台灣老人健康狀況初探：1989年至1999年

Preliminary Study of Elderly Health Status in Taiwan: 1989-1999

陳惠真(Hui-Jen Chen) ； 王香蘋(Hsiang-Ping Wang)

《台灣家庭醫學雜誌》 15卷1期 (2005/03) Pp. 25-35

https://doi.org/10.7023/TJFM.200503.0025

摘要

本文嘗試由老人的罹病特性、健康自評、功能狀態與死因的探討，釐清老年健康狀況的性別差異，探討影響健康變化的因素。本研究主要使用衛生署國民健康局（原家庭計畫研究所）1989年、1993年、1996年與1999年的「老人保健調查」。同時因該資料無法提供歷次調查死亡樣本之死亡原因，轉而使用1993-1999年「台灣地區死亡統計」資料，以了解老人的死亡原因。研究發現關節炎、高血壓、腸胃潰瘍、呼吸道疾病、白內障、以及心臟病，是老人罹患率最高的疾病。而疾病與失能之間的關係除了疾病類型之外，年齡是另一個重要的因素。就相同的活動功能，男性老人自評健康為「好」的比率高於女性，而男性自評健康為「不好」的比率則低於女性。其次，自評「不好」的比率隨著年齡增加而增加，自評為「好」的比率則隨著年齡的增加而減少。另外，活動功能愈佳者，自評健康狀況愈好。男性的死因分佈較為平均，沒有特別突出的死亡原因，女性則大幅集中在糖尿病、未提及精神病的老衰、及腦血管疾病等前三種死因。至於整體活動轉變，男性老人的各種變動性都超過女性老人。
當前健保研擬疾病之醫療給付，部分採論質支付方式，本文研究結果正可在慢性病況提供參考。

並列摘要

In this study, I first review the mortality change, elderly population, and the trend of feminization of later life in Taiwan. Secondly, different measures of health status, disease morbidity, and quality of life are used to analyze the gender differences of health status among the elderly in Taiwan, and to discuss the effects of factors which influence health change.
Using the data from the Survey of Health and Living Status of the Elderly in Taiwan published by Taiwan Bureau of Health Promotion, we investigate the patterns of diseases, functional status, self-rated health, and the casual relationships among them. In addition, Death Statistics of the Taiwan area and the Surveys on the Elder's Status published by the Department of Health are used to analyze the incidences of death.
The results from my analyses of these data suggest that both elderly men and women have the same pattern of disease: arthritis, hypertension, G-I peptic ulcer, respiratory disease, cataract, and heart disease. Other findings indicate that the association among disease pattern and functional status for men are much stronger than that for women. We also notice that diabetes mellitus, senility without mention of psychosis, and cerebrovascular disease are the main causes of death for women.

並列關鍵字

elderly ； self-rated ； functional status ； chronic condition ； death cause

參考文獻

王香蘋(1999)。死亡率與罹病類型差異：老年女性健康問題之探討。婦女與兩性學刊。129-150。

(2001)。中正大學。

Anderson RT,James MK,Miller ME,Worley AS,Longino CF(1998).The Timing of change: patterns in transitions in functional status among elderly persons.J Gerontol B Psychol Sci Soc Sci.53(1),17-27.

Beland F,Zunzunegui M(1999).Predictors of functional status in older people living at home.Age Ageing.28,153-159.

Dunlop DD,Hughes SE,Manhem LM(1997).Disability in activities of daily living: patterns of change and a hierarchy of disability.Am J Public Health.87,378-383.