- 學位論文
中部地區中老年人自費健康檢查之利用行為及其相關因素探討
Factors associated with the use of self-paid physical examination among middle-aged and the elder persons in central Taiwan
摘要
自費健康檢查為預防醫學之次段預防，如能早期發現疾病、早期治療則是預防保健措施的關鍵之一。本研究目的在於瞭解中老年人對於自費健康檢查之利用行為、偏好及原因，並分析影響其接受做自費健康檢查之相關因素。 本研究以中部某地區醫院之40歲以上之中老年人門診病患為研究對象，依自行設計之結構式問卷進行面對面訪談，共有469位。研究內容包括依變項為是否曾經做過自費健康檢查，自變項為人口學之基本資料、生活型態、慢性病數、自評健康、健康檢查之了解與可近性、社會支持、自費健康檢查信念、免費成人健康檢查與免費篩檢利用情形。透過統計軟體SPSS 10.0進行包含描述性統計、雙變量分析(獨立T檢定、卡方檢定)、多變量分析之邏輯斯回歸分析。 本研究之重要結果顯示： (一)中老年人曾經做過自費健康檢查之比例為26.65%。 (二)有做過自費健康檢查之中老年人較傾向去醫學中心受檢，其檢查費用以10,000~20,000元為主，未來可接受之費用為3,000元以下，著重之檢查項目之前三名為血液檢查、尿液檢查、肝膽功能。而沒有做過自費健康檢查之中老年人未來較傾向去地區醫院之健檢部門受檢，其可接受之檢查費用以3,000元以下為主，著重之檢查項目之前三名為心臟功能、血液檢查、沒意見。 (三)中老年人有無做自費健康檢查在自費健康檢查信念與慢性疾病數有顯著差異。 (四)年齡、教育程度、親友是否會告知有關健康檢查訊息、是否知道自費健康檢查、居住地、月收入、生活開支、自覺目前健康狀況皆與中老年人有無做過自費健康檢查有相關。 (五)邏輯斯回歸分析中，指出親友有告知有關健康檢查訊息、居住於城市地區及月收入5,001元以上，去做自費健康檢查的勝算比皆較高。
並列摘要
Early detection of diseases holds the key to secondary prevention. The purpose of this study was to understand the utilization, behavior of self-paid physical examination and its related factors among a group of middle aged and older persons in central Taiwan. Data were collected from patients at a local hospital in Taichung, using a structured questionnaire. A total of 469 patients gave their consents and completed the questionnaire. Information about their demographic statistics, life style, chronic disease status, self-rated current health status, the accessibility and cognitive on physical, social support, concept of self-paid physical examination, adult health examination of prevention health services, previous experiences of free health screening and check-ups were collected. The main findings were as follows: (1)The rate of had self-paid physical examination for the middle aged and the elder persons was 26.65%. (2)The middle-aged and older persons having past experience of self-paid physical examination were more likely to examine at Medical Center. Their acceptable cost around NTD 10,000 to 20,000 and acceptable cost below 3,000 in the next. Subjects also expressed that they would like to have their boold, urine, liver and gallbladder functions checked. The middle-aged and older persons who never had experiences of self-paid physical examination were more likely to examine at local hospital. Their acceptable costs were below NTD 3,000. Subjects want to focus on blood test and liver function checked. (3)The variables of belief of self-paid physical examination and numbers of chronic disease were significant factors in predicting the self-paid physical examination among this group of middle-aged and older persons. (4)Age, education level, relatives and friends told about information of physical examination, aware of self-paid physical examination, residence, monthly income, live expenses, self-rated current health status were correlated with the use of self-paid physical examination of middle-aged and older persons among this sample of adults. (5)The logistic regression results indicates that relatives and friends told about the information of physical examination, living in urban areas and monthly income above NTD 5,001 were more likely to use self-paid physical examination. Key words: middle-aged and older adult, self-paid physical examination, utilization behavior, central Taiwan.