健康壓縮或擴張？─1993-2003年台灣老人健康變化情形

Health Compression or Expansion? Changes in the Health Status of Taiwan’s Elderly in 1993 and 2003

陳思綺(Sz-Chi Chen)

指導教授 ： 林文德

長榮大學/健康科學學院/醫務管理學研究所/碩士(2009年)

摘要

目的
以罹病狀況、自評健康及失能狀況探討1993年及2003年台灣老人健康狀態的變化，以瞭解老人在平均餘命延長下，對於不同健康狀況下與平均餘命之關係及其變化情形，並且交叉檢視不同健康測量指標反映健康餘命之結果是否不同。
材料與方法
本研究為回溯性之縱貫研究，利用國民健康局1993年「台灣地區老人保健與生活問題調查」及2003年「台灣地區中老年人身心社會生活狀況長期追蹤調查」中，年齡65歲以上之受訪者為樣本（分別為2,962位及2,751位）。健康狀況以疾病狀況（分別以完全無疾病或無重大疾病判定疾病狀況）自評健康、及失能狀況（分別以日常生活功能及工具性日常生活功能來判定失能狀況）加以測量，而年齡層以五歲為差距分為五層，並以Sullivan生命表方法計算各年齡層的健康餘命（healthy life expectancy），最後以健康餘命佔平均餘命之比例評估老人之健康究為壓縮或擴張。
結果
1993年及2003年台灣65歲以上老人健康測量結果發現，如以罹病狀況及自評健康測量健康狀況，各年齡層老人之健康餘命呈下降情形，且佔平均餘命之比例下降幅度增加，如以日常生活功能測量健康狀況，則各年齡層之健康餘命稍有增加，但佔平均餘命之比例上升幅度減少。
結論
以罹病狀況、自評健康測量結果發現1993年及2003年台灣65歲以上老人健康狀況呈現健康壓縮；以功能測量方面，工具性日常生活測量結果呈現無擴張亦無壓縮現象。以加權失能盛行率計算健康餘命其結果較一般盛行率計算結果較於為穩定。

關鍵字

健康餘命 ； 老年人口

並列摘要

Purpose
The purpose of this study is to review the diseases, self-perceived health and dysfunction statuses of Taiwan’s elderly in 1993 and 2003 as well as to understand the relationship between health status and average life expectancy after the expanded life expectancy enjoyed by the elderly in Taiwan. This study also cross-examines the influence of different health measurement indicators on healthy life expectancy.

Material and Method
This study is a retrospective longitudinal study and uses the “Survey of the Health and Living Status of the Elderly in Taiwan” and the “Survey Report of the Health and Living Status of the Middle-aged and Elderly in Taiwan” published by the Bureau of National Health Promotion in 1993 and 2003, respectively, to interview subjects who were 65 years old and above (2,962 and 2,751 subjects, respectively, were interviewed). Their health status was measured through disease (determined by whether they suffer from disease or major ones), self-perceived health, and dysfunction (judged from daily activities and daily instrumental activities). There are five age intervals, which are divided into five year periods, in the present study. In addition, Sullivan’s Life Table is applied to calculate healthy life expectancy and in the end, the percentage of healthy life expectancy of the average life expectancy is used to evaluate the health compression or expansion of the elderly in Taiwan.

Results
The results of the health measurements of the elderly (those who were aged 65 and above) in Taiwan in 1993 and 2003 indicate that among each age group, their healthy life expectancy and the percentage of healthy life expectancy of the average life expectancy have been in a downward trend according to health measurements for disease and self-perceived health status. In terms of the measurement of daily activities, the healthy life expectancy of each age group has been in an upward trend and the percentage of healthy life expectancy of the average life expectancy has also increased.

Conclusion
The measurement results of disease and self-perceived health show health compression of the elderly in Taiwan in 1993 and 2003. The functional measurements through daily instrumental activities indicate neither health compression nor health expansion.

並列關鍵字

Healthy life expectancy ； the elderly population

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