台灣地區老人身心健康狀況對醫療服務利用之研究

The Study of Physical and Mental Health Status on Medical Services Utilization among the Elderly in Taiwan

張梅瑛(Mei-Ying Chang)

指導教授 ： 徐尚為

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2009年)

摘要

本研究主要目的在探討台灣地區老人身心健康狀況對醫療服務利用的相關因素，資料來源為行政院衛生署國民健康局民國94年「國民健康訪問調查」資料，採計65歲以上共2‚725人為研究對象。參考Andersen的健康行為模式，以描述性、卡方檢定及邏輯斯迴歸統計進行分析。
本研究結果發現，老人身體健康變項的自評目前健康狀況顯著影響急診、住院及西醫門診服務利用；慢性疾病數顯著影響所有醫療服務利用；IADLs顯著影響急診及住院服務利用；心理健康變項的CES-D顯著影響急診及住院服務利用；MMSE顯著影響牙醫、西醫及中醫門診服務利用。
建議未來研究，可以採用縱貫性研究方式，進一步探討憂鬱傾向與急診及住院醫療服務利用之間的相關因素。

關鍵字

老人 ； 身體健康 ； 心理健康 ； 醫療服務利用

並列摘要

The main purpose of this study was to investigate the influence factors about physical and mental health status on medical services utilization among the elderly people in Taiwan. The interview result of 2,725 people, age over 65, from the 2005 National Health Interview Survey, were obtained from the National Health Research Institute and analyzed.The Andersen's health behavior model was used to explore the relation between the physical and mental health status of study population and medical utilization.
The results of this study show that the service utilization of the emergency,in-patient and Western medicine out-patient are statistically significant related to the level of self-rated health of study samples. Numbers of chronic diseases of study population has significant influence on all kinds of medical service utilization. The score of IADLs of sample has significant affect on the emergency and inpatient service utilization. The CES-D scale has notable affect on the emergency and in-patient service utilization. The service utilization of the dentists, Western medicine and traditional Chinese medicine out-patient are statistically significant related to the MMSE score of the study population.
A longitudinal study design to explore the relevant factors on the tendency of depression with the emergency and inpatient medical service utilization is suggested for the future study.

並列關鍵字

elderly ； physical health ； mental health ； medical services utilization

參考文獻

Lan, T.Y., Chang, H.Y., & Chen, C.Y. (2007) .Physical functioning and health care costs in an older population in Taiwan. Taiwan J Public Health, 26(6):482-490.

Lan, T. Y. (2003). Population aging in Taiwan: future health implications. Taiwan J Public Health, 22(3), 237-244.

林怡君、余豎文、張宏哲(2004)‧新店地區機構和非機構老人憂鬱情形及相關因素之調查‧台灣家醫誌，14，81-9。

行政院衛生署‧http://www.doh.gov.tw/

羅紀瓊(1992)‧勞保中醫醫療利用‧行政院衛生署研究計劃。