Tourism, by providing qualified health services with affordable prices. in service provision in Health Tourism the private sector will always have priority. 10. Target Indicators: a) In foreign patients 7 billiard USD, b) In foreign patients 20 billiard USD, c) Ten percent of these figures are expected to admit to public hospitals. d) Until the end of 2013, all necessary regulations will be fully issued. Dr. Dursun AYDIN Department Head of Health Tourism

4 CONTENTS SUMMARY 2 I. ESTABLISHMENT and DUTIES 5 II STATISTICS 6 III. PUBLICATIONS and REPORTS 9 IV. INTERNATIONAL PATIENT SUPPORT UNIT V. Health Tourism WEBSITE 13 VI. FOREIGN PATIENT RECORD SYSTEM 14 VII. MEETINGS AND TRAINING ACTIVITIES 15 VIII. LEGISLATION WORKS 16 IX. HEALTH FREE ZONES 17 X. TARGETS AND STRATEGIC PLANS 18

5 I. ESTABLISHMENT and DUTIES 1. Establishment Health Tourism Unit has been established to control the Tourism health services from a single source with the approval no , dated March 31, 2010, of Turkey General Directorate of Primary Health Care. In order to carry out activities related to Health Tourism; Unit within the General Directorate of Primary Health. This unit was transferred to the in May 5, 2011 with the approval no Within the General Directorate of Curative Services the unit continued its activities as the Health Tourism Coordinator. On November 2, 2011, by the Decree Law No. 663 Department of Health Tourism under the General Directorate of Health Services has been established and continues its activities on the following topics: 2. Duties 1. Planning services in terms of Health Tourism and health of the tourist, granting the necessary permissions, 2. Carrying out works and operations related with Health Tourism in coordination with relevant agencies and organizations 3. Monitoring the activities of the spas, spring resorts and Climatotherapy centers, mostly related to the Advanced Age and Disability Tourism and thermal Tourism, in terms of Health Tourism. 4. Establishing the admission criteria of the patients who would come to our country for receiving medical treatment in terms of Health Tourism and examining the demands and complaints of these patients. 5. Providing assistance and consultancy to the patients of Health Tourism and health of the tourist when needed and to keep their records 6. Carrying out works and operations related to the Health Free Zones to the health services which will be provided in those zones 7. Planning and coordinating the procedures related with the patients who come to our country within the scope of bilateral cooperation in the health sector and whose treatment is accepted. 5Sağlık Medical Turizmi Tourism Faaliyet Activity Raporu Report 5

6 II STATISTICS Health Tourism: is the visit to our country for receiving medical treatment, Health of the tourist: is tourists receiving emergency medical service while in vacation in Turkey. All the data is based on that of Figure 1: Distribution of Patients receiving Health Care in Turkey by Year P l H alt E ta l t P at H alt E ta l t Total Figure 2: Rate of the health tourists being treated in public and private hospitals (Number of Patients) 6Sağlık Medical Turizmi Tourism 2012 Faaliyet Activity Raporu Report P Figure 3: Rate of the patients receiving treatment in public and private hospitals, within the Category of health of the tourist P Total P P Total

7 Figure 4: Distribution of health tourist numbers by country Public Hospitals (first 10 countries) N o Pa t N o Pa t N o Pa t Figure 5: Distribution of health tourist numbers by country Private Hospitals (first 10 countries) N o Pa t A a G a G a B l a a Figure 6: Distribution of numbers of patients in health of the tourist category by country Public Hospitals (first 10 countries) G a A a B l a a G o a I a R a a R a L a G o a Holla A a E la Holla E la Figure 7: Distribution of numbers of patients in health of the tourist category by country Private Hospitals (first 10 countries) G a R a Holla F a I a I a R a I a A a T ta S a F a D a U a B l S a F a Ka a ta USA R a L a I a 7 7Sağlık Medical Turizmi Tourism Faaliyet Activity Raporu Report

