Utilization of health care services by elderly people with National Health Insurance in Taiwan: The heterogeneous health profile approach

Liu, Li Fan; Tian, Wei Hua; Yao, Hui

doi:10.1016/j.healthpol.2012.08.022

Cited by 41 publications

(42 citation statements)

References 23 publications

(34 reference statements)

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“…It may be that in Taiwan, living in urban areas with more healthcare resources (e.g., hospitals and medical clinics), compared with living in rural areas, made it easier to express health care needs. In general, previous research indicated the relationship of socioeconomic status to health [19]. Some also showed the relationship of income to health, after controlling for the factor of education [41,42,43].…”

Section: Socio-demographic and Economic Determinants Of Health Hetmentioning

confidence: 99%

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The Health Heterogeneity of and Health Care Utilization by the Elderly in Taiwan

Liu

2014

IJERPH

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A good understanding of the health heterogeneity of elderly people, their characteristics, patterns of health care utilization and subsequent expenditures is necessary to adequately evaluate the policy options and interventions aimed at improving quality and efficiency of care for older people. This article reviews studies that used Latent Class Analysis to identify four health profiles among elderly people in Taiwan: High Comorbidity (HC), Functional Impairment (FI), Frail (FR), and Relatively Healthy (RH). Variables associated with increased likelihood of being in the FR group were older age, female gender, and living with one’s family, and these also correlated with ethnicity and level of education. The HC group tended to use more ambulatory care services compared with those in the RH group. The HC group tended to be younger, better educated, and was more likely to live in urban areas than were people in the FI group. The FI group, apart from age and gender, was less likely be of Hakka ethnicity and more likely to live with others than were individuals in the RH group. The FI group had relatively high probabilities of needing assistance, and the FR group had higher healthcare expenditures. A person-centered approach would better satisfy current healthcare needs of elderly people and help forecast future expenditures.

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Section: Socio-demographic and Economic Determinants Of Health Hetmentioning

confidence: 99%

“…The effects of health heterogeneity on the utilization of healthcare services were explored in Taiwan [19]. The effect was significant for both the likelihood of utilization and its cost (Figure 2).…”

Section: The Effect Of Health Profiles On Utilization Of Health Camentioning

confidence: 99%

The Health Heterogeneity of and Health Care Utilization by the Elderly in Taiwan

Liu

2014

IJERPH

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“…The China Statistical Bureau reports that 88 million people in China were over 65 years old in the year 2000, accounting for 7.0 % of the total population, meaning that China has become an aging country [4]. Many researchers have worked on the demands and utilization of health services [5], the equity of health services [3], and Fall risk-increasing drugs and falls [6] by the elderly. Older adults are more likely to suffer from disease and need hospitalization more urgently [5, 7], resulting in a larger increase of both direct and indirect medical care costs [3].…”

Section: Introductionmentioning

confidence: 99%

“…Many researchers have worked on the demands and utilization of health services [5], the equity of health services [3], and Fall risk-increasing drugs and falls [6] by the elderly. Older adults are more likely to suffer from disease and need hospitalization more urgently [5, 7], resulting in a larger increase of both direct and indirect medical care costs [3]. Most nations have established medical insurance schemes to reduce high medical expenses for individuals.…”

Section: Introductionmentioning

confidence: 99%

Elderly hospitalization and the New-type Rural Cooperative Medical Scheme (NCMS) in China: multi-stage cross-sectional surveys of Jiangxi province

