Yaşlı Türk Göçmenlerin Yaşadıkları Ülkenin ve Türkiye’nin Sağlık Sistemine Yönelik Algıları: Danimarka, İngiltere ve Almanya’da Bir Alan Araştırması

Türkiye’den Avrupa’ya göç etmiş olan bireyler, yaşlanmakta, emekli olmakta ve yılın daha fazla dönemini Türkiye’de geçirmektedirler. Bunun yanında misafir ülkenin sağlık hizmetlerinden yararlanamadıkları olanaklardan Türkiye’de yararlanmaktadırlar. Bu durum, yaşlı ve emekli göçmenlerin artması nedeniyle kalıcı hale gelmektedir. Buradan hareketle bu araştırmada Avrupa’da yaşayan göçmenlerin yaşadıkları ülkedeki ve Türkiye’deki sağlık sistemine yönelik algılarını ele almak ve sağlık hizmetleri kullanımlarına etkisini ortaya koymak hedeflenmiştir. Bu betimsel nitel araştırmada 50 yaş ve üzeri Danimarka, İngiltere ve Almanya’da yaşayan 67 birey ile yarı yapılandırılmış soru formu ile görüşmeler yapılmıştır. Göçmenler yaşadıkları ülkenin sağlık hizmetlerinden kalitesi ve hasta merkezli hizmet yaklaşımları nedeniyle memnun olsalar da uzman doktora erişim ve dil bariyeri konusunda endişe duymaktadırlar. Araştırmada sağlık sisteminin yapısı, finansal, politik koşullar ve sağlık sisteminin avantaj ve dezavantajlarının göçmenlerin sağlık hizmetlerine yönelik algılarını etkilediği ortaya çıkmıştır ve bu koşullar göçmenlerin Türkiye’de ve yaşadıkları ülkelerde sağ hizmetleri kullanımını pragmatik olarak etkilemektedir. Katılımcılar genel olarak yaşadıkları ülkelerde sağlık hizmetlerin kalitesinin düşme, Türkiye’de ise yükselme eğiliminde olduğunu ifade etmişlerdir.

Anahtar Kelimeler:

Yaşlı göçmenler, sağlık hizmeti, refakatçi sistemi

THE PERCEPTIONS OF ELDERLY TURKISH IMMIGRANTS OF THE HEALTH CARE SYSTEMS IN THEIR HOME AND HOST COUNTRIES: A FIELD STUDY FOCUSED ON DENMARK, BRITAIN AND GERMANY

Turkish individuals migrating to European countries are aging, they retire and spent more time in Turkey. Once in Turkey, they use health care services in case of emergencies, routine checks and investigations difficult to obtain in their host countries. This practice has turned into routine with increasing number of retired immigrants. We therefore aimed to evaluate older Turkish immigrant's perceptions of health care services in Turkey and their host countries. This descriptive qualitative study was conducted with individuals over the age of 50, who have migrated from Turkey into Britain, Denmark and Germany. A semi-structured questionnaire was conducted on 67 participants. Overall there was a high level of satisfaction with the provision of health care services in the host countries in terms of quality and patient centered care but concerns were raised about access to specialist care and language barriers.The structure of health systems, financial and politic conditions shaping those structures and the advantages and disadvantages of the health systems in both countries were affecting perceptions of health care services and pragmatically determine preferences. Respondents agreed there had been a decrease in quality of health services in their host countries and an opposite trend for Turkey.

Keywords:

