SAYILARIN ÖTESİNDE YAŞLANMA: OECD ÜLKELERİNDE NÜFUSUN YAŞLANMASI İLE MALİYET NEDENİYLE SAĞLIK HİZMETLERİNE ERİŞİM ARASINDAKİ İLİŞKİ

Öz

Giriş: Bu çalışma, OECD ülkelerinde nüfusun yaşlanması ile maliyet nedeniyle sağlık hizmetlerine erişim arasındaki ilişkiyi incelemektedir. Yöntem: Araştırmada, 2000–2023 dönemini kapsayan 15 OECD ülkesine ait 102 ülke-yıl gözleminden oluşan dengesiz panel veri seti kullanılmıştır. Ülke düzeyinde kümelenmiş sağlam standart hatalara sahip sabit etkiler ve rassal etkiler modelleri tahmin edilmiştir. Hausman testi sonucuna göre rassal etkiler modeli tercih edilen model olarak belirlenmiştir. Bulgular: Tercih edilen rassal etkiler modelinde nüfusun yaşlanması ile maliyet nedeniyle vazgeçilen sağlık konsültasyonları arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır (β = −0,155; %95 GA: −0,800–0,489; p = 0,637). Açıklayıcı değişkenlerin hiçbiri istatistiksel olarak anlamlı bulunmamış ve modelin genel anlamlılığı da doğrulanmamıştır (Wald χ²(5) = 6,91; p = 0,227). Yaşam beklentisi sabit etkiler modelinde pozitif ve anlamlı bir ilişki göstermesine rağmen (β = 1,035; p = 0,038), bu ilişki tercih edilen rassal etkiler modelinde anlamlı değildir (β = 0,414; p = 0,255). Sonuç: Bulgular, nüfusun yaşlanmasının tek başına seçilen OECD ülkelerinde maliyet nedeniyle sağlık hizmetlerine erişimi açıklamadığını göstermektedir. Sağlık sistemi ve bağlamsal göstergeleri içeren ileri araştırmalar, sağlık hizmetlerine erişilebilirliğin daha kapsamlı biçimde anlaşılmasına katkı sağlayabilir.

Anahtar Kelimeler

• Nüfus yaşlanması
• sağlık hizmetlerine erişim
• karşılanamayan sağlık ihtiyacı
• OECD ülkeleri
• panel veri analizi

AGING BEYOND NUMBERS: THE ASSOCIATION BETWEEN POPULATION AGING AND COST-RELATED HEALTHCARE ACCESS IN OECD COUNTRIES

Öz

Background: This study examines the association between population aging and cost-related healthcare access across OECD countries. Methods: An unbalanced panel dataset comprising 102 country-year observations from 15 OECD countries over the period 2000–2023 was analyzed. Fixed-effects and random-effects models with standard errors clustered at the country level were estimated. Based on the Hausman test, the random-effects model was retained as the preferred specification. Results: In the preferred random-effects model, population aging was not significantly associated with consultations skipped due to cost (β = −0.155, 95% CI: −0.800 to 0.489, p = 0.637). None of the explanatory variables was statistically significant, and the model was not jointly significant (Wald χ²(5) = 6.91, p = 0.227). Although life expectancy was positively associated with consultations skipped due to cost in the fixed-effects model (β = 1.035, p = 0.038), this association was not significant in the preferred random-effects model (β = 0.414, p = 0.255). Conclusion: The findings indicate that population aging alone does not explain cost-related healthcare access across the selected OECD countries. Further research incorporating additional health-system and contextual indicators may provide a more comprehensive understanding of healthcare accessibility.

Anahtar Kelimeler

• Population ageing
• healthcare access
• unmet needs
• OECD countries
• panel data analysis

Kaynakça

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