i̇güsbd Istanbul Gelisim University Journal of Social Sciences 2148-4287 2148-7189 İstanbul Gelişim Üniversitesi 10.17336/igusbd.1403999 Health Economy Sağlık Ekonomisi The Impact of Financial Inclusion on Borrowing, Concerns and Perceived Hardship for Health Expenditures in Türkiye Türkiye’de Finansal Katılımın Sağlık Harcamaları İçin Borçlanma, Endişeler ve Zorluk Algısına Etkisi https://orcid.org/0000-0001-6124-6109 Durmuş Veli KÜTAHYA SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, SAĞLIK YÖNETİMİ BÖLÜMÜ 10 21 2025 12 2 453 471 12 12 2023 07 28 2025 Copyright © 2014, İstanbul Gelişim Üniversitesi Sosyal Bilimler Dergisi 2014 İstanbul Gelişim Üniversitesi Sosyal Bilimler Dergisi

Aim: The adverse effects of financial barriers to accessing healthcare on individual well-being underscore the importance of analyzing the role of financial instruments in covering health expenditures, particularly in societies with high economic vulnerability. The aim of this study is to examine the role of financial inclusion in addressing financial hardships related to health expenditures in Turkey and to determine the correlation of financial inclusion with sociodemographic variables. Method: Data from a 2021 nationally representative survey of 1000 adults in Turkey, conducted by the World Bank, in the World Bank Global Findeks database were used. Probit Regression analysis was applied to examine the impact of respondents' financial inclusion and demographic characteristics on various indicators of financial hardship related to health expenditures. Results: The financial inclusion rate was 84% and was found to vary by demographic characteristics such as gender, education level and age groups. Concerns about not having money for emergency expenses within 7 and 30 days and not being able to cover medical expenses in an emergency are higher among men compared to women. The rate of borrowing for health reasons was highest among those aged 25-34 years and lowest among those aged 55 years and older. Conclusion: Financial inclusion has an important impact on reducing the difficulties associated with obtaining money for emergency expenses. Therefore, it is important for policymakers and health service providers to prioritize financial inclusion and support programs for low-income individuals to increase access to health services.

Amaç: Sağlık hizmetlerine erişimde finansal engellerin bireylerin refahı üzerindeki olumsuz etkileri, özellikle ekonomik kırılganlığın yüksek olduğu toplumlarda, finansal araçların sağlık harcamalarını karşılamadaki işlevini analiz etmeyi önemli kılmaktadır. Çalışmanın amacı, Türkiye’de sağlık harcamalarıyla ilgili finansal zorlukların giderilmesinde finansal katılımın rolünü incelemek ve sosyodemografik değişkenlerle olan korelasyonunu belirlemektir. Yöntem: 2021 Global Findeks veri tabanında Dünya Bankası tarafından oluşturulan, Türkiye’deki 1000 yetişkin ile gerçekleştirilen ulusal temsili anket verileri kullanılmıştır. Katılımcıların finansal katılımı ve demografik özelliklerinin sağlık harcamalarıyla ilgili çeşitli finansal zorluk göstergelerindeki etkisini incelemek için Probit Regresyon analizi uygulanmıştır. Bulgular: Finansal katılım oranının toplamda %84 olduğu, bunun cinsiyet, yaş grubu, eğitim düzeyi gibi demografik özelliklere göre değiştiği tespit edilmiştir. Acil harcamalar için 7 ve 30 gün içinde para bulamama ve acil bir durumda tıbbi masrafları karşılayamama endişesi kadınlara kıyasla erkeklerde daha fazladır. Sağlık nedeniyle borçlanma oranı 25-34 yaş arasında en yüksek iken, en düşük 55 yaş ve üstünde görülmüştür. Sonuç: Finansal katılımın acil harcamalarda para elde etme ile ilgili zorlukları azaltmada önemli bir etkisi bulunmaktadır. Bu nedenle, yöneticilerin sağlık hizmetlerine erişimde finansal katılıma öncelik vermesi ve düşük gelirli bireylere yönelik programları desteklemesi önemlidir.

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