Geographical Variations in Elderly Disability in Taiwan

台灣地理區域間老年人失能比率之差異

莊坤洋(Kun-Yang Chuang) ； 莊媖智(Ying-Chih Chuang) ； 陳亮汝(Liang-Ju Chen) ； 吳淑瓊(Shwu Chong Wu)

《The Journal of Nursing Research》 16卷1期 (2008/03) Pp. 47-54

摘要

健康的不均分布是一個長期廣泛被討論的議題。本篇研究的目在於推估台灣23個行政區域中，老年人的失能盛行率並比較不同區域間的差異。本研究對一具有全國代表性的303,545位樣本進行訪談，共有239,861人完成調查，完成率將近80%，其中有114,873位65歲以上的老年人在本研究中被納入分析，計算各行政區域中老年人的失能比率以非標準化及標準化盛行率，並且以點圖呈現地理區間的差異。結果顯示，不同地理區域的盛行率有顯著的差異，且在調整年齡及性別結構後，差異仍存在。除此之外，兩性在失能率上的差異也隨著地理間的變異而有所不同。大致來說，與東部地區相較之下，西部地區有較低的失能盛行率。由於老年人的失能率在各個行政地區中有顯著的差異，因此，長期照護的資源分配不應僅根據行政區域內老年人口的數目，同時在高失能盛行率的地區應了解其成因並做適當的介入。

關鍵字

失能盛行率 ； 健康的不均等 ； 地理區域的差異

並列摘要

Inequality in health has long been a topic of discussion. The purpose of this research was to provide estimates of the proportions of elderly who had difficulties in activities of daily living in each of the 23 administrative areas of Taiwan, and to assess if there was geographical disparity in disability across areas. A nationally representative sample of 303,545 subjects was selected for interview. Among the subjects selected for interview, 239,861 completed the survey, a completion rate of about 80%. For the purpose of this research, only those aged 65 years or older were included (N=114,873) in the analyses. Non-standardized and standardized prevalences of disability were presented for each of the 23 administrative areas in Taiwan, and geographical distribution of elderly disability was plotted. Results show that significant difference in disability prevalence exists among administrative districts, even after adjusting for age and sex structure of the population. Moreover, the extent of gender disparity also varied from one area to another. The western region, in general, had lower disability prevalence than the eastern region. Findings imply that since disability prevalence varied significantly across administrative areas, funding for long-term care should not be allocated based on the number of elderly population in an administrative area. Areas with high prevalence should identify reasons for their high prevalence rates and implement proper interventions.

並列關鍵字

disability prevalence ； health inequality ； geographical variation

參考文獻

Blaxter, M(1987).Evidence on inequality in health from a national survey.Lancet.2(8549),30-33.

Ellis, E.,Grimsley, M.,Goyder, E.,Blank, L.,Peters, J(2007).Physical activity and health: Evidence from a study of deprived communities in England.Journal of Public Health.29(1),27-34.

Elo, I. T.,Preston, S. H(1992).Effects of early-life conditions on adult mortality: A review.Population Index.58(2),186-212.

Fukuda, Y.,Nakamura, K.,Takano, T(2004).Municipal socioeconomic status and mortality in Japan: Sex and age differences, and trends in 1973–1998.Social Science & Medicine.59(12),2435-2445.

Fukuda, Y.,Nakamura, K.,Takano, T(2004).Increased excess deaths in urban areas: Quantification of geographical variation in mortality in Japan, 1973–1998.Health Policy.68(2),233-244.