The Relations of Health Behavior and Medical Services Utilization among the Hypertension of the Elderly in Taiwan

[[abstract]]The purpose of this study is to investigate the relationship between the medical service utilization and health behaviors, including health promoting behaviors and health risk behaviors, among elderly people with hypertension. This study conducted the National Health Interview Survey Database provided by the Bureau of Health Promotion (BHP), National Health Research Institutes (NHRI), and Food and Drug Administration (FDA). In 2005, the third wave investigation, the participants in National Health Interview survey (over 65 years old questionnaire of personal data files) and of these potential participants, provided their consent for data linkage to 2005 National Health Insurance claims database. This study used SPSS 12.0 version for statistical analyses. Regarding the study purpose, we converted the original questionnaires items related to health promoting behaviors and health risk behaviors into simply scaling items. This study firstly involved a descriptive analysis of the relative variables. Lastly, multivariate regression analysis was used to examine influencing factors on the relationship between the medical utilization and health promoting behaviors and health risk behaviors. The results showed: (1) Regarding health promoting behaviors among the elderly people with hypertension in Taiwan, the proportion of the absence of health promoting behavior, only one kind of, two kinds of, three kinds of, and four health promoting behaviors were15.3%, 29.7%, 34.7%, 17.2%, 3.2%, respectively. In the meantime, the proportion of behavior in the absence of health hazard, one kind of, two kind of, and three health risk behavior rates were 61.1%, 21%, 14%, 3.9%, respectively. Therefore, the majority of elderly people with hypertension have the implementation of health-promoting behaviors, while less like in health risk behaviors. (2) The use of outpatient and inpatient medical care utilization rates were 63.8%, 13%, which meant the elderly preferred the outpatient medical service. The average visits of the doctor office were 20.3 times, the average cost of outpatient was NT 22,183 dollars, and the average length of stay were 3 days, which the average hospitalization cost was NT 17,844 dollars. (3) The factors related to health promotion behaviors were gender, education, and urbanization. The characteristics of patients with promotion behavior were as a male, high school and above, and in highly urbanized town; behavioral factors affecting health hazard were the gender, age, educational level, marital status and working conditions. The characteristics of patients with the hazard behavior were males, younger elderly, high school and above, married, and with a job status. (4) From regression analyses, we found that the use of inpatient medical services are related to the health promoting behaviors, and the use of outpatient medical services are associated with the health risk behaviors