Pan

Yuan

Zou

et al. 2016

BMC Health Serv Res

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BackgroundStudies assessing the impacts of China’s New-type Rural Cooperative Medical Scheme (NCMS) reform of 2003 among rural elderly have been limited.MethodMultistage stratified cluster sampling household surveys of 1838, 1924, 1879, 1888, 1890 and 1896 households from 27 villages in Jiangxi province were conducted in 2003/2004, 2006, 2008, 2010, 2012 and 2014. Data from older adults age 65 and above were analyzed. Weighted logistic regression was applied to find factors of elderly hospitalization services.ResultsSince 2003, hospitalization rates for elderly increased, while rates of patients leaving against medical advice and patients avoiding the hospital decreased (P < 0.05). Factors associated with a higher likelihood of reporting hospitalization in the past year for elderly were the per-capita financial level V in 2012 for NCMS (Adjusted Odds Ratios [aOR]: 2.295), the level VI in 2014 (aOR: 3.045) versus the level I in 2003 and chronic disease (aOR: 2.089) versus not having a chronic disease. Lower rate of elderly left against medical advice was associated with the financial level V in 2012 (aOR: 0.099) versus the level I. The higher rate of hospital avoidance was associated with chronic disease status (aOR: 5.759) versus not having a chronic disease, while the lower rate was associated with the financial level VI in 2014 (aOR: 0.143) versus the level I. Among reporting reasons for elderly hospital avoidance, the cost-related reasons just dropped slightly over the years.ConclusionsNCMS improved access to health services for older adults. The utilization of hospitalization services for rural elderly increased gradually, but cost-related barriers remained the primary reporting barrier to accessing hospitalization services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1638-5) contains supplementary material, which is available to authorized users.

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“…While this result was consistent with the findings of several previous studies, [12][13][14][15] some other studies reported conflicting results. [16][17][18][19] We found significant difference between years in terms of use of home health care services. In all age groups, 2015 was the most efficient year, because there was an increase in the use of home health care services in all age groups in this period.…”

Section: Discussionmentioning

confidence: 70%

Analyzes of health profiles of patients receiving home health care services over last five years in Diyarbakir, Turkey

Gümüş

Sarıbaş

2016

JHA

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Objective: To determine the health profiles of patients who have been delivered home health care services by public hospitals in over the last five years. Methods: Data which were recorded by the Ministry of Health and the Diyarbakır Directorate of Health Services had been provided from 1,826 patients from three city center and five district hospitals located in Diyarbakir, Turkey. Results: Of 1,826 patients, 989 (54%) were female and 837 (46%) were male. The patients were divided into three age groups: 0-18 years 467 (25%), 19-64 years 511 (28%) and +65 years 848 (47%). There were more female patients in +65 age group and male in 0-18 age group (χ 2 = 89.923, p < .001). In 2015, there was an increase in the number of people who received services in all age groups (χ 2 = 164.344, p < .001). It was found that neurodegenerative diseases were more widespread in +65 age group (χ 2 = 44.823, p < .001). Neurogenetic dieases were more seen in the 0-18 age group (χ 2 = 97.800, p < .001). In the +65 age group, musculoskeletal (χ 2 = 16.037, p < .001) and respiratory diseases (χ 2 = 6.054, p < .05) were detected to be more widespread. There were no significant sex-based differences between the years involved (χ 2 = 2.246, p > .05). Neurodegenerative diseases (χ 2 = 4.07, p < .05), neurogenetic diseases (χ 2 = 6.043, p < .05) and respiratory diseases (χ 2 = 5.254, p < .05) were determined to be more widespread in male patients. Musculoskeletal (χ 2 = 17.943, p < .001)and cardiovascular diseases (χ 2 = 11.994, p < .001) were seen more in female groups. Conclusions: Over the last five years, there has been an increase in the utilization of home health care services. Policy legislation for health care services to be provided at home is generating succesful results.

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Utilization of health care services by elderly people with National Health Insurance in Taiwan: The heterogeneous health profile approach

Cited by 41 publications

References 23 publications

The Health Heterogeneity of and Health Care Utilization by the Elderly in Taiwan

The Health Heterogeneity of and Health Care Utilization by the Elderly in Taiwan

Elderly hospitalization and the New-type Rural Cooperative Medical Scheme (NCMS) in China: multi-stage cross-sectional surveys of Jiangxi province

Analyzes of health profiles of patients receiving home health care services over last five years in Diyarbakir, Turkey

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