基隆市居家老人健康服務利用行為及相關因素研究

Health Services Utilization Behavior and Associated Factors Among the Elderly in Keelung City

本研究是以問卷採面對面訪問法針對基隆市247名六十五歲以上居家老人進行調查，目的在瞭解其健康服務利用行為（含健康檢查與看病行為）及探討影響此二類行為之相關因素；研究結果發現（1）健康檢查行為方面：近半數（49.6%）的老年人不認同健康檢查之重要性；34.0%的老年人曾經做過健康檢查，但僅8.1%者會定期接受健康檢查；經逐步對數複迴歸分析發現「對健檢重要性看法」、「體能活動狀況」、「教育程度」為影響老年人健康檢查行為之主要因素；（2）看病行為方面：老年人之就醫行為趨於複向求診行為模式；最近一個月中因病或身體不適就醫之比率為30.4%，經分析後發現「保險狀況」、「自覺健康狀況」為影響此行為之主要因素；（3）影響老年人選擇健康檢查或看病地點之主要因素主要為離家近、收費、醫師與醫院環境因素。

The purpose of this study were to describe the utilization of health services, including health examination and physician visit, and to analyze the factors influencing the utilization among the elderly. A questionnaire was used to collect data. A total of two hundred and forty-seven elderly completed the face-to-face interview in the study. The results of this study showed as follows: (1) In health examination behavior, nearly half (49.6%) of the elderly did not agree with the importance of health examination. 34.0% of the subjects had taken health examination, but just only 8.1% of the subjects took it annually. According to stepwise logistic regression analysis, three variables (i.e., perception of the importance of health examination, physical activity status, and educational level) were the significant predictors on the older person’s health examination behavior. (2) In physician visit behavior, it tended toward the multidimensional model. 30.8% of the subjects had been seen a physician for illness in the past one month. Two variables, health insurance and health status, had significant relationships with the older person’s physician visit behavior. (3) Furthermore, four factors (i.e., distance-from home to the most regular medical care resource, cost, physician, and hospital environment) were related to the choice of the place where they could acquire health examination and medical care services.