Older immigrants, health service, companionship system,

PDF

___

Abadan-Unat N. (2006).Bitmeyen göç - konuk işçilikten uluslararası yurttaşlığa. Bilgi Üniversitesi Yayınları, İstanbul
Benton T., Craib I. (2001). Philosophy of social science: philosophical foundation of social thought. Palgrave-Macmillan, New York
Bergmark R., Barr D., Garcia R. (2010). Mexican imimmigrants in the US living far from the border may return to Mexico for health services. J Imimmigrant and Minority Health, 12(4), 610-614.
Bradley, H.E., Curry L.A., Devers K.J. (2007). Qualitative Data Analysis for Health Services. Health Research and Educational Trust. DOI: 10.1111/j.1475-6773.2006.00684.x
Campbell C., Mclean C. (2002). Ethnic identities, social capital and health inequalities: factors shaping American-Craibbean participation in local community networks in the UK. Soc Sci Med, 55(4), 643-657.
Cohen L., Morrison L., Manion K. (2007). Research methods in education. Routledge, London
Danış D., Üstel F. (2008). Türkiye’den Fransa’ya göçün toplumsal ve tarihsel boyutları. In D. Danış, V. İrtiş (eds) Türkiye’den Fransa’ya göç ve göçmenlik halleri. İstanbul Bilgi Üniversitesi Yayınları, İstanbul, 1-32.
Erol H. (2014). Türkiye’de sağlık reformları ve sağlık harcamalarının değerlendirilmesi. Sosyal Güvenlik Dergisi, 4 (1),9-34.
Ettelt S., Nolte E., Thomson S., Mays N. (2010). Sağlık hizmetlerinde kapasite planlama-uluslararası deneyimlerin incelenmesi. T.C. Sağlık Bakanlığı Yayınları, Ankara
Ferraro, K. F., Farmer M. M. (1996). Double jeopardy to health hypothesis for African Americans: analysis and critique. J Health Soc Behav, 37(1),27-43.
Fokkema T., Naderi R. (2013). Differences in late-life loneliness: a comparison between Turkish and native-born older adults in Germany. Eur J Ageing, 10(4),289-300.
Gideon J. (2011). Exploring immigrants' health seeking strategies: the case of Latin American immigrants in London. International Journal of Migration Health & Social Care, 7(4),197-208.
Grollman E. A. (2014). Multiple disadvantaged statuses and health: the role of multiple forms of discrimination. J Health Soc Behav, 55(1):3-19.
Hazidimitriadou E, Çakır S (2009). Community activism and empowerment of Turkish-speaking immigrant women in London. Journal of Migration, Health and Social Care, 5,34-46.
IOM (2013). World migration report 2013-Migrant well-being and development. International Development for Migration (IOM) Publishing, Geneva.
Jatrana S., Toyota M. (2005). Introduction: Understanding migration and health in Asia. In S. Jatrana, M. Toyota (eds) Migration and Health in Asia. Routhledge, New York, 1-16.
Kızılocak G. (2007). Almanyadaki Türkler ve Türkiyedeki Almanlar. In Göç ve entegrasyon- Almanya ve Türkiye’de azınlık-çoğunluk ilişkileri. Konrad-Adenauer-Stiftung Yayınları, Ankara, 57-80.
Lee J.Y., Robin A., Kearns A., Friesen W. (2010). Seeking affective health care: Korean imimmigrants’ use of homeland medical services. Health&Place, 16(1),108-115.
Marshall E., Wong S., Haggerty J., Levesque J. (2010). Perceptions of unmet healthcare needs: what do Punjabi and Chinese-speaking imimmigrants think? A qualitative study. BMC Health Serv Res, 10(46),1-8.
Martin S. S. (2009). Healthcre-seeking behaviours of older Iranian imimmigrants: health perceptions and definitions. Journal of Evidence-Based Social Work, 6(1),58-78.
Mclean C. C. (2002). Ethnic identities, social capital and health inequalities: factors shaping American-Craibbean participation in local community networks in the UK. Soc Sci Med, 55(4), 643-657.
Merrill S (1986). Developing a critical perspective in medical anthropology. Med Anthropol, 17(5),129-129.
Nazroo J., Jackson J., Karlsen S., Torres M. (2008). The black diaspora and health inequalities in the US and England: does where you go and how get there make a difference? In W Ahmad, H Bradby (eds) Ethnicity, health and health care - understanding diversity, tackling disadvantage. Blackwell, Oxford, 16-34.
Olejaz M., Nielsen A.. J, Rudkjøbing A., Birk H. O., Krasnik A., Hernandez-Quevedo C. (2012).Health systems in transition Report. Denmark Health System Review, 14(2).
OECD (2014). Health at a glance: Europe. OECD Publishing, Paris.
Ozdemir O., Ocaktan E., Akdur R. (2003). Sağlik reformu sürecinde Türkiye ve Avrupada birinci basamak sağlik hizmetlerinin değerlendirilmesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 56(4),207-216.
Papadopoulos S. L., Lay M., Gebrehiwot A. (2007). Ethiopian refugees in the UK: Migration, adaptation and settlement experiences and their relevance to health. Ethnic Health, 9(1),55-73.
Phillipson C., Ahmed N. (2006). Transnational communities, migration and changing identities in later life: a new research agenda. In S O Daatland, S Biggs (eds) Ageing and Diversity –Multiple pathways and cultural migrations. Policy Press, Bristol.
Pool R., Geissler W. (2005). Medical Anthropology. Open University Press, Berkshire.
Poortinga W. (2006). Social capital: an individual or collective resource for health. Soc Sci Med (62):292-302.
Razum O., Sahin-Hodoglugil N. N., Polit K. (2005). Health, wealth or family ties? Why Turkish work immigrants return from Germany. J Ethn Migr Stud, 31(4),719-739.
Sahami M. S. (2009). Healthcre-seeking behaviours of older Iranian imimmigrants: health perceptions and definitions. Journal of Evidence-Based Social Work, 6(1), 58-78.
Searight H. R. (2003). Bosnian imimmigrants’ perceptions of the United States Health Care System: A qualitative interview study. Journal of Imimmigrant Health, 5 (2),87-92.
Sosyal Güvenlik Kurumu (2012). Yurt Dışı Sağlık İşlemleri. http://www.sgk.gov.tr/wps/portal/tr/Emeklilik/yurtdisi_islemler/yurtdisi_saglik_islemleri. (Accessed 4 February 2016).
Topal K., Eser E., Sanberk I., Bayliss E., Saatci E. (2012). Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking imimmigrants in London. Health Qual Life Out, 10(1),1-11.
Warnes M., Friendich K., Kellaher L., Torres S. (2004). The diversity and welfare of older immigrants in Europe. Ageing&Society, 24(3),307-326.
Winkelman, M (2009). Culture and health - applying medical anthropology. Wiley, San Francisco.