建立臺灣地區成功老化地區層次評估指標

Constructing the Community-Level Successful Aging Indicators for the Local Government in Taiwan

蔡瓊儀(tsai chiung yi)

指導教授 ： 徐慧娟

亞洲大學/健康學院/健康管理研究所/碩士(2007年)

摘要

背景：成功老化為老年人健康重要課題，而目前國內仍缺乏適宜 地區層次之成功老化情形評估工具，評估工具之建立將有助於地區級 政府單位發展協助老年人優化健康之政策。 目的：本研究目的在於了解成功老化之地區層次的內涵，建立地 區層次之評估指標，並評估各縣市之成功老化情形。 方法：利用修正式德菲法針對公共衛生、社會工作、健康促進、 人口老化等領域之八名專家學者進行三次德菲法問卷調查，篩選適宜 成功老化地區層次之評估指標，並利用層級分析評量各面向之重要程 度，最後以具縣市代表性之資料分析各縣市成功老化現況。 結果：以德菲法暨層級分析結果，共得出成功老化之地區層次評 估指標包含六個面向、六十五個指標。評估面向中以屬於內在因素的 「健康狀態」最為重要，衡量老年人口健康表現；其他五面向重要性 依序為「生活型態」：衡量老年人口之健康行為；「健康照護資源及 利用」：衡量照護資源之充足性；「社會參與」：呈現地區可提供之 老年人參與之社會資源；而「社會環境」：表現促進健康之硬體建設； 「自然環境」的重要性則居末。以現有資料庫顯示，低都市化程度城 市、中南部城市、人口老化程度較高的城市，皆較其他城市接近成功 老化。其中苗栗縣老人健康狀態最佳，臺北市、高雄市老人之生活型 態較好，嘉義市擁有最充足的健康照護資源及利用，雲林縣老人對社 會參與最踴躍、臺南縣有最能促進成功老化的社會環境，自然環境則 以基隆市最佳 結論：健康狀態及生活型態屬於成功老化地區層次的內在因素， 而健康照護資源及利用、社會參與、社會環境、自然環境屬於外在因 素，且內在因素較外在因素重要。建議政策應首先促進健康狀態與生 活型態，長期則應透過制度改革與社會教育改善外在因素。

關鍵字

成功老化、地區層次、研究指標、德菲法、衛生政策

並列摘要

Objective: Successful aging is an important topic in elderly health. However,
appropriate community-level indicators for assessing successful aging are unavailable.
To construct area-level indicators of successful aging will be useful for the local
government to develop policies to optimize the health of the elderly.
Methods: Initial community-level successful aging indicators were selected from
literature review, and then the modified Delphi method was used to select the
appropriate dimension and responding indicators. Three interviews of eight experts,
who were from the field of public health, social work, health improvement and
demography, were conducted. The analytic hierarchy process (AHP) was used to
recognize the relative importance of each dimension and thus to get the weights. And
next, according to the indicators, this study used the data from Nation Health
Interview Survey, 2002, as well as other government statistics to describe the current
successful aging status for all the counties/cities in Taiwan.
Results: The community-level successful aging was constructed of six
dimensions and measured by sixty-five indicators. The most importance dimension is
“health status” for evaluating the elder health. The other five dimensions included
“life style” for assessing the elder health behaviors; “health care resources and
utilization” as the adequacy of health care resources; “social participation”
representing local social support resources for elderly participation; “social
environment” indicating the public infrastructure of health promotion, and “natural
environment” as the ecological environment. The data showed that the cities of the
less urbanization, located middle or southern Taiwan, or higher aging population
proportion were more likely to be successful aging. Among the cities, the elderly in
Miaoli County showed the best health status. The elderly in Taipei City and
Kaohsiung City had better life style. Chiayi City owned the most sufficient health care
resources and more utilization. The elderly living in Yunlin County participated in the
social activity the most. The best social environment for successful aging was in
Tainan County, while the best natural environment was in Keelung City.
Conclusions: Health status and life style can be seen as internal factors of
successful aging; meanwhile, health care resources and utilization, social participation,
social environment and natural environment are attributes of external factors. Internal
factors are more important than external factors. We suggest that the short-term and
immediate policies for promoting successful aging should focus on health status and
life style. In the long run, the local governments should improve the external factors
through revolution of the system and social education.

並列關鍵字

successful aging, community level, indicators, Delphi method, health policy.

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