| Summary: | 碩士 === 高雄醫學大學 === 公共衛生學研究所碩士班 === 93 === Objective—The major purpose of this study is three-fold: 1) to compare demographic characteristics, economic resources, mental and health status of elderly people with and without diabetes; 2) to describe long-term medical utilization among elderly people with and without diabetes; 3) to examine effective factors associated with medical utilization among elderly people with diabetes residing on community over three years.
Research Design and Methods—These over 65 elderly people was separated into diabetes group (143) and non-diabetes group (874) from San-Min, Kaohsioung. The survey data were collected by the CMFAQ in 1998 and the medical utilization was obtained from Bureau of National Health Insurance. Using Andersen’s behavioral model assessed the predictable factors of medical utilization for individuals with diabetes over 65 years from San-Min community.
Results—The utilization of outpatient for individuals with diabetes was higher than those without diabetes. The utilization of inpatient for individuals with diabetes also was higher than those without diabetes. Generally, the diabetes was an important effective factor that affected outpatient charges, length of stay, and inpatient charges.
Marital status, having extra money for shopping, numbers of chronic diseases and previous medical utilization of outpatient services were significant associated with the health care expenditures of outpatient. The activities of daily living, numbers of complications and co-morbidities and previous medical utilization were significant associated with the length of stay. The numbers of complications and co-morbidities and previous medical utilization were significant associated with the health care expenditures of inpatient. Using the same model, we were able to explain more variation in medical utilization in 1998, and marital status, having extra money for shopping, numbers of chronic diseases and previous medical utilization of outpatient services were long-term predictable factors of health care expenditures of outpatient; the numbers of complications and co-morbidities were the long-term predictable factors for health care expenditures of inpatient. According to the medical utilization, after a replacement for numbers of complications and co-morbidities, having extra money for shopping, numbers of chronic diseases, and previous clinical visiting were associated with health expenditures of outpatient; on the other hand, numbers of complications and co-morbidities also were associated with length of stay and health expenditures of inpatient.
Conclusion— Overall, medical utilization of elderly people with diabetes was higher than non-diabetes. Marital status, having extra money for shopping, numbers of chronic diseases and previous medical utilization of outpatient services were significantly associated with the health care expenditures of outpatient; the numbers of complications and co-morbidities were significantly associated with the medical utilization of inpatient. Therefore, health care program should obtain the predisposibling, enabling, and need factors in order to picture a comprehensive medical service for diabetes.
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