AI Summary & Key Takeaways
AI InsightResults and Conclusion: The findings indicate that financial barriers play a significant role in limiting healthcare access among older adults; however, these barriers are often addressed independently from physical and structural factors.
📌 3 Key Takeaways
Abstract
Abstract Introduction and Objective: This research aims to examine the financial and physical barriers to healthcare access among older adults within a multidimensional framework and to critically evaluate the limitations of the existing literature. The ongoing global demographic transition, characterized by increasing life expectancy and declining fertility rates, has led to a rapid rise in the proportion of older populations, thereby intensifying financial and structural pressures on healthcare systems. Materials and Methods: This review is designed as a narrative review. The literature was reviewed by examining national and international studies focusing on healthcare access, ageing, financial barriers, and unmet healthcare needs. The findings were analyzed thematically within the framework of financial, physical, and structural determinants of healthcare access. Results and Conclusion: The findings indicate that financial barriers play a significant role in limiting healthcare access among older adults; however, these barriers are often addressed independently from physical and structural factors. While high out-of-pocket expenditures, insufficient income, and gaps in financial protection restrict access, physical constraints such as transportation difficulties, geographic distance, and healthcare system organization further exacerbate these limitations. In conclusion, healthcare access among older adults represents a complex and multidimensional phenomenon that cannot be adequately explained through single-dimensional approaches. By offering a holistic perspective, the present study provides actionable insights for the development of more inclusive and sustainable health policies. References: Allin, S., & Masseria, C. (2009). Unmet need as an indicator of health care access. Eurohealth, 15(3), 7–9. Allin, S., Grignon, M., & Le Grand, J. (2010). Subjective unmet need and utilization of health care services in Canada. Social Science & Medicine, 70(3), 465–472. https://doi.org/10.1016/j.socscimed.2009.10.027 Alonso, J., Orfila, F., Ruigomez, A., Ferrer, M., & Antó, J. M. (1997). Unmet health care needs and mortality among Spanish elderly. American Journal of Public Health, 87(3), 365–370. https://doi.org/10.2105/AJPH.87.3.365 Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care. Journal of Health and Social Behavior, 36(1), 1–10. Ayanian, J. Z., Weissman, J. S., Schneider, E. C., Ginsburg, J. A., & Zaslavsky, A. M. (2000). Unmet health needs of uninsured adults in the United States. JAMA, 284(16), 2061–2069. https://doi.org/10.1001/jama.284.16.2061 Beard, J. R., Officer, A., de Carvalho, I. A., ve ark. (2016). The World report on ageing and health. The Lancet, 387(10033), 2145–2154. Braveman, P. A. (2003). Monitoring equity in health and health care. Journal of Health, Population and Nutrition, 21(3), 181–192. Connolly, S., & Wren, M. A. (2017). Unmet healthcare needs in Ireland. Health Policy, 121(4), 434–441. Ensor, T., & Cooper, S. (2004). Overcoming barriers to health service access. Health Policy and Planning, 19(2), 69–79. Gakidou, E. E., Murray, C. J. L., & Frenk, J. (2000). Defining health inequality. Bulletin of the World Health Organization, 78(1), 42–54. Genç, G., & Kurutkan, M. N. (2021). Türkiye’de karşılanmayan sağlık ihtiyacı. SDÜ Sağlık Yönetimi Dergisi, 3(1), 34–51. Gibson, G., Grignon, M., Hurley, J., & Wang, L. (2019). Self-assessed unmet need. Health Economics, 28(6), 727–735. Goddard, M., & Smith, P. (2001). Equity of access to health care services. Social Science & Medicine, 53(9), 1149–1162. Grossman, M. (1972). The demand for health: A theoretical and empirical investigation. Columbia University Press. Gulliford, M., ve ark. (2002). What does access to health care mean? Journal of Health Services Research & Policy, 7(3), 186–188. Herr, M., ve ark. (2014). Unmet health care needs of older people. European Journal of Public Health, 24(5), 808–813. Jung, B., & Ha, I. H. (2021). Reasons for unmet healthcare needs. Health and Quality of Life Outcomes, 19, 1. Kawachi, I., Subramanian, S. V., & Almeida-Filho, N. (2002). Health inequalities glossary. Journal of Epidemiology & Community Health, 56(9), 647–652. Kim, Y. S., ve ark. (2018). Unmet healthcare needs of elderly. BMC Geriatrics, 18, 98. Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centred access. International Journal for Equity in Health, 12(1), 18.
