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  • 學位論文

探討台灣中老年人居住型態、健康情況對醫療利用之影響

Health Status and Living Pattern with Medical Resource Utilization among Elderly in Taiwan

指導教授 : 李金德
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摘要


人口老化是當前全球面臨的嚴峻挑戰,台灣地區由於平均壽命延長,以及生育率快速下降,而當老年人口在平均餘命不斷在延長,未來罹患慢性疾病及失能的老年人口數量必然將不斷攀升,老年人的器官功能亦會更加衰退,罹患慢性疾病、行動失能及認知障礙的風險亦會增加,嚴重時甚至只能依賴他人照顧,因此了解不同居住型態的老人健康照護措施及醫療資源分配日趨重要。 本研究採用橫斷式研究法,針對國民健康局2007年的台灣地區中老年身心社會生活狀況長期追蹤調查資料庫,不同居住型態、健康情況與醫療利用相互關係,探討其相互影響之因素,針對其結果協助醫療機構與社會支持,根據不同病患給予不同且正確的醫療服務利用。 研究發現與子女同住者男性及有偶者在住院次數(0.24次/年,P<0.001)、住院天數(1.43天/年,P<0.001)及急診次數(0.35次/年,P<0.001)上使用醫療服務利用的機率較高。而獨居者較易因罹患關節炎或風濕、高血脂增加急診次數(0.27次/年,P<0.001),與子女同住有罹患糖尿病者在過去一年住院天數(1.11天/年,P<0.001)及次數(0.16次/年,P<0.001)上有較高的醫療利用行為。而不論何種居住型態,日常生活活動功能有障礙、工具性日常生活活動功能有障礙、自覺健康狀況不好的皆是高醫療利用顯著( P<0.001)的因素。 根據上述結果分析,不論任何居住型態皆與日常生活障礙息息相關,反觀,獨居者無子女同住之情況之患者,是否能正確使用醫療服務,以達到對慢性疾病的控制,且降低濫用醫療服務的情況,使其達到最完善的醫療服務。

並列摘要


In Taiwan, population become aging, and the average life expectancy, as well as the rapid decline in fertility, the chronic diseases are common among the elderly people.However, the organ of the elderly will be more recession, and suffering from chronic diseases, the risk of disability and cognitive impairment action will also increase. Therefore, measures to improve health care for the elderly and health care resource allocation is increasingly important. Our study use the Health Promotion Administration, Ministry of Health and Welfare method, and collect data of “Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan”. Designed a cross-senctional, secondary data analysis study and used the case of 2007 survey data for the study sample. The study found male inmates with their children, spouse in the number of hospitalization higher probability of the use of medical services(0.24 per year,P<0.001) and emergency department visits for several days(0.35per year). And live alone are more likely to suffer from arthritis or rheumatism because, hyperlipidemia increased emergency department visits, living with children who have diabetes in the past year, the number of hospital days and have high medical-use behavior(0.27 per year). And regardless of residential patterns, impaired activities of daily living functions, instrumental activities of daily living function disorders, poor perceived health status are all significantly higher healthcare utilization factor. According to the results of the analysis, regardless of any living patterns are closely related to daily life obstacles, the other hand, living alone without the children live with the patient's condition, whether the proper use of medical services, in order to achieve control of chronic diseases, and reduce the abuse of health care information on services, to the best of comprehensive medical services.

並列關鍵字

living patterns health status, medical using

參考文獻


Andersen, R. M. (2008). National health surveys and the behavioral model of health services use. Medical Care, 46(7), 647-653. doi: 10.1097/MLR.0b013e31817a835d
Lehnert, T., Heider, D., Leicht, H., Heinrich, S., Corrieri, S., Luppa, M., . . . Konig, H. H. (2011). Review: health care utilization and costs of elderly persons with multiple chronic conditions. Med Care Res Rev, 68(4), 387-420. doi: 10.1177/1077558711399580
中文文獻
顧勝敏. (2011). 台灣高齡老人的醫療服務使用情形.碩士論文, 中山醫學大學, 台中.
吳淑瓊、 林惠生(1999)臺灣功能障礙老人家庭照護者的全國概況剖析。中華公共衛生雜誌18(1):44-53。

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