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Sığınmacıların Sağlık Hizmetlerini Kullanımına İlişkin Ampirik Bir Çalışma: ARDL'den Kanıtlar

Year 2025, Volume: 26 Issue: 3, 485 - 494, 25.07.2025

Hatice Genç Kavas , Ahmet Şengönül

https://doi.org/10.37880/cumuiibf.1681210

Abstract

Amaç: Göçmen yoğunluğunun küresel olarak arttığı son dönemde, göçmen davranışlarını analiz etme ve buna göre yorumlama yapma gerekliliği belirginleşmiştir. Bu çalışmada, sığınmacıların ve yerel halkın sağlık hizmetlerinden yararlanma davranışlarının COVID-19 salgını öncesi ve sonrasında nasıl değiştiği ve salgınla ilişkili değişkenlerin sığınmacıların motivasyonunu nasıl etkilediği analiz edilmektedir.
Yöntemler: Pandemi sırasında Türkiye'deki vaka, ölüm ve aşılama sayılarının sığınmacıların hastane ziyaretleri üzerinde caydırıcı veya çekici bir etkisi olup olmadığını inceledik. Hastane bölümlerine (tüm poliklinikler - 55 bölüm -) başvurular, bağımlı değişken olarak kullanıldı. Açıklayıcı değişkenlerin bağımlı değişken üzerindeki kısa ve uzun vadeli etkileri, Gecikmesi Dağıtılmış Otoregresif Gecikme Modeli (ARDL) kullanılarak tahmin edildi.
Sonuçlar: Genel pandemi durumunun sığınmacılar arasında uzun vadeli sağlık hizmeti kullanımını önemli ölçüde etkilediğini bulduk. Kısa vadede, yalnızca aşıların önemli bir etkisi vardı. Ayrıca sığınmacıların toplam sağlık hizmeti kullanımının yalnızca %1'ini oluşturduğunu, kalan %99'unun ise yerel halk tarafından kullanıldığını bulduk.
Sonuçlar: Sığınmacıların sağlık hizmeti kullanımının sosyal ve ekonomik etkisi değerlendirildiğinde, pandemi dışı dönemlerde ve pandemiler sırasında bu hastalar için uygun politikaların belirlenmesi gerekebilir. Yerel halkın tepkilerinin artmasını önlemek için, doğru veriler ve mevcut durumun fırsatları kamuoyuna iletilebilir. Sağlık kuruluşları için bir fırsat olarak hedef pazar oluşturabilecek bu hastalar için farklı pazarlama faaliyetlerinin uygulanması gerekebilir. Aşılama politikaları dikkatlice düşünülmelidir.

Keywords

Sağlık Hizmetleri Covid-19 Sığınmacılar Tüketici Davranışı ARDL

Ethical Statement

Sayı : 60263016-050.06.04-E.482051 Konu : Etik Kurul Kararı 05/10/2020 tarihinde etik kurul kararı verilmiştir