Özet
Öz Giriş ve Amaç: Bu araştırma, yaşlı bireylerin sağlık hizmetlerine erişiminde karşılaşılan finansal ve fiziksel engelleri çok boyutlu bir çerçevede incelemeyi ve mevcut literatürdeki sınırlılıkları eleştirel bir perspektifle değerlendirmeyi amaçlamaktadır. Küresel ölçekte yaşlanan nüfus, sağlık sistemleri üzerinde artan talep ve maliyet baskısı yaratmakta ve erişim konusunu sağlık politikalarının temel alanlarından biri haline getirmektedir. Gereç ve Yöntem: Söz konusu çalışma, anlatı temelli (narrative) bir derleme olarak tasarlanmıştır. Literatür taraması kapsamında sağlık hizmetlerine erişim, yaşlı sağlığı, finansal engeller ve karşılanmayan sağlık ihtiyacı konularında ulusal ve uluslararası çalışmalar incelenmiştir. Elde edilen bulgular, finansal, fiziksel ve yapısal faktörler çerçevesinde tematik olarak analiz edilmiştir. Bulgular ve Sonuç: Literatür bulguları, yaşlı bireylerin sağlık hizmetlerine erişimde finansal engellerin önemli bir rol oynadığını; ancak bu engellerin çoğu zaman fiziksel ve yapısal faktörlerden bağımsız ele alındığını göstermektedir. Cepten sağlık harcamaları, gelir yetersizliği ve finansal koruma eksiklikleri erişimi sınırlarken; ulaşım güçlükleri, coğrafi uzaklık ve sağlık sisteminin organizasyon yapısı bu engelleri derinleştirmektedir. Sonuç olarak, yaşlı bireylerin sağlık hizmetlerine erişimi tek boyutlu yaklaşımlarla açıklanamayacak kadar karmaşık bir süreçtir. Mevcut derleme, erişim sorununa bütüncül bir perspektif sunarak sağlık politikalarının daha kapsayıcı ve sürdürülebilir şekilde tasarlanmasına katkı sağlamaktadır. Kaynakça: Allin, S., & Masseria, C. (2009). Unmet need as an indicator of health care access. Eurohealth, 15(3), 7–9. Allin, S., Grignon, M., & Le Grand, J. (2010). Subjective unmet need and utilization of health care services in Canada. Social Science & Medicine, 70(3), 465–472. https://doi.org/10.1016/j.socscimed.2009.10.027 Alonso, J., Orfila, F., Ruigomez, A., Ferrer, M., & Antó, J. M. (1997). Unmet health care needs and mortality among Spanish elderly. American Journal of Public Health, 87(3), 365–370. https://doi.org/10.2105/AJPH.87.3.365 Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care. Journal of Health and Social Behavior, 36(1), 1–10. Ayanian, J. Z., Weissman, J. S., Schneider, E. C., Ginsburg, J. A., & Zaslavsky, A. M. (2000). Unmet health needs of uninsured adults in the United States. JAMA, 284(16), 2061–2069. https://doi.org/10.1001/jama.284.16.2061 Beard, J. R., Officer, A., de Carvalho, I. A., ve ark. (2016). The World report on ageing and health. The Lancet, 387(10033), 2145–2154. Braveman, P. A. (2003). Monitoring equity in health and health care. Journal of Health, Population and Nutrition, 21(3), 181–192. Connolly, S., & Wren, M. A. (2017). Unmet healthcare needs in Ireland. Health Policy, 121(4), 434–441. Ensor, T., & Cooper, S. (2004). Overcoming barriers to health service access. Health Policy and Planning, 19(2), 69–79. Gakidou, E. E., Murray, C. J. L., & Frenk, J. (2000). Defining health inequality. Bulletin of the World Health Organization, 78(1), 42–54. Genç, G., & Kurutkan, M. N. (2021). Türkiye’de karşılanmayan sağlık ihtiyacı. SDÜ Sağlık Yönetimi Dergisi, 3(1), 34–51. Gibson, G., Grignon, M., Hurley, J., & Wang, L. (2019). Self-assessed unmet need. Health Economics, 28(6), 727–735. Goddard, M., & Smith, P. (2001). Equity of access to health care services. Social Science & Medicine, 53(9), 1149–1162. Grossman, M. (1972). The demand for health: A theoretical and empirical investigation. Columbia University Press. Gulliford, M., ve ark. (2002). What does access to health care mean? Journal of Health Services Research & Policy, 7(3), 186–188. Herr, M., ve ark. (2014). Unmet health care needs of older people. European Journal of Public Health, 24(5), 808–813. Jung, B., & Ha, I. H. (2021). Reasons for unmet healthcare needs. Health and Quality of Life Outcomes, 19, 1. Kawachi, I., Subramanian, S. V., & Almeida-Filho, N. (2002). Health inequalities glossary. Journal of Epidemiology & Community Health, 56(9), 647–652. Kim, Y. S., ve ark. (2018). Unmet healthcare needs of elderly. BMC Geriatrics, 18, 98. Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centred access. International Journal for Equity in Health, 12(1), 18.