YAŞLANAN TOPLUMLARDA SÜRDÜRÜLEBİLİRLİĞİ YENİDEN DÜŞÜNMEK: OECD ÜLKELERİNDE UZUN DÖNEM BAKIM HARCAMALARININ ROLÜ

Öz

Nüfusun yaşlanması, özellikle OECD ülkelerinde sağlık sistemlerinin sürdürülebilirliği açısından önemli bir politika alanı haline gelmiştir. Yaşlanma ile sağlık harcamaları arasındaki ilişki literatürde geniş ölçüde incelenmiş olmasına rağmen, uzun dönem bakım harcamalarının sağlık harcamaları ile ilişkisi sınırlı düzeyde ele alınmıştır. Bu çalışma, 2000–2023 döneminde 33 OECD ülkesine ait panel veri kullanarak nüfus yaşlanması ve uzun dönem bakım harcamalarının sağlık harcamaları ile ilişkisini incelemeyi amaçlamaktadır. Çalışmada panel veri yöntemleri kullanılmış; havuzlanmış En Küçük Kareler (OLS), sabit etkiler ve rassal etkiler modelleri tahmin edilmiş, ayrıca çeşitli tanısal testler uygulanmıştır. Bulgular hem nüfus yaşlanmasının hem de uzun dönem bakım harcamalarının sağlık harcamaları ile pozitif ve istatistiksel olarak anlamlı şekilde ilişkili olduğunu göstermektedir. Nihai model sonuçlarına göre, nüfusun 65 yaş ve üzerindeki payındaki %1’lik artış sağlık harcamalarında yaklaşık %0,32’lik bir artış ile ilişkilidir. Benzer şekilde, uzun dönem bakım harcamalarındaki %1’lik artış sağlık harcamalarında yaklaşık %0,08’lik bir artış ile ilişkilidir. Buna karşılık, kişi başına düşen gelir değişkeninin istatistiksel olarak anlamlı olmadığı belirlenmiştir. Ayrıca ülkeler arasında anlamlı düzeyde yatay kesit bağımlılığı tespit edilmiştir. Sonuç olarak çalışma, sağlık harcamalarının yaşlanan toplumlarda hem demografik hem de kurumsal faktörlerle ilişkili olduğunu göstermekte ve sağlık sistemi sürdürülebilirliğinin değerlendirilmesinde uzun dönem bakım sistemlerinin dikkate alınmasının önemine işaret etmektedir.

Anahtar Kelimeler

• Nüfus yaşlanması
• uzun dönem bakım
• sağlık harcamaları
• panel veri
• OECD

RETHINKING SUSTAINABILITY IN AGEING SOCIETIES: THE ROLE OF LONG-TERM CARE EXPENDITURE IN OECD COUNTRIES

Öz

Population ageing has become an important policy concern for the sustainability of healthcare systems, particularly in OECD countries. Although the relationship between ageing and healthcare expenditure has been widely examined in the literature, the association between long-term care expenditure and healthcare expenditure has received relatively limited attention. This study aims to examine the relationship between population ageing, long-term care expenditure, and healthcare expenditure using panel data from 33 OECD countries covering the period 2000–2023. The analysis employs panel data techniques, including pooled Ordinary Least Squares (OLS), Fixed Effects, and Random Effects models, together with several diagnostic tests. The empirical findings indicate that both population ageing and long-term care expenditure are positively and statistically significantly associated with healthcare expenditure. According to the final model, a 1% increase in the proportion of the population aged 65 and above is associated with an approximately 0.32% increase in healthcare expenditure. Similarly, a 1% increase in long-term care expenditure is associated with an approximately 0.08% increase in healthcare expenditure. In contrast, GDP per capita was not found to be statistically significant. The results also reveal significant cross-sectional dependence among countries. Overall, the study suggests that healthcare expenditure in ageing societies may be associated with both demographic and institutional factors and highlights the importance of considering long-term care systems when evaluating healthcare system sustainability.

Anahtar Kelimeler

• Population ageing
• long-term care
• healthcare expenditure
• panel data
• OECD

Kaynakça

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