Supporting Institution

Sivas Cumhuriyet Üniversitesi

References

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  • Balkan, B., & Tumen, S. (2016). Immigration and prices: quasi-experimental evidence from Syrian refugees in Turkiye. J Popul Econ., 29, 657–686. doi:10.1007/s00148-016-0583-2
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  • Hacker, K., et al. (2015). Barriers to health care for undocumented immigrants: a literature review. Risk Management and Healthcare Policy, 8, 175-183. https://doi.org/10.2147/RMHP.S70173
  • Hamidi, F., & Karachiwalla, Z. (2022). Note: “fear is grounded in reality”: the impact of the COVID-19 pandemic on refugees’ access to health and accessibility resources in the United States. COMPASS’22, June 29 – July 01, Seatle, WA, USA. 661-667. https://doi.org/10.1145/3530190.3534851
  • Heslehurst, N., et al. (2018). Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BMC Medicine, 16(89), 1-25. doi.org/10.1186/s12916-018-1064-0
  • Jansen, C. (1969). Some Sociological Aspects of Migration. J. A. Jackson (Ed.), In Migration (p. 157-186), Cambridge, Cambridge University Press.
  • Kay, M.J. (2007). Healthcare marketing: what is salient?. International Journal of Pharmaceutical and Healthcare Marketing, 1(3), 247-263. DOI: 10.1108/17506120710818256
  • Khanom, A., Alanazy, W., Couzens, L., Evans, B.A., Fagan, L., Fogarty, R., John, A., Khan T., Kingston, M.R., Moyo, S., Porter, A., Rhydderch, M., .richardson, G., Rungua, G., Russell, I. & Snooks, H. (2021). Asylum seekers’ and refugees’ experiences of accessing health care: a qualitative study. BJGP Open, 5(6), 1-11. DOI:10.3399/BJGPO.2021.0059
  • Kolukırık, S. (2009). Image of refugees and asylum-seekers in the media: an evaluation on media politics. Gaziantep Ünviersitesi Sosyal Bilimler Dergisi, 8(1), 1-20. https://dergipark.org.tr/en/download/article-file/223479 Visited on: 06.19.2024
  • Lee, O.F. & Davis T.R.V. (2004). International patients: a lucrative market for U.S. hospitals. Health Marketing Quarterly, 22(1), 41-56. doi.org/10.1300/J026v22n01_04
  • Mangrio, E., Paul-Satyaseela, M. & Strange, M. (2020). Refugees in Sweden during the COVID-19 pandemic - the need for a new perspective on health and integration. Front. Public Health, 8, 574334.
  • Matlin, S. A., et al. (2021). COVID-19: marking the gaps in migrant and refugee health in some massive migration areas. International Journal of Environmental Research and Public Health, 18, 12639. doi.org/10.3390/ijerph182312639
  • Ministry of Interior Directorate General of Migration Management (MIDGMM), (2014). The temporary protection regulation; Republic of Turkiye. https://www.goc.gov.tr/kurumlar/goc.gov.tr/gk_yon_getirdigi_yenilikler.pdf Visited on: 06.20.2024
  • Mutlu, S., & Yılmaz, Ş. (2021). Comparison of HBsAg, Anti-HBs, Anti-HCV and Anti-HIV seropositivity of Turkish and refugee pregnant women. Journal of Duzce University Health Sciences Institute, 11(1), 21-24. doi.org/10.33631/duzcesbed.723989
  • Nasjlova, L. (2023). Architectures of similarity: fragments, islands and other escapes from the Turkiye and Europe framework. International Relations, 20 (77), 147-164. https://doi.org/10.33458/uidergisi.1273325
  • Navarro-Roman, L., & Roman, G.C. (2022). The devastating effects of the COVID-19 pandemic among ethnic minorities, migrants, and refugees. M. El Alaoui-Faris et al. (Eds.), Neurology in Migrants and Refugees. https://doi.org/10.1007/978-3-030-81058-0_13
  • Pesaran, M.H., Yongcheol, S., & Smith, R.J. (2001). Bound testing approaches to the analysis of long run relationships. Journal of Applied Econometrics Special Issue, 16, 289-326. doi.org/10.1002/jae.616
  • Rafieifar, M., et al., (2021). Impacts of COVID-19 on refugees and immigrants in the United States: a call for action. International Social Work, 64(5), 771-776. doi: 10.1177/00208728211017964
  • Republic of Turkiye Ministry of Health. (2021). Turkish national covıd-19 vaccine administration strategy. (Visited on 06/23/2024) https://covid19asi.saglik.gov.tr/EN-78317/turkish-national-covid-19-vaccine-administration-strategy.html
  • Saatçioğlu, B., (2020). The European Union’s refugee crisis and rising functionalism in EU-Turkiye relations. Turkish Studies, 21(2), 169-187. doi.org/10.1080/14683849.2019.1586542
  • Turkish Statistical Institute (TSI)., (2018). International migration statistics 2017. https://data.tuik.gov.tr/Bulten/Index?p=Uluslararasi-Goc-Istatistikleri-2017-30607 Visited on: 07.14.2024
  • Turkish Statistical Institute (TSI)., (2019). International migration statistics 2018. https://data.tuik.gov.tr/Bulten/Index?p=International-Migration-Statistics-2018-30711# Visited on: 07.14.2024
  • Turkish Statistical Institute (TSI)., 2020. International migration statistics 2019. https://data.tuik.gov.tr/Bulten/Index?p=Uluslararasi-Goc-Istatistikleri-2019-33709 Visited on: 07.14.2024
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  • World Health Organization., 2020. Basic documents. 49th Edition. Geneva. https://apps.who.int/gb/bd/pdf_files/BD_49th-en.pdf
  • World Health Organization., 2021. Refugees and migrants in times of COVID-19: mapping trends of public health and migration policies and practices. Geneva: Licence: CC BY-NC-SA 3.0 IGO. https://iris.who.int/bitstream/handle/10665/341843/9789240028906-eng.pdf?sequence=1 Visited on: 07.27.2024
  • Valette, D., Nepesova, N., Korobkova, N., 2021. High risk – low priority why unlocking COVID-19 vaccine access for refugees and internally displaced communities is critical for children. World Vision International, https://www.wvi.org/sites/default/files/2021-06/WRD%20report_v2_reduced.pdf Visited on: 05.14.2024
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Between Borders and Viruses: A Time Series Analysis of Healthcare Use by Asylum-Seekers