8 Figure 8: Distribution of the first 10 Public Hospitals admitting foreign health tourists Ta ERH Ha ERH Atat ERH B SH l E al Ho tal Ul a la E Ho tal Kartal L K r ar ERH Ye le P l o ar D ea e Ka a T al Ho tal ta l ERH Figure 9: Distribution of the first 10 Private Hospitals admitting foreign health tourists P at A a ol H alt C t Pr ate Ho tal a l a Pr ate D a G Atat Pr ate Me al ar Fa h Pr ate Ba r Ho tal Pr ate Me al ar G te e Pr ate A a e F l a Pr ate Me al Par I ta l I ter a o al Pr ate Me al Par Sa Figure 10: Numbers of Health Tourists by Province 8Sağlık Medical Turizmi Tourism 2012 Faaliyet Activity Raporu Report Figure 11: General Distribution of Public-Private Sector by Branch in Health Tourism P at Other E e O olo Ortho e Car olo Bra Pla De tal Total CVS S r er S r er P l In 2011, foreign patients from 107 different countries received medical treatment in our hospitals.

9 III. PUBLICATIONS and REPORTS - Although it is a new department, it created an efficient work environment. By its publications issued on the Health Tourism it provided both guiding and informative service. In addition, many foreign scientific papers were translated into Turkish, and many reports were examined. Our publications; 9Sağlık Medical Turizmi Tourism Faaliyet Activity Raporu Report 9

10 IV. INTERNATIONAL PATIENT SUPPORT UNIT ( ) International Patient Call Center was founded on February 1, 2012 under the Department of Health Tourism. Arabic) and by means of outsourcing 21 individuals are employed currently. In 2013 Persian and French - will be included. interpreting services are given in 4 languages. - 3-way conference system interpreting services are given in 4 languages. - language, interpreting services are provided in calls through teleconferencing system. hospitals are given assistance in foreign language regarding the procedures and works on the report, epicrisis and receiving provision from abroad. When the calls received So far, are analyzed, most incoming calls are respectively in English, Arabic, Russian, and German. In August, the total number of calls was 828. Monthly average number of calls is expected to approach In addition, various documents, especially the medical - reports from our hospitals are translated. Although this service is not known or used frequently in the field, in emergency cases, in the event of complaints and patient examination this service provides many benefits to foreigners in our country, fills an important gap. Thirty two million general purpose tourists and health tourists coming to our country can receive - services in their own languages 7/24. Such a practice is not common, and our country has been a pioneer in the world. Medical Sağlık Turizmi Tourism 2012 Faaliyet Activity Raporu Report 10

11 INTERNATIONAL PATIENT SUPPORT UNIT- FEBRUARY NOVEMBER 2012 NUMBER OF CALLS RECEIVED General English German Arabic Russian FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER Number of Calls Received in Terms of Cities FEBRUARY AUGUST PERIOD Province Quantity Rate % (Europe) (Anatolia) Medical Sağlık Turizmi Tourism Faaliyet Activity Raporu Report (Anatolia) 11 11

12 Number of Calls (Hours) FEBRUARY AUGUST 2012 Number of Calls (Hours) Quantity Medical Sağlık Turizmi Tourism 2012 Faaliyet Activity Raporu Report Time Quantity Rate % records are listed Total Minimum Maximum Average

13 V. HEALTH TOURISM WEBSITE - Our website, bearing information on the Health Tourism potentials in four languages has been established and is constantly updated ((www.saglikturizmi.gov.tr / gov.tr). Through this website, the health system and Health Tourism potential in our country are announced to whole world in 4 languages. Everybody can reach the statistics on Health Tourism - through this website. At the beginning, the number of daily visitors was / TURKISH RUSSIAN ARABIC Medical Sağlık Turizmi Tourism Faaliyet Activity Raporu Report 13 ENGLISH GERMAN 13

