An Evidence Review of Ageing, Long-Term Care Provision and Funding Mechanisms in Turkey: Using Existing Evidence to Estimate Long-Term Care Cost

Abstract

Turkey is transitioning from an ageing to aged population at a fast pace. This process requires immediate policy and practice planning and actionable strategies. Formulating and implementing such policies needs to acknowledge parallel demographic and socio-economic changes to ensure adequate resources and appropriate services are developed to enhance the growing older population’s quality of life and wellbeing. Limited long-term care (LTC) provision, funding mechanisms and reliance on informal support primarily provided by women pose considerable challenges to all stakeholders, including the state, families and older people. This paper provides an evidence review on older people's status and their health and care needs, current LTC policies, provision and funding mechanisms in Turkey. It employs a mixed review methodology, making use of published statistics, indicators and literature. The study also adapts existing LTC funding estimation models to predict LTC cost for Turkey. The review highlights the increasing share of older people in Turkey, the fast pace of population ageing, and escalating health and LTC unmet needs. Older people are reported to have high levels of depression, loneliness and co-morbidity with regional, gender and educational differentials. The Turkish LTC and welfare models rely on the family, particularly women, in meeting increased demand. A hierarchical model with random intercept was implemented and estimated the LTC cost in Turkey to be 0.02% of GDP, acknowledging the high proportion of people at labour participation age range and low female employment levels.

Demand and Countermeasures for an “Internet + Nursing” Service for Elderly Patients with Chronic Diseases in Northeast China

“…Besides a few elderly people who can enjoy stable nursing resources, most elderly people cannot enjoy the same nursing resources because of limitations of their education level, region, and other aspects [26] . Education level, sex, rural areas, and other factors can affect the demand for and access to elder care services [27] . To provide high-quality "Internet + nursing" elder care services, we must make them available when they need it and bene cial after they use it.…”

Understanding the “state of play” of long‐term care provision in low‐ and middle‐income countries

“…In Turkey, as in most of the MENA region, care for older people is primarily provided informally by the family and the community (Ismail and Hussein, 2021). However, socio‐demographic trends, such as changes in family structures, migration and increases in women’s formal employment, are undercutting the availability of such care.…”

“…In recent years, the Ministry of Family and Social Policy has piloted some new elderly care interventions, such as shared living and elderly care centres, organized by the State for groups of older people to live together with support workers attending to their needs during the day. Since 2010, the Ministry of Health has implemented a new national community‐based palliative care programme in line with the National Turkish palliative care policy, making Turkey the only country in the MENA region (besides Israel) to have such policies (Ismail and Hussein, 2021).…”

“…Africa. There has been some recent acknowledgement in the region that policies and strategies should be put in place to address the need for formal LTC provision (Ismail and Hussein, 2021;Hussein and Ismail, 2017). Recent developments such as cash-for-care schemes and social assistance schemes are a result of these discussions.…”

“…For example, Turkey has developed plans to address LTC within the context of maintaining the family's central role and ensuring care delivery at home and in the community. The most recent aged care plan (2017) prioritized home-based care services with responsibilities at the municipal level (Ismail and Hussein, 2021).…”