城鄉老人健康行為、醫療利用與健康狀況相關性研究

Association between Health Behavior, Medical Service Utilization, and Health Status in Urban and Rural Senior Citizens

湯淑貞(Shu-Chen Tang) ； 闕帝宜(Ti-I Chueh) ； 李文傑(Wen-Chieh Lee) ； 陳靖宜(Chin-Yi Chen) ； 謝明娟(Ming-Chuan Hsieh) ； 何秀玲(Hsiu-Ling Ho) ； 陳楚杰(Chu-Chieh Chen)

《醫務管理期刊》 21卷4期 (2020/12) Pp. 314-333

https://doi.org/10.6174/JHM.202012_21(4).314

摘要

目的：探討城鄉老人健康行為、醫療利用與健康狀況，及影響其健康狀況的因素。方法：本研究資料來自國民健康署提供的「2013年國民健康訪問調查」資料，本研究以1,263位65歲（含）以上老人為研究對象。首先以頻率及百分比，描述自變項及依變項的狀況再以複邏輯斯迴歸分析，找出獨立影響城鄉老人健康狀況的因素。本研究使用SAS 9.4統計套裝軟體進行資料整理與統計分析。結果：在健康行為方面，50.36%運動行為為不運動，53.68%一年內不曾接受流感疫苗接種。在醫療利用方面，53.60%近一個月有看過西醫門診，15.44%近一年曾住院，18.84%近一年曾看過急診。在健康狀況方面，74.74%自覺健康狀況佳，85.67%無多重慢性病；影響城鄉老人自覺健康狀況的因素有城鄉別、教育程度、工作狀況、家庭月平均收入、運動行為、門診、急診；影響城鄉老人多重慢性病的因素有城鄉別、工作狀況、運動行為、門診、住院。結論：城市老人規律運動、自覺健康狀況好、有多重慢性病的比率顯著高於鄉村老人。在控制其他變項後，鄉村老人自覺健康狀況好及有多重慢性病的機率較低。建議衛生主管機關推廣鄉村老人的運動行為，同時重視都市老人慢性病的預防與治療，以提升城鄉老人的健康水準。

關鍵字

老人 ； 醫療利用 ； 健康行為 ； 健康狀況 ； 鄉村地區

並列摘要

Objectives: To explore the health behavior, medical utilization, and health status of urban and rural elderly residents and the factors that affect their health status. Methods: The study data were obtained from the 2013 National Health Interview Survey provided by the National Health Agency. The sample population comprised 1,263 elderly people aged 65 years and above. First, describe the overview of the independent variable and dependent variable with descriptive statistics. Thereafter, to identify the factors that independently affected the health status of urban and rural elderly residents, we used multivariate logistic regression. The SAS 9.4 statistical software package was used for data collation and statistical analysis. Results: In terms of healthy behavior, 50.36% of the exercise behavior comprised nonexercise activities, and 53.68% of the participants had not received influenza vaccine in the past 1 year. In terms of medical utilization, 53.60% of the participants had visited a Western medicine clinic in the past month, 15.44% had been hospitalized in the past year, and 18.84% had been to an emergency department in the past year. In terms of health status, 74.74% of the participants had a good perceived health status, and 85.67% had no multiple chronic diseases. The factors affecting the self-perceive health status of urban and rural elderly residents were location (urban or rural), educational qualification, employment status, average monthly family income, exercise behavior, outpatient service, and emergency department visit. The factors affecting the multiple chronic diseases of urban and rural elderly residents were location (urban or rural), employment status, exercise behavior, outpatient service, and hospitalization. Conclusions: The rate of regular exercise, good self-perceive health status, and multiple chronic diseases in urban elderly residents is significantly higher than the rate in rural elderly residents. After controlling for other variables, elderly people in rural areas have a lower chance of good self-perceive health status and developing multiple chronic diseases. Health authorities should promote exercise behavior in elderly people in rural areas and should focus on the prevention and treatment of chronic diseases in urban elderly people to improve their health.

並列關鍵字

geriatric ； medical service utilization ； health behavior ； self-perceive health status ； rural areas

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