14 VI. FOREIGN PATIENT RECORD SYSTEM Health TOURISM Patient Tracking System Web Applications Note: In 2013 our records will be kept through HIMS. Foreign patients receiving health care within the scope of the Circular, will be registered into the Health Tourism patient tracking system in the web page; or (http://sbu. saglik.gov.tr/sbyabanci/) - of the Ministry (all the spaces in the registration form will be filled in) Report Sample Medical Sağlık Turizmi Tourism 2012 Faaliyet Activity Raporu Report 14 NAME HASTA OF THE ADI PATIENT NAME OF THE DATE OF PATIENT CATEGORY OF THE THE ÜLKE ADI NAME OF THE CLINIC NAME KURUM OF THE INSTUTION ADI PROVINCE COUNTRY ADMISSION PATIENT ADMISSION HOSPITAL TUR... Slovak Ankara Dışkapı Yıldırım Beyazıt Education State Emergency Devlet Health of the Tourist Republic Cumhuriyeti and Research Hospital Hospital Hastanesi... The Rusya Russian Federation Federasyonu Orthopedics and Traumatology Private Bilgi Hospital Health of the Tourist Private Özel Hastane Hospital... Norway Cardiology Private Gazi Hospital Health of the Tourist Private Özel Hastane Hospital... Germany Almanya Emergency Private Medical Park Izmir Hospital Health of the Tourist Private Özel Hastane Hospital... Azerbaijan Azerbaycan Emergency Karadeniz Technical University Farabi University Üniversite Hospital Health of the Tourist Hospital Hastanesi... The Ingiltere UK Emergency Mugla Marmaris Public Hospital State Devlet Health of the Tourist Hospital Hastanesi... Azerbaijan Azerbaycan Emergency Izmir Ege University Medical School University Üniversite Health of the Tourist Hospital Hospital Hastanesi... The Netherlands Hollanda Children s Health and Diseases Private Akdeniz Hospital Health of the Tourist Private Özel Hastane Hospital... The UK Infectious Private Medical Park Izmir Diseases Devletler Hospital Health of the Tourist Private Özel Hastane Hospital... Czech Çek Republic Cumhuriyeti Orthopedics and Traumatology Private Akdeniz Hospital Health of the Tourist Private Özel Hastane Hospital... The Hollanda Netherlands Children s Health and Diseases Private Akdeniz Hospital Health of the Tourist Private Özel Hastane Hospital... Germany Almanya Internal Diseases Private Akdeniz Hospital Health of the Tourist Private Özel Hastane Hospital... Switzerland Internal Diseases Private Akdeniz Hospital Health of the Tourist Private Özel Hastane Hospital... Germany Almanya Ear, Nose and Throat Diseases Private Akdeniz Hospital Health of the Tourist Private Özel Hastane Hospital... Syria Suriye Biochemistry and Clinical Biochemistry Private Uskudar Anadolu Hospital Health of the Tourist Private Hospital Özel Hastane... Iran Orthopedics and Traumatology Private Uskudar Anadolu Hospital Health of the Tourist Private Özel Hastane Hospital... Germany Almanya Children s Health and Diseases Private Belek Anadolu Hospital Health of the Tourist Private Özel Hastane Hospital Reports can be received from every Provincial Health Directorates or throughout Turkey

15 VII. MEETINGS AND TRAINING ACTIVITIES Meetings and Trainings Relevant ministries, institutions, and representatives of the sector are constantly meeting and making consultations regarding the legislation work on Health Tourism. In addition, regulations related to the Health Tourism and the field meetings, are explained to the concerned parties and the participants. International meetings are participated in to monitor developments throughout the world and to tell about the potentials our country has Internal - Turkey Health Tourism Platform Istanbul Conference Medical Sağlık Turizmi Tourism Faaliyet Activity Raporu Report Abroad

