as to private hospitals publicly funded patients accessing care in private hospitals must make significant outofpocket contributions to meet the costs not covered by public insurance turkey has an opportunity to use the rich data infrastructure and coding processes already in place to shift to casemix adjustment relatively rapidly thereby appropriately remunerating complexity of care this should be accompanied by monitoring of quality of care for example to ensure that any expansion in numbers treated is clinically appropriate and to reduce unwarranted variation in medical practice across providers or geographical regions this would have the further advantage of helping the ministry of health move fully and expeditiously in the aspired direction of focusing on quality governance of the health system and relinquishing responsibility over operations