Changes in lifestyle behaviors may effectively maintain or improve the health status of individuals with chronic diseases. However, such health behaviors adopted by individuals are unlikely to demonstrate similar patterns. This study analyzed the relationship between the heterogeneous latent classes of health behavior and health statuses among middle-aged and older adults with hypertension, diabetes, or hyperlipidemia in Taiwan. After selecting 2103 individuals from the 2005 and 2009 Taiwan National Health Interview Survey (NHIS), we first identified heterogeneous groups of health behaviors through latent class analysis (LCA). We further explored the relationship between each latent class of health behavior and health status through ordered logit regression. We identified the following five distinct health behavior classes: the all-controlled, exercise and relaxation, healthy diet and reduced smoking or drinking, healthy diet, and least-controlled classes. Regression results indicated that individuals in classes other than the all-controlled class all reported poor health statuses. We also found great magnitude of the coefficient estimates for individuals who reported their health status to be poor or very poor for the least-controlled class. Therefore, health authorities and medical providers may develop targeted policies and interventions that address multiple modifiable health behaviors in each distinct latent class of health behavior.

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Our simulations demonstrate that increasing the number of physicians in medium-sized cities (such as capitals of counties or provinces), and/or improving the transportation time between medium-sized cities and rural areas, could be feasible solutions to mitigate the problem of geographical maldistribution of physicians.

Summary Objectives Patients in Taiwan's National Health Insurance (NHI) program can choose a medical care facility of any tier for outpatient visits, without a referral. However, this system results in high medical expenditures and costs of outpatient visits. In this study, patients who had only minor diseases but who accessed high‐tier medical care facilities were investigated using classification and regression trees. Methods For this study, data were obtained from the Taiwan NHI Research Database. First, 280 diseases, coded according to the Clinical Classification Software (CCS), were examined to determine whether patients chose the most appropriate facility when seeking medical care. After controlling for the CCS codes, an investigation into the types of patients who visit high‐tier medical care facilities was conducted. Results Chronic disease status and CCS code were critical for constructing the classification trees. Male patients living in urban areas and earning a higher income were more likely to access high‐tier medical care facilities. However, changes to the NHI copayment policies have significantly reduced the probability of utilizing high‐tier medical care facilities. Conclusions Factors relevant to patients' selection of high‐tier medical care facilities were identified. Overall, increasing patients' out‐of‐pocket payments significantly reduced the probability of accessing high‐tier medical facilities.