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Journals / Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi / 2026 / Cilt: 44 Sayı: 2

The Association of Refugees and Out-of-Pocket Health Expenditure: An Empirical Study for the Selected European Countries

Mülteci Nüfusu ve Cepten Sağlık Harcamaları Arasındaki İlişki: Seçilen Avrupa Ülkeleri Üzerine Ampirik Bir Çalışma

Necmettin Çelik(İZMİR KATİP ÇELEBİ ÜNİVERSİTESİ)0000-0003-0139-7778
Hüseyin Demir(İZMİR KATİP ÇELEBİ ÜNİVERSİTESİ)0000-0002-8990-7228
Pages
289–313
Publication Date
2026-06-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Policymakers are urged to expand public health coverage, offer financial support to refugees, and prioritize preventive care to mitigate the financial burden and foster a more inclusive and equitable healthcare system.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Universal health coverage is essential for equitable healthcare access, including for refugees.
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Key Findings & Data:However, out-of-pocket health expenditure remains a significant barrier to access healthcare in Europe.
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Conclusion & Impact:Policymakers are urged to expand public health coverage, offer financial support to refugees, and prioritize preventive care to mitigate the financial burden and foster a more inclusive and equitable healthcare system.
🔬Design:Araştırma Makalesi
📍Scope:2005 Verileri
⚙️Variables:Mülteciler · cepten sağlık harcaması · panel veri analizi

Abstract

Universal health coverage is essential for equitable healthcare access, including for refugees. However, out-of-pocket health expenditure remains a significant barrier to access healthcare in Europe. This study examines the impact of refugee populations on out-of-pocket health expenditure in ten European countries between 2005 and 2020. The analysis reveals that refugee populations positively affect out-of-pocket health expenditure, indicating that increased refugee presence increases out-of-pocket health expenditure. Public health expenditure also shows a negative effect highlighting a substitution effect between public health expenditure and out-of-pocket health expenditure, while Gross Domestic Product per capita and an aging population positively influence out-of-pocket health expenditure. The rise in refugee populations has contributed to an increase in out-of-pocket health expenditure, placing additional financial burden on both host communities and refugees themselves. The growing refugee population has intensified demand for healthcare services, driving up out-of-pocket costs and pushing individuals toward private health insurance. Policymakers are urged to expand public health coverage, offer financial support to refugees, and prioritize preventive care to mitigate the financial burden and foster a more inclusive and equitable healthcare system.

Özet

Evrensel sağlık güvencesi, mülteciler de dahil olmak üzere tüm bireyler için sağlık hizmetlerine erişimin sağlanmasında kritik öneme sahiptir. Bununla birlikte, Avrupa'da sağlık hizmetlerine erişimin önündeki en önemli engellerden biri hane halkının yaptığı cepten sağlık harcamalarıdır. Bu çalışma, 2005-2020 yılları arasında on Avrupa ülkesinde mülteci nüfusunun cepten sağlık harcaması üzerindeki etkisini incelemektedir. Analizler, mülteci nüfusunun cepten sağlık harcaması üzerinde istatistiksel olarak anlamlı ve pozitif bir etkiye sahip olduğunu, mülteci sayısında görülen artışın cepten sağlık harcamaları üzerinde arttırıcı etki yarattığını ortaya koymaktadır. Kamusal sağlık harcamalarının cepten sağlık harcamaları üzerinde negatif bir etki gösterdiği, kamusal sağlık harcaması ile cepten sağlık harcaması arasında ikame ilişkisinin olduğu belirlenmiştir. Bunun yanı sıra, kişi başına Gayri Safi Yurt İçi Hasıla ve yaşlanan nüfusun cepten sağlık harcamalarını pozitif yönde etkilediği görülmüştür. Dolayısıyla mülteci nüfusundaki artış, cepten sağlık harcamalarının yükselmesine katkıda bulunarak hem vatandaşlar hem de mülteciler üzerinde finansal yük oluşturmaktadır. Artan mülteci nüfusu, sağlık hizmetlerine olan talebi yoğunlaştırmakta; cepten yapılan sağlık harcamalarını artırmakta ve bireyleri özel sağlık sigortasına yöneltmektedir. Politika yapıcıların, mali yükü hafifletmek ve daha kapsayıcı bir sağlık sistemi oluşturmak amacıyla kamusal sağlık güvencesini genişletmeleri, mültecilere yönelik finansal destek mekanizmaları geliştirmeleri ve koruyucu sağlık hizmetlerini ön plana çıkarmaları önerilmektedir.

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Cite This Article

Çelik, N., Demir, H. (2026). The Association of Refugees and Out-of-Pocket Health Expenditure: An Empirical Study for the Selected European Countries. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, Cilt: 44 Sayı: 2, 289–313. https://doi.org/10.17065/huniibf.1686827

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