臺灣地區高血壓的老人健康行為與醫療服務利用情形探討

The Relations of Health Behavior and Medical Services Utilization among the Hypertension of the Elderly in Taiwan

施惠中(Hui-Chung Shi)

指導教授 ： 邱尚志

亞洲大學/健康學院/健康管理研究所/碩士(2011年)

摘要

本研究旨在探討高血壓老人之健康行為與醫療服務利用情形，瞭解健康促進行為、健康危害行為與醫療服務利用之間的關係。
本研究使用行政院衛生署國民健康局、國家衛生研究院與管制藥品管理局合作之「2005年國民健康訪問暨藥物濫用調查」與其個案同意串聯2005年健保資料庫之資料，進行次級資料分析。並以SPSS 12.0軟體進行描述性統計與推論性統計。
研究結果顯示：（1）台灣地區高血壓的老人在沒有健康促進行為、有一項健康促進行為、有二項健康促進行為、有三項健康促進行為、有四項健康促進行為的比例分別為15.3%、29.7%、34.7%、17.2%、3.2%；在沒有健康危害行為、有一項健康危害行為、有二項健康危害行為、有三項健康危害行為的比例分別為61.1%、21%、14%、3.9%。因此高血壓老人大部分都有進行健康促進行為之相關活動，然從事健康危害行為之比例則相對較少。（2）2005年門診醫療利用與住院醫療利用比例分別為63.8%、13%，故高血壓的老人之醫療服務利用以門診為主，平均門診就醫次數為20.3次、平均門診醫療費用為22,183元、住院平均天數為3天、平均住院醫療費用為17,844元。（3）健康行為將隨著不同人口社會學特性而有所差異，其中影響健康促進行為因素為性別、教育程度與都市化程度，該行為族群特徵為男性、高中及以上、高度都市化市鎮；影響健康危害行為因素為性別、年齡、教育程度、婚姻狀況與工作狀況，該行為族群特徵為男性、較年輕的老人、高中及以上、有偶、有工作。（4）住院醫療服務利用較與健康促進行為有關，門診醫療服務利用則較與健康危害行為有關。婚姻狀況皆為影響門診和住院醫療服務利用的因素。

關鍵字

健康促進行為 ； 健康危害行為 ； 醫療服務利用

並列摘要

The purpose of this study is to investigate the relationship between the medical service utilization and health behaviors, including health promoting behaviors and health risk behaviors, among elderly people with hypertension.
This study conducted the National Health Interview Survey Database provided by the Bureau of Health Promotion (BHP), National Health Research Institutes (NHRI), and Food and Drug Administration (FDA). In 2005, the third wave investigation, the participants in National Health Interview survey (over 65 years old questionnaire of personal data files) and of these potential participants, provided their consent for data linkage to 2005 National Health Insurance claims database. This study used SPSS 12.0 version for statistical analyses. Regarding the study purpose, we converted the original questionnaires items related to health promoting behaviors and health risk behaviors into simply scaling items. This study firstly involved a descriptive analysis of the relative variables. Lastly, multivariate regression analysis was used to examine influencing factors on the relationship between the medical utilization and health promoting behaviors and health risk behaviors.
The results showed: (1) Regarding health promoting behaviors among the elderly people with hypertension in Taiwan, the proportion of the absence of health promoting behavior, only one kind of, two kinds of, three kinds of, and four health promoting behaviors were15.3%, 29.7%, 34.7%, 17.2%, 3.2%, respectively. In the meantime, the proportion of behavior in the absence of health hazard, one kind of, two kind of, and three health risk behavior rates were 61.1%, 21%, 14%, 3.9%, respectively. Therefore, the majority of elderly people with hypertension have the implementation of health-promoting behaviors, while less like in health risk behaviors. (2) The use of outpatient and inpatient medical care utilization rates were 63.8%, 13%, which meant the elderly preferred the outpatient medical service. The average visits of the doctor office were 20.3 times, the average cost of outpatient was NT 22,183 dollars, and the average length of stay were 3 days, which the average hospitalization cost was NT 17,844 dollars. (3) The factors related to health promotion behaviors were gender, education, and urbanization. The characteristics of patients with promotion behavior were as a male, high school and above, and in highly urbanized town; behavioral factors affecting health hazard were the gender, age, educational level, marital status and working conditions. The characteristics of patients with the hazard behavior were males, younger elderly, high school and above, married, and with a job status. (4) From regression analyses, we found that the use of inpatient medical services are related to the health promoting behaviors, and the use of outpatient medical services are associated with the health risk behaviors.

並列關鍵字

Health Promotion ； Health Risk Behavior ； Medical Services Utilization

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