Physical Functioning and Health Care Costs in an Older Population in Taiwan

台灣老年人活動功能與健康照護費用之關係

10.6288/TJPH2007-26-06-05

藍祚運(Tzuo-Yun Lan)；張新儀(Hsing-Yi Chang)；陳慶餘(Ching-Yu Chen)

活動功能 ； 健康照護費用 ； 老年人 ； functional status ； health care costs ； elderly

台灣公共衛生雜誌

26卷6期（2007 / 12 / 01）

482 - 490

英文

目標：過去對於老年人活動功能與醫療服務利用的研究侷限於使用較早期的調查資料、地區性人口、女性，或僅使用日常生活活動功能(ADLs)為功能狀況的測量，且很少有美國之外其他國家的研究資料。我們希望利用台灣的近期健康調查資料，重新檢視老年人功能狀況對健康照護使用的影響。方法：分析2001年「國民健康訪問調查」資料，2,243名60歲以上樣本納入分析。以六項ADLs及九項身體活動的問題測量活動功能。並與全民健保資料庫連結以獲取醫療服務利用資料。統計上利用線性複迴歸分析活動功能與健康照護費用間之關係。結果：分析結果中觀察到功能狀況與照護成本間呈現出清楚的線性關係，且小部份功能嚴重衰退的人耗用了大部分的費用。經過複迴歸模式分析，控制其他相關因素後仍顯示功能狀況與健康照護費用間有顯著的相關性。結論：本研究以台灣本土之全國性調查資料進行分析後，證實老年人活動功能對健康照護的使用有獨立且重要的影響。此研究結果與其他相關研究的發現一致。

Objectives: Past research involving functional problems and medical utilization has been limited to earlier surveys, local people, women, or use of Activities of Daily Living (ADLs) as the only measure of functional status, and is rarely investigated in non-US countries. We sought to re-examine the effect of functional status on health care utilization in the elderly, using a recent health survey conducted in Taiwan. Methods: 2,243 community-dwelling residents 60 years of age and older in the 2001 National Health Interview Survey (NHIS) in Taiwan were analyzed. Physical function was assessed using six ADLs questions and nine questions involving mobility tasks. The NHIS data were merged with the National Health Insurance claim data. Multiple linear regression was used to model the relationship between functional status and health care costs. Results: A clear gradient relationship between functional status and expenses was observed, with a small proportion of people with declining function responsible for a large proportion of the expenses. Functional status was independently associated with health care expenditures in the multiple regression model. Conclusions: Results from this more recent, non-US, nationwide research support the notion that functional status has an independent contribution to total healthcare expenditures in the elderly across countries.

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