Factors associated with perceived healthcare access difficulties among older adults in Türkiye

In Türkiye, the demand for healthcare services is rising quickly due to the country's aging population, which calls for a review of the sustainability, equity, and accessibility of its healthcare system. The aging population brings a number of structural and individual problems in terms of access to healthcare services. The success of active aging policies, health outcomes, and the quality of life of the elderly are all significantly correlated with access to healthcare services. Therefore, examining the barriers to healthcare that older adults face will help develop more focused healthcare policies. With this motivation, the present study aims to offer an analytical view point on factors associated with older adults' access to healthcare and is the first to use a micro-dataset of older adults representative of Türkiye.

The Turkish Statistical Institute's 2023 Türkiye Older Adults Profile Survey micro-dataset was used in this study. Given the dichotomous nature of the dependent variable (perceived difficulty in accessing healthcare services), a binary logit model was employed to identify factors associated with healthcare access difficulties among older adults. This approach is widely used in empirical studies analyzing healthcare access using survey-based data.

The findings indicate pronounced socioeconomic, health-related, and organizational disparities in healthcare access among older adults. Older adults are more likely to have limited access to healthcare services if they receive an old-age pension, are able to prepare meals on their own, have partial or severe vision problems, complete difficulty walking, trouble with pedestrian transportation, difficulty obtaining medications, communicating with medical staff (such as doctors, nurses, or clerks), scheduling appointments, consulting the doctor of their choice, experience difficulties with waiting times, and encounter physical barriers within healthcare facilities (such as elevators, stairs, and stretchers). On the other hand, regarding health status and functional capacity indicators, older adults who report good and moderate health are 24.1% and 14.8% less likely, respectively, to experience difficulties compared with those reporting poor health. Compared with those without any formal education, older adults who graduated from high school, and university are 31.3%, and 24.5% less likely, respectively, to experience difficulties in healthcare access. Older adults who do not live alone are 14.5% less likely to face access difficulties than those who live alone.

Health policies developed by the Ministry of Health that take into account the factors associated with healthcare access among older adults are crucial to improving service usage in this sociodemographic. This study presents empirical evidence that can help the Ministry of Health build effective access initiatives for older adults. In this sense, health policies that focus on criteria such as health status and health literacy may help to reduce obstacles to healthcare access and promote a more equitable delivery of services.