Patient companions in the Turkish healthcare system: the role, expectations and problems Yusuf C ß elik PhD 1 , Nes ßet Hikmet PhD 2 , Fatih S ß antas ß PhD 1 , Abide Aksungur PhD Candidate 1 ,G€ ulsen Topaktas ß PhD Candidate 1 and _ Ilkay Sevinc ß Turac ß PhD Candidate 1 1 Faculty of Economics and Administrative Sciences, Department of Healthcare Management, Hacettepe University, Ankara, Turkey and 2 Department of Integrated Information Technology, University of South Carolina, Columbia, SC, USA Accepted for publication 14 December 2016 Correspondence Yusuf C ß elik Faculty of Economics and Administrative Sciences Department of Healthcare Management Hacettepe University 06800 Ankara, Turkey E-mail: yucelik@hacettepe.edu.tr What is known about this topic • Companions are used widely in Turkey as well as in other developing countries. • Companions are usually relatives of patients, and they play a significant role in supporting their patients emotionally during treatment. • Companions can increase the efficacy of healthcare services by facilitating the communication Abstract The purpose of this study was to determine the roles, expectations and problems of patient companions and to develop solutions to the difficulties encountered by the nurses, patients and their companions. A qualitative approach with semi-structured face-to-face interviews was used during May and June 2014 to collect data. A convenience sample of participants was selected from the nurses, patients and their companions. Content analysis was used for the data. The results of this study revealed that the need for companions is important to the current Turkish healthcare system, but it has many drawbacks. As companions are witness to a patient’s declining health and family, social and financial problems, their role should be to support their patients emotionally or socially, but they should not perform medical tasks. Therefore, the agencies responsible for managing the use of patient companions should regularly review its function by communicating often with the patients and their caregivers. Open communication between patient companions and all those responsible for patient care could improve the present difficulties which exist. Keywords: patient care, the role and problems of companions, Turkish hospitals between patients and healthcare providers. What this paper adds • Revealed a small, disparate literature with few papers focusing on the intersection of care co- ordination, older people and third sector provision. • Found that few care co-ordination services in the third sector focus exclusively on older people. • Uncovered little evidence of older people valuing user-led organisations as mechanisms for co-ordinating their care. Introduction There have been strong and stable leadership to transform Turkish healthcare system to improve health status and increase the responsive- ness in the past 15 years. Significant improvements in utilisation, effec- tiveness and health outcomes have been achieved by the reforms implemented by Ministry of Health. The reforms under Health Transfor- mation Programme (HTP) were based on a number of guiding principles: people-focused, pluralism, separation of power, incremental shift towards health provider autonomy and competitiveness (WHO 2012). The HTP enabled the Ministry of Health to focus on policy and strategy develop- ment, while other agencies oversaw public health and delivery of per- sonal health services (Atun 2015). The reforms introduced between 2003 and 2010 separated policy making, regulatory, financing and service pro- vision roles. Overall, substantial progress has been made by: (i) increas- ing public spending on health in line with GDP growth; (ii) consolidating of previously fragmented health financing pools under Social Security Institution (SSI); (iii) determining effective strategies to ensure collection © 2017 John Wiley & Sons Ltd 1199 Health and Social Care in the Community (2017) 25(3), 1199–1208 doi: 10.1111/hsc.12421