| Summary: | 碩士 === 亞洲大學 === 健康產業管理學系長期照護組 在職專班 === 99 === Background and Objective: Recent increase in life expectancy has led to increased care needs in Taiwan. At the same time, the change in family structure has aggravated care needs. To relieve the demand, policy makers have established new types of care and have allowed the introduction of foreign carers to enter the country. Thus, today there are several types of care ranging from part time in-home assistance to institutional full-time care available. This study aimed to investigate the factors that impact the use of care services by elderly Taiwanese.
Methods: This study analyzed the 2007 data of the original cohort of the "Survey of Health and Living Status of the Elderly in Taiwan". All subjects were 78 years-old or older. Binary logistic regression analysis was used to determine the factors impacting long-term care use. Statistical significance was accepted at alpha=0.05.
Results: Of 1268 elderly, 24 used home visits, 109 used private carer, and 92 used institutional care during the past year. Old age was the only significant variable associated with use of home visit. Mild or moderate ADL (Activities of Daily Living) impairment (OR=3.16, 95%CI=0.96-10.48, p=0.06) was close to be significantly associated with increased use of home-visits. ADL impairment (mild or moderate impairment =7.59, 3.94-14.61, p<0.001 and severe/very severe impairment=14.23, 6.18-32.8, p<0.001) was associated with the major variable associated with increased use of private home-care. Old age, being female, more years of education, having ≥3 children, and have a spouse were also associated with increased likelihood home care use. ADL impairment was also the major predictor of institutionalization. Being male, having ≤ 2 children, no spouse, later immigrants, hospitalization, incontinence, low social support, being the main source of family income were also significant predictors of institutionalization.
Conclusion: "ADL status" is the main determinant of care service use. The more the dependency is, the greater the likelihood in using a more comprehensive care service. Results suggest that preventing ADL impairment is the key to delay the onset of care use.
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