本研究主要探討台灣地區50歲以上中老年人不同身體健康、心理健康、社會支持三種健康情形與醫療服務利用情形之相關性。所涉及之影響因素除了此三種健康情形外,尚包括基本人口社會學特性、使能因素(居住地區都市化程度、是否參加全民健康保險),因此本文將透過二元邏輯式迴歸分析、多項式邏輯式迴歸分析、逐步迴歸分析等方式,探討身體健康、心理健康以及社會支持對醫療服務利用情形之影響。 本研究主要利用行政院衛生署國民健康局「民國九十二年台灣地區中老年身心社會生活狀況長期追蹤調查」第五主波資料庫的資料進行研究分析,篩選出五十歲以上可用樣本為主要研究對象,樣本數共計4961位。 分析結果顯示:(1)二元邏輯式迴歸:以過去一年是否醫療服務利用,其利用之族群特徵為:有偶、自覺健康不好、有抑鬱症狀者;(2)多項式邏輯式迴歸:以過去一年醫療服務利用次數,利用一次之族群其特徵為:自覺健康不好、工具性日常生活功能有障礙;利用二次以上之族群其特徵為:有抑鬱症狀者;(3)逐步迴歸分析結果發現「社會支持」、「心理健康狀況」、「身體健康狀況」皆為預測過去一個月門診醫療服務利用次數的影響因素,其中又以「社會支持」之R2改變量為最大。 因此本研究建議未來要探討整體健康情形對醫療服務利用影響的研究採用長期追蹤調查的方式,且納入更整體的全人健康情形,以便能更明顯看出其之間的影響關係。
This study focused on more than 50 years of age in Taiwan were different from adults with physical health, psychological health, social support, three kinds of health conditions and medical services, the relevance of using the case. The factors involved in addition to the health situation of these three things, include basic demographic characteristics of Sociology, enabling factors (areas norm is the degree, whether to participate in the National Health Insurance), this article will be through binary logistic regression analysis, polynomial logistic regression analysis, stepwise regression analysis, to explore physical health, mental health, and social support services to the medical impact of using the case. This study using Department of Health, Executive Yuan, the Bureau of Health "of the Elderly in Taiwan, Republic of Brand in Brand Extension of Health and Living Status of the investigation," the fifth wave is the information database to conduct research and analysis, selected aged over five samples can be used as the main object of study, a total of 4961 samples. The results showed that: (1) binary logistic regression: whether the past year, using medical services, using the population of its features are: a spouse, perceived health status is not good, mental health, those with depressive phenomena ; (2) Multiple logistic regression: medical services over the past year, using number of times, using one of the groups characterized by: not good perceived health status, activities of daily living are impaired social barriers; utilize secondary characterized by above groups: those with depressive phenomena; (3) stepwise regression analysis: The results showed that "social support", "mental health", "physical health" are all predicted in the past month use of outpatient medical services, the impact of the number of factors, among which "social support" of the change in R2 of the largest volume. Therefore, this study suggests that the future should assess the overall health status of the medical impact of utilization of service by way of long-term tracking surveys, and holistic health into the more general case, to facilitate more apparent to the relationships between its .