退休對心理健康之影響—以鎮定安眠藥之使用為指標

The Effects of Retirement on Mental Health as Measured by the Use of Hypnotic Drugs

孟欣宏(Shin-Hung Meng) ； 吳春樺(Chun-Hua Wu) ； 林文德(Wen-Der Lin)

《台灣公共衛生雜誌》 32卷1期 (2013/02) Pp. 52-61

https://doi.org/10.6288/TJPH2013-32-01-06

摘要

目標：探討退休者與未退休者在退休者之退休日期前後鎮靜安眠藥使用之變化情形，以瞭解退休對心理健康的影響。方法：本研究利用1999年至2009年之健康保險承保歸人檔資料（LHID2005），分析50-64歲之退休與未退休年者在退休者之退休日期前三年及後六年的鎮靜安眠樂每年定義日劑量（defined daily doses, DDDs）之用量差異。藉由傾向分數配對法（propensity score, PS），依其退休前鎮靜安眠藥利用量分為高、低利用兩組，分別以1 : 1的方式配對產生對照之未退休樣本。最後以無母數的中位數比較方法，分別分析高利利用組的退休與未退休者間用藥量的差異。結果：配對前，高、低利用組分別有16,518人及14,322人，配對後，兩組分別有3,057個配對及3,282個配對，合計6,339組配對，共12,678個樣本。未配對前，退休者的鎮靜安眠藥用量均顯著高於未退休者，但配到後，兩者的用藥型態並沒有顯著差異。結論：退休者的鎮靜安眠藥用量在退休前後數年均顯著高於同年齡的未退休者，顯示退休者可能有較大的心理健康問題而使用較多的鎮靜安眠藥，而退休本身並無法改善其心理健康而減少鎮靜安眠藥的用量。

關鍵字

退休 ； 心理健康 ； 鎮靜安眠藥物 ； 傾向分數法

並列摘要

Objectives: We investigated the impact of retirement on mental health by examining hypnotic drug use 3 years before and 6 years after retirement for retirees compared with non-retirees. Methods: We designed a retrospective cohort study to explore the association between retirement and hypnotic drug use. The data in this study were retrieved from Taiwan's 2005 Longitudinal Health Insurance Data set which contained 1 million representative samples. The hypnotic drug dosages were obtained from prescription information contained in ambulatory care claims for both retirees and non-retirees between the ages of 50 and 64. We classified the retired people into high-and low-user groups according to the dosages used before retirement. A greedy match based on propensity score (PS) for retirement was used to select comparable samples from those who were not retired. Wilcoxon's rank sum test and signed-rank test were used respectively to examine the difference in hypnotic drug use between retirees and non-retirees year by year before and after PS matching. Results: There were 3,282 and 3,057 pairs in the high- and low-user groups, respectively. Before PS matching, the annual hypnotic dosage for the retired was significantly higher than that for the non-retired samples in both groups; however, after PS matching, the annual dosage for retirees and non-retirees in both groups did not differ significantly. Conclusions: Retirees have more mental health problems as measured by the use of hypnotic drugs. Retirement per se had no positive impact on mental health.

並列關鍵字

retirement ； mental health ； hypnotic drugs ； propensity score

參考文獻

林文德、謝其政、邱尚志、吳慧俞、黃一展(2010)。以傾向分數配對法評估糖尿病論質計酬方案之成效。台灣衛誌。29，54-63。

林文德、謝其政、邱尚志、吳慧俞、黃一展(2010)。以傾向分數配對法評估糖尿病論質計酬方案之成效。台灣衛誌。29，54-63。

WHO. The anatomical therapeutic chemical classification system with defined daily doses (ATC/DDD index 2012). Available at: http://www.whocc.no/atc_ddd_index/. Accessed January 1. 2012.

行政院主計總處：台灣地區歷年勞動力之年齡。http://win.dgbas.gov.tw/dgbas04/bc4/manpower/year/year_t1-t22.asp?table=6&ym=1&yearb=82&twEW=99。引用2011/07/09。Directorate-General of Budget, Accounting and Statistics, Exective Yuan, R.O.C. (Taiwan). Age of the labor force in Taiwan by year. Available at : http://win.dgbas.gov.tw/dgbas04/bc4/manpower/year/year_t1-t22.asp?table=6&ym=1&yearb=82&twEW=99. Accessed July 9, 2011. [In Chinese]

行政院主計總處：受雇員工動向調查統計結果綜合分析。http://www.dgbas.gov.tw/ct.asp?xItem=15413&CtNode=4600&mp=1 2006。引用2011/07/09。Directorate-General of Budget, Accounting and Statistics, Exective Yuan, R.O.C. (Taiwan). Comprehensive statistical analyses of labor trends. Available at: http://www.dgbas.gov.tw/ct.asp?xItem=15413&CtNode=4600&mp=1 2006. Accessed July 9, 2011. [In Chinese]