Year 2025, Volume: 26 Issue: 3, 485 - 494, 25.07.2025

Hatice Genç Kavas , Ahmet Şengönül

https://doi.org/10.37880/cumuiibf.1681210

Abstract

Objective: In the recent period when the density of immigrants has increased globally, the necessity of analyzing immigrant behaviors and making interpretations accordingly has become evident. This study analyzes how the healthcare utilization behaviors of asylum-seekers and locals changed before and after the COVID-19 pandemic and how pandemic-related variables affect asylum-seekers' motivation.
Methods: We examined whether the number of cases, deaths, and vaccinations in Turkey during the pandemic had a deterrent or attractive effect on hospital visits by asylum-seekers. Admissions to hospital departments (all medicine departments- 55 departments-) were used as the dependent variable. The short-term and long-term effects of explanatory variables on the dependent variable were estimated using the Autoregressive Distributed Lag (ARDL) model.
Results: We found that the overall pandemic situation significantly impacted long-term healthcare use among asylum-seekers. In the short term, only vaccines had a significant impact. We also found that asylum-seekers accounted for only 1% of total healthcare use, with the remaining 99% used by the locals.
Conclusions: When the social and economic impact of asylum-seekers' healthcare services use is evaluated, it may be necessary to determine appropriate policies for these patients in non-pandemic periods and during pandemics. To prevent local’s reactions from growing, accurate data and the opportunities of the current situation can be conveyed to the public. Different marketing activities may need to be implemented for these patients, who can also constitute a target market as an opportunity for healthcare institutions. Vaccination policies should be carefully considered.

Keywords

Health Services Covid-19 Asylum-Seekers Consumer Behavior ARDL

Thanks

We thank 2024 International Economy, Finance and Business Congress participants for their helpful comments. We are also grateful to the Sivas Provincial Health Directorate and hospital data processing personnel for providing the admission data.

