探討中風對台灣地區中老年人身心健康狀況及醫療服務利用之影響

Influence of stroke history on physical and mental health and health care utilization of the middle-aged and elderly population in Taiwan

王思涵(Su-Han Wang)

指導教授 ： 王俊毅

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2010年)

摘要

目的：中風是造成中老年人身心障礙的主因。本研究目的在探討中風狀態對中老年人身心健康狀況及醫療服務利用之影響。方法：分析國健局「中老年身心社會生活狀況長期追蹤調查」1999年及 2003年之訪談資料，研究對象依中風狀態分為「無中風病史組」3207人、「新發病個案組」170人及「既有中風病史組」109人。結果：中老年人隨著年齡增長，身心健康功能下降、醫療服務利用增加。「新發病個案組」在罹患中風後，自覺健康、日常生活功能、工具性日常生活功能變差，社會團體參與變少，慢性病罹患率、輔具使用、急診及住院使用增加；且其變化趨勢皆明顯大於「無中風病史組」。「既有中風病史組」因長期罹患中風，僅慢性病罹患率、輔具使用和接受健康檢查等項目之變化趨勢大於「無中風病史組」。結論：老化對於中老年人健康狀況有全面性的影響。中風狀態的改變，導致身體功能顯著下降，急性醫療利用需求增加。本研究以縱貫性分析中風狀態對於中老年身心健康狀況及醫療服務利用之影響，結果可對於政府在社會醫療福利措施和中風患者照護資源等政策規劃上，提供實質且重要的參考依據。

關鍵字

長期追蹤調查；中風；健康狀況；醫療服務利用

並列摘要

Purpose: Stroke is one of the main causes of elderly disability in physical and mental health. The aim of this study is to investigate the influence of stroke history on physical and mental health and health care utilization of the middle-aged and elderly adults. Methods: The data come from a follow-up of the Survey of Health and Living Status of the Elderly in Taiwan. Based on the responses of stroke history reported in 1999 and 2003, subjects were grouped into ‘no stroke’ (n=3207), ‘onset of stroke’ (n=170) and ‘had stroke history’ (n=109). Results: Physical and mental health of middle-aged and elderly people got worse and utilization of health care increased along with increased age. Subjects in the ‘onset of stroke’ group showed worse self-evaluated health, ADL and IADL, less social activities, increased chronic diseases, increased usage of aids, and increased utilization of emergency and hospitalized services. The differences were all apparently greater than those of ‘no stroke’ group. Besides, subjects in the ‘had stroke history’ group showed significantly increased chronic diseases, increased usage of aids and decreased utilization of physical examination by comparing with the ‘no stroke’ group. Conclusion: Aging thoroughly affects health of middle-aged and elderly adults. The study investigates the influence of stroke history on health and health care utilization of the middle-aged and elderly adults by using longitudinal data analysis methods. This study could offer substantial and important reference materials for planning social or medical welfare of stroke patients.

並列關鍵字

follow-up survey；health status； stroke； utilization of medical services

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