Management of chronic diseases and healthcare use among the elderly in Turkey and Turkish migrants

Background Turkish migrants are one of the largest groups of migrants in Germany, the Netherlands and Sweden. Particularly older migrants face different barriers in the health system that may limit their access to and quality of health care. The aim of this study was to examine how elderly people in Turkey and Turkish migrants in Germany, the Netherlands and Sweden manage chronic conditions, including how they utilize the respective healthcare systems. Methods A qualitative study design was used. A total of 20 in-depth interviews with individuals in Turkey and 10 semi-structured in-depth interviews each with Turkish migrants in Germany, the Netherlands and Sweden were conducted during 07/2018 and 05/2019. The interviews were based on a topic guide and were analyzed using qualitative content analysis. Results Participants from all groups experienced barriers in accessing health services and described difficulties in managing chronic conditions in their daily life. Pathways to care and patterns of utilization strongly depended on the structure of the respective health systems and differed between all groups. Circular migrants to Turkey relied on health professionals from their respective host countries to treat their chronic diseases, consulting professionals in Turkey mostly for emergencies or acute illness. Conclusions Turkish migrants and elderly adults in Turkey experience similar barriers and challenges in managing chronic diseases. How they access and utilize health services is dependent on the respective health system structures. Circular migrants use the Turkish health system differently than health systems in their host countries and elderly adults from Turkey. These results can contribute to the development of diversity-sensitive health care strategies. Key messages Turkish migrants and adults in Turkey experience similar challenges in managing chronic diseases. How Turkish migrants and adults in Turkey access healthcare depends on the respective systems.