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Journals / Uluborlu Mesleki Bilimler Dergisi / 2026 / Cilt: 9 Sayı: 2026

Experiences of High-Risk Patients in Accessing Private Health Insurance: A Phenomenological Study in Samsun Province

Yüksek Riskli Hastaların Özel Sağlık Sigortasına Erişim Deneyimleri: Samsun İlinde Bir Fenomenoloji Çalışması

Hüsne Ercan(SAMSUN ÜNİVERSİTESİ)0009-0008-3186-9995
Ayşe İspirli Turan(SAMSUN ÜNİVERSİTESİ)0000-0002-1397-0730
Pages
1–13
Publication Date
2026-09-15
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AI Summary & Key Takeaways

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

The findings revealed that high-risk individuals face various barriers during the private health insurance enrollment process, such as high premiums, coverage restrictions, and application rejections.

📌 3 Key Takeaways

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Objective & Hypothesis:This study aims to understand the experiences of high-risk patients in the process of accessing private health insurance.
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Key Findings & Data:While health insurance systems are among the key financial tools that enable individuals to access health care, the risk-based assessment processes applied in private health insurance can make it difficult for individuals with chronic illnesses, the elderly, or those requiring ongoing treatment to access coverage.
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Conclusion & Impact:The findings revealed that high-risk individuals face various barriers during the private health insurance enrollment process, such as high premiums, coverage restrictions, and application rejections.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Özel Sağlık Sigortası · Sağlık Finansmanı · Sağlık Hizmetlerine Erişim

Abstract

This study aims to understand the experiences of high-risk patients in the process of accessing private health insurance. While health insurance systems are among the key financial tools that enable individuals to access health care, the risk-based assessment processes applied in private health insurance can make it difficult for individuals with chronic illnesses, the elderly, or those requiring ongoing treatment to access coverage. A qualitative research approach was adopted in the study, utilizing a phenomenological design. Data obtained from in-depth interviews with high-risk individuals residing in Samsun, Turkey, who had experience applying for private health insurance, were analyzed using thematic analysis. The findings revealed that high-risk individuals face various barriers during the private health insurance enrollment process, such as high premiums, coverage restrictions, and application rejections. Consequently, it was determined that current private health insurance practices may lead to inequalities in access to healthcare services for high-risk individuals and that more inclusive policies are needed.

Özet

Bu çalışma, yüksek riskli hastaların özel sağlık sigortasına erişim sürecindeki deneyimlerini anlamayı amaçlamaktadır. Sağlık sigortası sistemleri bireylerin sağlık hizmetlerine erişimini sağlayan önemli finansal araçlar arasında yer almakla birlikte, özel sağlık sigortalarında uygulanan risk temelli değerlendirme süreçleri kronik hastalığı olan, ileri yaşta bulunan veya sürekli tedavi gereksinimi duyan bireylerin sigortaya erişimini zorlaştırabilmektedir. Araştırmada nitel araştırma yaklaşımı benimsenmiş ve fenomenolojik desen kullanılmıştır. Türkiye'nin Samsun ilinde yaşayan ve özel sağlık sigortasına başvuru deneyimi bulunan yüksek riskli bireylerle gerçekleştirilen derinlemesine görüşmelerden elde edilen veriler tematik analiz yöntemiyle değerlendirilmiştir. Bulgular, yüksek riskli bireylerin özel sağlık sigortasına erişim sürecinde yüksek primler, teminat kısıtlamaları ve başvuru reddi gibi çeşitli engellerle karşılaştıklarını göstermiştir. Sonuç olarak, mevcut özel sağlık sigortası uygulamalarının yüksek riskli bireylerin sağlık hizmetlerine erişiminde eşitsizliklere yol açabildiği ve daha kapsayıcı politikalara ihtiyaç duyulduğu belirlenmiştir.

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Cite This Article

Ercan, H., Turan, A. İ. (2026). Experiences of High-Risk Patients in Accessing Private Health Insurance: A Phenomenological Study in Samsun Province. Uluborlu Mesleki Bilimler Dergisi, Cilt: 9 Sayı: 2026, 1–13. https://doi.org/10.71445/umbd.1906396

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