台灣社區老年人使用健康檢查的相關因子──2009年國民健康訪問暨藥物濫用調查

Factors Associated With the Utilization of Health Examinations by Community-Dwelling Elderly Taiwanese: An Analysis of the 2009 National Health Interview Survey

目的：健康檢查能藉早期診斷疾病以提早治療及延緩疾病的惡化，然而台灣老年人健康檢查的使用率偏低，因此，本研究旨在探討影響台灣社區老年人健康檢查行為之相關因子。方法：本研究採安德遜（Andersen）醫療服務行為模式為理論架構，分析2009年「國民健康訪問暨藥物濫用調查」資料檔，以羅吉斯迴歸模型探討65歲以上受訪者過去一年間是否曾接受健康檢查與傾向因素、使能因素、需求因素與健康行為的關聯。結果：經加權處理的有效樣本2,399名受訪者中，過去一年間有使用健康檢查者共759人（31.6％）。在過去一年中曾有健康檢查之顯著獨因子包括13項獨立因子，包括族群屬外省或其它、教育程度為國小或以上、與配偶同住、有家族病史、醫療利用習慣為看西醫或中醫、個人月所得為一萬元或以上、行動能力沒有或有些困難、有聯絡朋友、有定期參加社區活動、現居地行政區層別為鄉或鎮、患有慢性疾病、過去兩週有運動及沒有嚼檳榔。結論：台灣老年人健康檢查行為與多項因素呈顯著獨立關聯，本研究之結果可作為日後醫護人員計畫社區老年人健康檢查策略之參考。

Purposes: Health examinations, through the early diagnosis of disease, may delay disease progression with the initiation of early treatment; however, health examinations are underutilized by elderly Taiwanese. The aim of this study was to determine the factors associated with the utilization of health examinations by community-dwelling elderly people in Taiwan. Methods: We used Andersen’s Behavioral Model of Health Services as a framework in this study and analyzed the data from Taiwan’s 2009 National Health Interview Survey. The predisposing factors, enabling factors, need factors, and health behavioral factors associated with the utilization of health examinations within the previous year in respondents aged 65 and older were analyzed using logistic regression analyses. Results: Of the 2,399 respondents (sampling weight-adjusted), 759 (31.6%) had received a health examination within the previous year. The 13 significant independent factors associated with the utilization of health examinations within the previous year included ethnic background of mainlander or other, educational level of elementary school or above, living with a spouse, family history of diseases, habit of using Western or traditional Chinese medicine, personal monthly income of 10,000 New Taiwan dollar or above, no or little difficulty with mobility, connections with friends, regular participation in community activities, living in villages or towns, afflicted with chronic diseases, engaged in exercise during the previous two weeks, and no habit of betel nut chewing. Conclusions: A number of factors were significantly and independently associated with the utilization of health examinations by elderly Taiwanese. Findings from this study can serve as a basis for healthcare practitioners in planning preventive strategies for communitydwelling elderly people in Taiwan.