SavedAdd your journal

Journals / International Journal of Health Services Research and Policy / 2026 / Volume: 11 Issue: 2

POLICY GAPS IN AGEING SOCIETIES: A COMPARATIVE ANALYSIS OF HEALTHCARE ACCESS AMONG OLDER ADULTS IN OECD COUNTRIES

Zeliha Köse(ALTINBAŞ ÜNİVERSİTESİ, LİSANSÜSTÜ EĞİTİM ENSTİTÜSÜ, SAĞLIK YÖNETİMİ (DR))0009-0004-4979-5681
Pages
—
Publication Date
2026-06-24
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

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

The findings reveal that while population ageing does not have a statistically significant direct effect on unmet healthcare needs, physician density was negatively associated with unmet healthcare needs.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Population ageing has become a defining demographic trend in many countries, raising important concerns about the sustainability and accessibility of healthcare systems.
📊
Key Findings & Data:Due to data availability constraints, particularly for unmet healthcare needs (ANMEX) indicators, the dataset was restricted to the period starting from 2008 and observations with missing values were excluded to ensure consistency.
💡
Conclusion & Impact:The findings reveal that while population ageing does not have a statistically significant direct effect on unmet healthcare needs, physician density was negatively associated with unmet healthcare needs.
🔬Design:Modeling & Simulation
📍Scope:2008 Verileri
⚙️Variables:Population ageing · healthcare access · unmet healthcare needs

Abstract

Population ageing has become a defining demographic trend in many countries, raising important concerns about the sustainability and accessibility of healthcare systems. While existing research has largely focused on the fiscal implications of ageing, relatively less attention has been given to healthcare access inequalities, particularly among older populations. This study aims to examine potential policy gaps in ageing societies by analysing the relationship between demographic ageing, healthcare workforce capacity and unmet healthcare needs. The analysis is based on secondary data obtained from the OECD, the World Bank and Eurostat. Due to data availability constraints, particularly for unmet healthcare needs (ANMEX) indicators, the dataset was restricted to the period starting from 2008 and observations with missing values were excluded to ensure consistency. The final dataset consists of country-year observations structured in a long format. The study employs descriptive statistics, correlation analysis and panel data regression analysis. Model selection was guided by the Hausman specification test and a random-effects model was estimated to examine the relationship between population ageing, physician density and unmet healthcare needs. The findings reveal that while population ageing does not have a statistically significant direct effect on unmet healthcare needs, physician density was negatively associated with unmet healthcare needs. These findings suggest that healthcare system capacity may play an important role in shaping healthcare access outcomes, although the observed relationship should be interpreted cautiously. The results indicate that ageing does not automatically lead to increased access problems, but insufficient system capacity may create barriers in healthcare delivery. These findings highlight the importance of strengthening healthcare workforce planning and resource allocation in order to ensure equitable access in ageing societies.

🔖

Cite This Article

Köse, Z. (2026). POLICY GAPS IN AGEING SOCIETIES: A COMPARATIVE ANALYSIS OF HEALTHCARE ACCESS AMONG OLDER ADULTS IN OECD COUNTRIES. International Journal of Health Services Research and Policy, Volume: 11 Issue: 2. https://doi.org/10.33457/ijhsrp.1933545

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (28)

