The Relationship between the Preventive Care Service and the Medical Care Utilization among the Elderly

• Main Authors: LEE,PING-CHANG, 李秉璋
• Other Authors: CHEN, CHIN-SHYAN
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/84019336410248923974

碩士 === 國立臺北大學 === 經濟學系 === 98 === Since the inception of the National Health Insurance System in 1996, the bureau has been providing adult preventive care services, hoping to increase and maintain an individual’s health. Nevertheless, the usage rate was only around 40 percent. Furthermore, there are no other studies concerning subsequent medical utilization. Therefore, this research uses 「2001 National Health Interview Survey」and 「2001 & 2002 National Health Insurance Database」 which include 2,156 elderly aged beyond 65, to analyze the utilization of preventive care services in 2001 and medical utilization in 2002. The research uses logistic regression model to analyze the usage rate of preventive care services, and uses two-part model to analyze subsequent medical utilization. Logistic regression model is used in the analysis of whether or not an individual had received outpatient and inpatient care services. Negative binomial regression model is used to estimate the number of outpatient visits and length of stay in the hospital. Ordinary least squares regression model is used to analyze the medical expenditure. The study also uses instrumental variables in the regression in order to solve the endogeneity problem of medical utilization.The results show that the proportion utilizing preventive care services was only 31.03% which was quite low. There is a significantly positive likelihood of receiving preventive care services among those lived in the central and southern region. We also find that individuals aged 75 or more, have healthy status, have limitations in activities of daily living, do not exercise regularly, and smoked, there will tend to be a significantly lower likelihood of them using preventive care services. Moreover, individuals who use preventive care services tend to have higher probability of receiving outpatient service but lower length of stay during inpatient service. This indicates that serious illness can be detected and avoided in advance through preventive care services for the elderly.