Spatial Dependence of Nursing Home Preference of Older Age Population in TurkiyeÖzlem Dündar, Volkan Alptekin
It is important that the cost to the economy of Turkey as regards nursing home needs, which is a service provided for the care of the older population has increased significantly in recent years. As the preference of the older population becomes dense toward the nursing homes affiliated with the Turkish Rebuplic Ministry of Family and Social Services (MFSS), where the old with low-income levels are taken care of for free, it is observed that their capacities are full and the need for nursing homes has increased. For this reason, this study aimed to determine the spatial dependence of the elderly population in nursing homes among the border neighbors (regions that share a common border) in 26 subregions (It is based on the Turkish Statistical Institute's (TSI) Second Level Nomenclature Units for Territorial Statistics (NUTS2)) of Turkey and the socioeconomic factors that affect the elderly population's nursing home preferences in these regions using spatial data analysis for 2016. Therefore, in this study, the spatial dependence of older age population between the Turkey's neighbor subregion 26 (It is based on the TSI Second Level Nomenclature Units for Territorial Statistics (NUTS2)) for the year 2016 has been aimed to determine the socioeconomic factors affecting the nursing home preferences of the elderly population in these regions using spatial data analysis. Since the regional statistical data of the older age population in the nursing home and senior age population needing the caring service were unavailable after 2016, in this study, spatial data analysis was used just for 2016. It was concluded that the border neighborhood positively affects the older population's preference for nursing homes. In the analysis, it was shown that the disposable income of the population above 60 years, the rate of becoming a house owner, and the older pension do not affect the older age population's preference for nursing home. Additionally, it has been determined that the number of older age population needing the caring service and elementary family structure positively and crimes against the property negatively affects the older age population's preference for nursing homes.
Türkiye’de Yaşlı Nüfusun Huzurevi Tercihinin Mekansal BağımlılığıÖzlem Dündar, Volkan Alptekin
Son yıllarda önemli oranda artış gösteren yaşlı nüfusun bakımına yönelik verilen hizmetlerden biri olan huzurevi ihtiyacının Türkiye ekonomisine olan maliyeti önem arz etmektedir. Yaşlı nüfusun tercihinin ağırlıklı olarak, düşük gelir düzeyine sahip yaşlıların ücretsiz bakıldığı Türkiye Cumhuriyeti Aile ve Sosyal Hizmetler Bakanlığına (ASHB) bağlı huzurevlerine yönelik olması nedeniyle kapasitelerinin dolu olduğu, özellikle söz konusu huzurevlerine olan ihtiyacın arttığı görülmektedir. Bu nedenle çalışmada 2016 yılı için huzurevlerindeki yaşlı nüfusun Türkiye’nin 26 alt bölgesi içerisinde (Türkiye İstatistik Kurumu’nun (TÜİK) ikinci düzey İstatistiki Bölge Birimleri (İBBS2) sınıflandırması temel alınmıştır) sınır komşusu olanlar (ortak sınırı paylaşan bölgeler) arasındaki mekansal bağımlılığının ve söz konusu bölgelerde yaşlı nüfusun huzurevi tercihlerine etki eden sosyoekonomik faktörlerin mekansal veri analiziyle belirlenmesi amaçlanmıştır. Huzurevlerindeki yaşlı nüfus sayıları ve bakıma ihtiyacı olan yaşlı nüfus sayısına yönelik bölgesel verilerin 2016 yılı sonrasında mevcut olmaması nedeniyle 2016 yılı için mekansal veri analizi yapılmıştır. Sınır komşuluğunun yaşlı nüfusun huzurevi tercihini pozitif yönde etkilediği sonucuna ulaşılmıştır. Analizde ekonomik faktörlerden 60 yaş ve üzeri nüfusun kullanılabilir geliri, ev sahibi olma oranı ve yaşlılık aylığının yaşlı nüfusun huzurevi tercihine etkisinin olmadığı görülmüştür. Bunun yanı sıra yaşlı nüfusun huzurevi tercihine bakıma ihtiyacı olan yaşlı sayısı ve çekirdek aile yapısının pozitif yönde, malvarlığına karşı işlenen suçların ise, negatif yönde etkisi olduğu belirlenmiştir.
Population growth brings about problems material to economic and social perspectives, such as food, housing, and employment for the entire world economy. Turkey's population is on the rise yearly, and simultenously, the share of older age people in the population is also increasing yearly thanks to advancements in health care conditions and declining mortality rates. An increase in the proportion of the older age population in the total population, also known as the aging of the population, causes the older age population to face difficulties, such as making ends meet, housing, etc. Therefore, the significance of care service is increasing. The caring services, when examined within the scope of the OECD (Organization for Economic Cooperation and Development) and MFSS, could be inferred that caring services in Turkey occupy a small percentage compared to OECD member countries. Therefore, the weight of free care in the family that is defined as informal care in Turkey may have an effect. The increase in the number of older age population yearly increases the need for care of older age population, thus it may increase the need for older age population care in Turkey, which is lower than that in the OECD countries. The caring services for the older population are split into two, which are the home care and the institutional care. Although the institutional caring figures are lower than that in the OECD countries, the predominant preference of the older age population is in nursing homes affiliated with MFSS, where older adults with low-income levels are taken care of for free of charge. For this reason, it can be said that the capacities of these nursing homes are full. The almost full potential makes us think about the need for an increase in nursing homes at an alarming rate, and it is also commonly known that the older people are waiting to be settled in there. Although the number of these nursing homes increases, it still does not satisfy the demand, and causes costs to rise for the government. Therefore, the spatial dependence of the older age population in nursing homes between Turkey's border neighbor 26 subregions (TSI NUTS2) aimed to determine the socioeconomic factors affecting the nursing home preferences of the older age population in these regions by spatial data analysis. Since the regional statistical data of the older age population in the nursing home and senior age population needing care services were unavailable after 2016, in this study, spatial data analysis was used for just 2016. The older age population's nursing home preference was investigated for 26 border neighborhood subregions using Likelihood Ratio (LR), according to the Spatial Autoregressive Model (SAR), Spatial Error Model (SEM), and Spatial Durbin Model (SDM). As a result of applying the LR test in the SEM model, statistically significant and positive lambda coefficient, the statistical significance of the tests (Moran MI and Getis-Ords GO) showed that there is an autocorrelation between error terms indicating that there is spatial dependence in the older age population's nursing home preference. Similarly, in the SEM model, the impact of independent variables emanating from socioeconomic factors on the number of older age population nursing homes agrees with expectations. This study concluded that the SEM model is the most proper model compared to other SAR and SDM models. The SEM model results determined that there is spatial dependence in the older age population's nursing home preference, and following IBBS2, the border neighborhood positively affects the older age population's nursing home preference. Therefore, the older age population's nursing home preference shows spillover effect among the 26 subregions; in other words, the fact that the nursing home preference grows somewhere else triggers the other neighbors to this region: this means that the older age population in the nursing homes shows spatial spillover. Additionally, in this study, following the SEM model's empirical findings and the effect of the disposable income of the population aged 60 and above, the rate of becoming a house owner, and the older age pension on the preference of the nursing home are not statistically significant. It is stated in the paper that on one hand, the older age population needing the care services and elementary family structure positively affects the nursing home preference of the older age, as crimes against property, on the other hand, negatively affects it. Additionally, the impact of the population aged 60 and over on the older age population's nursing home preference is statistically significant at 10%.