  1. J. R. Beard, A. Officer, I. A. de Carvalho, R. Sadana, A. M. Pot, J. P. Michel, P. Lloyd-Sherlock, J. E. Epping-Jordan, G. M. E. E. Peeters, W. R. Mahanani, J. A. Thiyagarajan, and S. Chatterji, “The world report on ageing and health,” The Lancet, vol. 387, no. 10033, pp. 2145–2154, 2016.
  2. OECD, Health at a Glance 2023: OECD Indicators. Paris, France: OECD Publishing, 2023.
  3. E. L. Schneider and J. M. Guralnik, “The aging of America: Impact on health care costs,” JAMA, vol. 263, no. 17, pp. 2335–2340, 1990.
  4. T. E. Getzen, “Health care is an individual necessity and a national luxury: Applying multilevel decision models to the analysis of health care expenditures,” J. Health Econ., vol. 19, no. 2, pp. 259–270, 2000.
  5. J. Cylus, I. Papanicolas, and P. Smith, Health System Efficiency: How to Make Measurement Matter for Policy and Management. Paris, France: OECD Publishing, 2016.
  6. J. W. Rowe, T. Fulmer, and L. Fried, “Preparing for better health and health care for an aging population,” JAMA, vol. 316, no. 16, pp. 1643–1644, 2016.
  7. M. Gulliford, J. Figueroa-Munoz, M. Morgan, D. Hughes, B. Gibson, R. Beech, and M. Hudson, “What does access to health care mean?,” J. Health Serv. Res. Policy, vol. 7, no. 3, pp. 186–188, 2002.
  8. J.-F. Levesque, M.-F. Harris, and G. Russell, “Patient-centred access to health care: Conceptualising access at the interface of health systems and populations,” Int. J. Equity Health, vol. 12, no. 1, Art. no. 18, 2013.
  9. S. Allin, M. Grignon, and J. Le Grand, “Subjective unmet need and utilization of health care services in Canada: What are the equity implications?,” Soc. Sci. Med., vol. 70, no. 3, pp. 465–472, 2010.
  10. M. Herr, J. J. Arvieu, P. Aegerter, J. M. Robine, and J. Ankri, “Unmet health care needs of older people: Prevalence and predictors in a French cross-sectional survey,” Eur. J. Public Health, vol. 24, no. 5, pp. 808–813, 2014.
  11. K. Hashimoto and K. Tabata, “Population aging, health care, and growth,” J. Popul. Econ., vol. 23, no. 2, pp. 571–593, 2010.
  12. S. Ogura and M. M. Jakovljevic, “Global population aging—Health care, social and economic consequences,” Front. Public Health, vol. 6, Art. no. 335, 2018.
  13. R. M. Andersen, “Revisiting the behavioral model and access to medical care: Does it matter?,” J. Health Soc. Behav., vol. 36, no. 1, pp. 1–10, 1995.
  14. G. Gibson, M. Grignon, J. Hurley, and L. Wang, “Here comes the SUN: Self-assessed unmet need, worsening health outcomes and health care inequity,” Health Econ., vol. 28, no. 6, pp. 727–735, 2019.
  15. S. Allin and C. Masseria, “Unmet need as an indicator of health care access,” Eurohealth, vol. 15, no. 3, pp. 7–9, 2009.
  16. Eurostat, Self-Reported Unmet Needs for Medical Examination and Care (hlth_silc_08). Luxembourg: European Commission, 2023. [Online]. Available: https://ec.europa.eu/eurostat. Accessed: Apr. 14, 2026.
  17. M. Goddard and P. Smith, “Equity of access to health care services,” Soc. Sci. Med., vol. 53, no. 9, pp. 1149–1162, 2001.
  18. D. McIntyre, M. Thiede, G. Dahlgren, and M. Whitehead, “What are the economic consequences for households of illness and of paying for health care?,” Bull. World Health Organ., vol. 84, no. 11, pp. 858–865, 2006.
  19. OECD, Waiting Times for Health Services: Next in Line. Paris, France: OECD Publishing, 2022.
  20. O. O'Donnell, E. van Doorslaer, A. Wagstaff, and M. Lindelow, Analyzing Health Equity Using Household Survey Data. Washington, DC, USA: World Bank, 2008.
  21. S. Okamoto, M. Sata, M. Rosenberg, et al., “Universal health coverage in the context of population ageing: Catastrophic health expenditure and unmet need for healthcare,” Health Econ. Rev., vol. 14, no. 1, Art. no. 8, 2024.
  22. R. B. Saltman, A. Rico, and W. Boerma, Primary Care in the Driver's Seat? Organizational Reform in European Primary Care. Maidenhead, U.K.: Open University Press, 2006.
  23. E. Saurman, “Improving access: Modifying Penchansky and Thomas's theory of access,” J. Health Serv. Res. Policy, vol. 21, no. 1, pp. 36–39, 2016.
  24. A. Wagstaff and E. van Doorslaer, “Catastrophe and impoverishment in paying for health care: With applications to Vietnam 1993–1998,” Health Econ., vol. 12, no. 11, pp. 921–934, 2003.
  25. World Bank, World Development Indicators. Washington, DC, USA: World Bank, 2023. [Online]. Available: https://data.worldbank.org. Accessed: Apr. 14, 2026.
  26. World Health Organization, Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Geneva, Switzerland: World Health Organization, 2008.
  27. World Health Organization, Health Systems Financing: The Path to Universal Coverage. Geneva, Switzerland: World Health Organization, 2010.
  28. World Health Organization and World Bank, Global Monitoring Report on Financial Protection in Health 2021: Executive Summary. Geneva, Switzerland: World Health Organization, 2022.