16 VIII. LEGISLATION WORKS In line with the development in health sector, sub-regulatory works started to avoid potential problems in applications and to ensure the sustainability of the sector. Naturally, international agreements on health and Tourism and laws in this regard form the basis of our works. Done so far: a) By the amendments in the Regulation on Private Hospitals and Outpatient Diagnosis and Treatment of Private Health Institutions, establishment and operation of health units at the hotels (for emergency situations), establishment and operation of health facilities at the accommodation facilities (for Health Tourism services), b) The health care and rehabilitation services at the spas, c) The procedures and principles of remunerating the health services that will be provided to the foreign patients at the public hospitals have been identified. d) Records of the foreign patients are being kept. e) By the organizational law, the labor division and mission definitions regarding the followup of the Health Tourism at the center and field have been fixed. (In provinces health services will be followed up by the branch directorates). f) Regulation No amending the Regulation on dialysis centers. It will be possible to open dialysis centers at the accommodation facilities and at the clinic guest houses that would serve the tourists and Health Tourism. g) Promotion and informing in HealthTourism have been expanded. Medical Sağlık Turizmi Tourism 2012 Faaliyet Activity Raporu Report Ongoing Legislation Efforts: a) Circular on the opening of health care organizations in the accommodation facilities b) Regulations on Health Free Zone c) Regulations on intermediary organizations and Health Tourism procedures d) Curing and rehabilitation services legislation and medical SPA legislation e) Regulations on medical SPA services f) Finally, general regulation determining the procedures and principles of Health Tourism generally and broadly g) Criteria establishment for quality and performance in Health Tourism. Legislations issued by other Ministries: a) With notification no. 2012/4 to the Ministry of Economy, financial support to the promotion of Health TOURISM abroad has been provided. b) Article 9 of Law no. 6322, issued by Ministry of Finance, 50 % income tax relief from the Health Tourism has been obtained. The notification on the procedures and principles of this law have been issued on December31, 2012 in the 4th edition of the official gazette c) Thermal Tourism investments planning and investment incentives of the Ministry of Culture and TOURISM 16

17 IX. HEALTH FREE ZONES Legislation efforts regarding the free zone are continuing, we intend to publish regulations in Ministry of Economy prepared a draft to change Law No on free zones to be submitted to the parliament. Basic Principles of Health Free Zone (HFZ) Sport Fields and so on) / Healthy living centers, Although a few of the HFZ are very large, some small scale of them can be installed either The Draft Scheme Hospitals Recreation Areas Training Center Graveyard, Mosque, Church, Synagogue Social Facilities Sport Plants Congress Center ENTRY Rehabilitation Geriatrics Short Distance to Airport Teknokent Research-Development The Draft Calendar for HFZ ( ) by the board of ministers, Hotel Teknokent Research-Development Medical Sağlık Turizmi Tourism Faaliyet Activity Raporu Report 17 17

18 X. TARGETS AND STRATEGIC PLANS A) Targets a)to be the regional leading country in terms of Health Tourism b) In foreign patients 7 billiard USD, c) In foreign patients 20 billiard USD, 9. Ultimate Goals: Turkey aims at being a leader in the world in terms of Health Tourism, by providing qualified health services with affordable prices. in service provision in Health Tourism the private sector will always have priority. 10. Target Indicators: a) In foreign patients 7 billiard USD, b) In foreign patients 20 billiard USD, c) Ten percent of these figures are expected to admit to public hospitals. d) Until the end of 2013, all necessary regulations will be fully issued. Medical Sağlık Turizmi Tourism 2012 Faaliyet Activity Raporu Report 18 * Are realized quantities, and other years are targeted as projection. B) Strategic Plans ( Vision) STRATEGIC GOAL 4: to continue to improve the health care system as a means of contribution to Turkey s economic and social development and global health. STRATEGIC GOAL 4.5: To strengthen Health Tourism in Turkey Strategies for the target Promotion and creating charm within the scope of Health Tourism. level. foreign tourists coming to our country.

19 4.5.2 Improving the quality of health service provided within the context of Health Tourism. service in Health Tourism promotion and development of Health Tourism Broadening the scope of Health Tourism services. Elderly Care activities Improving the governance of Health Tourism. of Health Tourism. work at the Health Tourism services To strengthen health tourism in Turkey PERFORMANS PERFORMANCE GÖSTERGESİ INDICATOR Number of patients coming within the scope of health tourism ( thousand) Revenue from health tourism (SGP US$) Revenue from health tourism (SGP US$) CURRENT POSITION OBJECTIVE OBJECTIVE T 2023 T 156 (1) 1 billion 2,5 (1) billion 4, billion 10 Medical Sağlık Turizmi Tourism Faaliyet Activity Raporu Report Number of Free health region (1) General Directorate of Health Services 19

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