References

  • Altun, Y., İşleyen, Ş. & Görür, Ç. (2018). The effect of education and health payments on economic growth in Turkey, 1999-2017. The Journal of Social Sciences Institute, 39, 223-244. https://dergipark.org.tr/en/pub/yyusbed/issue/43786/537732 Visited on: 07.03.2025
  • Assi, R., Özger-İlhan, S., & İlhan, M.N. (2019). Health needs and access to health care: the case of Syrian refugees in Turkiye. Public Health, 172, 146-152. https://doi.org/10.1016/j.puhe.2019.05.004
  • Balkan, B., & Tumen, S. (2016). Immigration and prices: quasi-experimental evidence from Syrian refugees in Turkiye. J Popul Econ., 29, 657–686. doi:10.1007/s00148-016-0583-2
  • Bolgün, C., & Uçan, G. (2020). Is it possible to live together?: construction of the “Syrian asylum seeker” discourse in reader comments. Celal Bayar Üniversitesi Sosyal Bilimler Dergisi, 18(1), 250-269. doi: 10.18026/cbayarsos.647227
  • Chebet, Y.T., & Ghazala, B. (2024). Consumer behaviour among refugees in Sweden: a comprehensive study of acculturation and consumer behaviour. MA thesis. Jönköping University. https://ju.diva-portal.org/smash/record.jsf?pid=diva2%3A1869653&dswid=-6822 Visited on: 06.25.2024
  • Coleman, D. (2006). Immigration and ethnic change in low-fertility countries: a third demographic transition. Population and Development Review, 3(3), 401-446. https://www.jstor.org/stable/20058898?origin=JSTOR-pdf Visited on: 06.25.2024
  • Da Mosto, D., et al. (2021). Health equity during COVID-19: A qualitative study on the consequences of the syndemic on refugees’ and asylum seekers’ health in reception centres in Bologna (Italy). Journal of Migration and Health, 4, 100057. https://doi.org/10.1016/j.jmh.2021.100057
  • Gbadeyan, R.A., 2010. Health care marketing and public relations in not for profit hospitals in Nigeria. International Journal of Business and Management 5 (7), 117-125. https://pdfs.semanticscholar.org/7f16/f0d00b98dcb587c41feb61948f82fe376a67.pdf Visited on: 06.25.2024
  • Grove, N.J., & Zwi, A.B. (2005). Our health and theirs: forced migration, othering, and public health. Social Science & Medicine, 62, 1931-1942. doi:10.1016/j.socscimed.2005.08.061
  • Gunst, M.,et al. (2019). Healthcare access for refugees in Greece: challenges and opportunities. Health Policy, 123, 818-824. doi.org/10.1016/j.healthpol.2019.06.003
  • Hacker, K., et al. (2015). Barriers to health care for undocumented immigrants: a literature review. Risk Management and Healthcare Policy, 8, 175-183. https://doi.org/10.2147/RMHP.S70173
  • Hamidi, F., & Karachiwalla, Z. (2022). Note: “fear is grounded in reality”: the impact of the COVID-19 pandemic on refugees’ access to health and accessibility resources in the United States. COMPASS’22, June 29 – July 01, Seatle, WA, USA. 661-667. https://doi.org/10.1145/3530190.3534851
  • Heslehurst, N., et al. (2018). Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BMC Medicine, 16(89), 1-25. doi.org/10.1186/s12916-018-1064-0
  • Jansen, C. (1969). Some Sociological Aspects of Migration. J. A. Jackson (Ed.), In Migration (p. 157-186), Cambridge, Cambridge University Press.
  • Kay, M.J. (2007). Healthcare marketing: what is salient?. International Journal of Pharmaceutical and Healthcare Marketing, 1(3), 247-263. DOI: 10.1108/17506120710818256
  • Khanom, A., Alanazy, W., Couzens, L., Evans, B.A., Fagan, L., Fogarty, R., John, A., Khan T., Kingston, M.R., Moyo, S., Porter, A., Rhydderch, M., .richardson, G., Rungua, G., Russell, I. & Snooks, H. (2021). Asylum seekers’ and refugees’ experiences of accessing health care: a qualitative study. BJGP Open, 5(6), 1-11. DOI:10.3399/BJGPO.2021.0059
  • Kolukırık, S. (2009). Image of refugees and asylum-seekers in the media: an evaluation on media politics. Gaziantep Ünviersitesi Sosyal Bilimler Dergisi, 8(1), 1-20. https://dergipark.org.tr/en/download/article-file/223479 Visited on: 06.19.2024
  • Lee, O.F. & Davis T.R.V. (2004). International patients: a lucrative market for U.S. hospitals. Health Marketing Quarterly, 22(1), 41-56. doi.org/10.1300/J026v22n01_04
  • Mangrio, E., Paul-Satyaseela, M. & Strange, M. (2020). Refugees in Sweden during the COVID-19 pandemic - the need for a new perspective on health and integration. Front. Public Health, 8, 574334.
  • Matlin, S. A., et al. (2021). COVID-19: marking the gaps in migrant and refugee health in some massive migration areas. International Journal of Environmental Research and Public Health, 18, 12639. doi.org/10.3390/ijerph182312639
  • Ministry of Interior Directorate General of Migration Management (MIDGMM), (2014). The temporary protection regulation; Republic of Turkiye. https://www.goc.gov.tr/kurumlar/goc.gov.tr/gk_yon_getirdigi_yenilikler.pdf Visited on: 06.20.2024
  • Mutlu, S., & Yılmaz, Ş. (2021). Comparison of HBsAg, Anti-HBs, Anti-HCV and Anti-HIV seropositivity of Turkish and refugee pregnant women. Journal of Duzce University Health Sciences Institute, 11(1), 21-24. doi.org/10.33631/duzcesbed.723989
