本文採用Andersen行為模式探討台灣高齡人口醫療服務使用情形,研究對象為國民健康局2007年的台灣地區中老年身心社會生活狀況長期追蹤調查資料,納入條件為78歲以上的高齡受訪個案,有效樣本數為1,261人。本研究結果發現,高齡老人的疾病盛行率前三名為白內障(55.4%)、高血壓(48.5%)、心臟病(28.7%),對日常生活影響較大者則為髖骨骨折(64.7%)、中風(55.6%)、關節炎/風濕(38.2%)。自認一年內的健康狀態變差者佔半數以上(57.0%),自評健康狀態良好者僅有21.0%,曾使用急診醫療服務者約為23.6%,曾使用西醫門診者則高達92.1%。影響高齡老人使用急診或西醫門診的醫療服務行為的傾向因素為獨居,使能因素為經濟滿意度或居住地區,需要因素則為自評健康狀態、疾病種類、行走能力等。本研究提出台灣地區高齡人口主要的健康問題,以及影響其使用醫療服務行為的可能因素,可供政府未來制定老人醫療照護政策的政要參考依據。本研究結果可供制定高齡老人醫療服務政策及後續相關研究的參考,並期能夠使高齡老人獲得更好的醫療服務及較佳的老年生活品質。
The Andersen Behavioral Model renders us to explore medical service utilization of very elderly population of Taiwan in this study. Data of this study are from the 2007 survey of a longitudinal cohort project titled, ‘Survey of Health and Living Status of the Elderly in Taiwan’ (SHLSET), conducted by the Bureau of Health Promotion of Taiwan. Of all, 1,261 qualified respondents who aged more than 78 years in this study. We found that cataract (55.4 %), hypertension (48.5 %), and heart disease (28.7 %) were common diseases in very elderly population. Hip fracture (64.7 %), stroke (55.6 %), and rheumarthritis (38.2 %) were greater impact on their daily life. We also found that only 21.0 % of respondents presented a good self-rank of healthy status while 57.0 % of them with a health deterioration in a period of one year before. Moreover, the results stated that 23.6 % of them experienced emergency services utilization, 92.1 % of them experienced outpatient services utilization, and the related factors were live alone, economical satisfaction, inhabited area, self-rank of healthy status, diseases, and ability of walking. Our study states the majority health problems in very elderly population of Taiwan and the related factors of their behaviors of medical services utilization. Our results maybe render policy-makers or researchers a reference to ensure very elderly population a good quality of medical services utilization and life.