影響高齡者生活獨立能力之多層次分析

A Multilevel Analysis of the Determinants on Life Independence of the Elderly

本文從「身體健康」、「社會健康」、「心理健康」及「經濟安全」等四個面向，建立衡量高齡者晚年生活獨立能力之指標，並以此一指標得分建立多層線性模型，瞭解台灣地區高齡者之獨立能力是否存在縣市差異。結果在指標方面，台灣多數縣市之高齡者之平均獨立能力並不佳，尤其以台東縣高齡者之平均獨立能力更顯弱勢。在多層線性模型檢定方面，零模型顯示65歲以上高齡者存在顯著的群體差異，表示高齡者平均獨立能力存在縣市差異。以平均數為結果的迴歸模型顯示，都市計畫區內人口密度為顯著、正向變數，表示愈都市化地區，高齡者之獨立能力愈佳。最後，完整模型顯示，個體因素的隨機係數並不存在縣市差異。雖然總體因素在模型的固定效果係數並不顯著，但隨機效果卻顯示為顯著有差異，表示高齡者之獨立能力仍存在縣市平均差異，只是仍有解釋變數未被本文所採用。合理判斷其原因，乃資料階層受限於縣市層級，因而使其結果受到限制。

The 'physical health,' 'social health,' 'psychological health,' and 'economic security' (financial resources) were included in this research. The purpose was to develop the independent indices for the elderly, and to understand independent variations in the different areas for the elderly. The methodologies in this study were employed 'normalized standard Z scores' and 'hierarchical linear modeling'. The data in this study were drawn from the '2007 Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan Survey'. The findings of this research show that there are variations existed in life independence of the elderly between different areas. The elders in urban area have better ability to live independently. According to the random effects, we found out that the independence of the elderly significantly vary across different areas. However, some important variables were not able to be considered in this research because the second hand data could not expose more detail information. In the future, the resources availability constrained the generalization of this research. More details about environment determinants could be disclosed if adequate local areas information is available.