  • Nasjlova, L. (2023). Architectures of similarity: fragments, islands and other escapes from the Turkiye and Europe framework. International Relations, 20 (77), 147-164. https://doi.org/10.33458/uidergisi.1273325
  • Navarro-Roman, L., & Roman, G.C. (2022). The devastating effects of the COVID-19 pandemic among ethnic minorities, migrants, and refugees. M. El Alaoui-Faris et al. (Eds.), Neurology in Migrants and Refugees. https://doi.org/10.1007/978-3-030-81058-0_13
  • Pesaran, M.H., Yongcheol, S., & Smith, R.J. (2001). Bound testing approaches to the analysis of long run relationships. Journal of Applied Econometrics Special Issue, 16, 289-326. doi.org/10.1002/jae.616
  • Rafieifar, M., et al., (2021). Impacts of COVID-19 on refugees and immigrants in the United States: a call for action. International Social Work, 64(5), 771-776. doi: 10.1177/00208728211017964
  • Republic of Turkiye Ministry of Health. (2021). Turkish national covıd-19 vaccine administration strategy. (Visited on 06/23/2024) https://covid19asi.saglik.gov.tr/EN-78317/turkish-national-covid-19-vaccine-administration-strategy.html
  • Saatçioğlu, B., (2020). The European Union’s refugee crisis and rising functionalism in EU-Turkiye relations. Turkish Studies, 21(2), 169-187. doi.org/10.1080/14683849.2019.1586542
  • Turkish Statistical Institute (TSI)., (2018). International migration statistics 2017. https://data.tuik.gov.tr/Bulten/Index?p=Uluslararasi-Goc-Istatistikleri-2017-30607 Visited on: 07.14.2024
  • Turkish Statistical Institute (TSI)., (2019). International migration statistics 2018. https://data.tuik.gov.tr/Bulten/Index?p=International-Migration-Statistics-2018-30711# Visited on: 07.14.2024
  • Turkish Statistical Institute (TSI)., 2020. International migration statistics 2019. https://data.tuik.gov.tr/Bulten/Index?p=Uluslararasi-Goc-Istatistikleri-2019-33709 Visited on: 07.14.2024
  • Turkish Statistical Institute (TSI)., 2021. International migration statistics 2020. https://data.tuik.gov.tr/Bulten/Index?p=Uluslararas%C4%B1-G%C3%B6%C3%A7-%C4%B0statistikleri-2020-37212 Visited on: 07.14.2024
  • Turkish Statistical Institute (TSI)., 2022. International migration statistics 2021. https://data.tuik.gov.tr/Bulten/Index?p=Uluslararas%C4%B1-G%C3%B6%C3%A7-%C4%B0statistikleri-2021-45814&dil=1 Visited on: 07.14.2024
  • Turkish Statistical Institute (TSI)., 2023. International migration statistics 2022. https://data.tuik.gov.tr/Bulten/Index?p=Uluslararasi-Goc-Istatistikleri-2022-49457 Visited on: 07.14.2024
  • UNHCR The UN Refugee Agency., 2023. Türkiye fact sheet. https://www.unhcr.org/tr/wp-content/uploads/sites/14/2023/10/bi-annual-fact-sheet-2023-09-turkiyeF.pdf Visited on: 06.20.2024
  • UNHCR The UN Refugee Agency. Refugees and asylum seekers in Turkiye. https://www.unhcr.org/tr/en/refugees-and-asylum-seekers-in-Turkiye Visited on: 06.20.2024
  • UNICEF United Nations Children’s Fund. (2023). Immunization road map to 2030. New York: USA. https://www.unicef.org/media/138976/file/UNICEF%20Immunization%20Roadmap%20To%202030.pdf Visited on: 06.20.2024
  • World Health Organization., 2020. Basic documents. 49th Edition. Geneva. https://apps.who.int/gb/bd/pdf_files/BD_49th-en.pdf
  • World Health Organization., 2021. Refugees and migrants in times of COVID-19: mapping trends of public health and migration policies and practices. Geneva: Licence: CC BY-NC-SA 3.0 IGO. https://iris.who.int/bitstream/handle/10665/341843/9789240028906-eng.pdf?sequence=1 Visited on: 07.27.2024
  • Valette, D., Nepesova, N., Korobkova, N., 2021. High risk – low priority why unlocking COVID-19 vaccine access for refugees and internally displaced communities is critical for children. World Vision International, https://www.wvi.org/sites/default/files/2021-06/WRD%20report_v2_reduced.pdf Visited on: 05.14.2024
  • Zivot Eric ve Donald. W. K. Andrews. 1992. Further Evidence on the Great Crash the Oil Price Shock and the Unit-Root Hypothesis. Journal of Business and Economic Statistics, 10(3), 251–270. https://doi.org/10.2307/1391541
There are 41 citations in total.

Details

Primary Language English
Subjects Policy and Administration (Other), Business Administration
Journal Section Makaleler
Authors

Hatice Genç Kavas 0000-0002-6813-529X

Ahmet Şengönül 0000-0002-4999-1461

Early Pub Date July 19, 2025
Publication Date July 25, 2025
Submission Date April 22, 2025
Acceptance Date July 10, 2025
Published in Issue Year 2025 Volume: 26 Issue: 3

Cite

APA Genç Kavas, H., & Şengönül, A. (2025). Between Borders and Viruses: A Time Series Analysis of Healthcare Use by Asylum-Seekers. Cumhuriyet Üniversitesi İktisadi Ve İdari Bilimler Dergisi, 26(3), 485-494. https://doi.org/10.37880/cumuiibf.1681210
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