Healthcare Financing for the Elderly: A Comparative Study

Abstract

Context: The increase in life expectancy has resulted in a growing elderly population, presenting numerous challenges, particularly in the healthcare sector. Accordingly, this study aimed to adapt a health financing model for the aging population in Iran based on the experiences of selected countries of the world. Evidence Acquisition: This comparative study was conducted in 2025 to examine elderly care policies across selected countries. Using keywords such as “elderly”, “financing”, “health system”, “health services”, and “management”, targeted searches were performed in PubMed, Scopus, and Web of Science. English-language studies published up to 2025 and comparable to Iran’s elderly care system were included. Using the PRISMA guideline and health financing-based tool, 39 studies from seven countries focusing on insurance-based models were analyzed. Results: This study examined the policies and programs of Germany, Japan, China, South Korea, France, Ghana, India, and Iran concerning elderly care. It was revealed that long-term care (LTC) is a significant component of the healthcare strategies in all these countries, implemented through various approaches. Moreover, health systems in the studied countries are mainly financed by a combination of public and private health insurance. Conclusions: This study showed that Iran should prioritize creating long-term care insurance (LTCI) to secure sustainable funding for elderly healthcare, while also enhancing public-private partnerships and ensuring fair access to quality care for older adults.