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.