Associations between Abnormal Health Examination Indicators and Health Care Utilization among The Elderly in Taiwan

[[abstract]]Taiwan’s population is aging rapidly, so are the concerns towards the cost and burden of caring for an increased number of older people. Chronic diseases are prevalent among older populations. Up to now, health care cost for all chronic disease has accounted for 38.4% of the total expenditure of the National Health Insurance. Prevention for chronic diseases holds the key to reduce the demand for health care resources. The main purpose of this study to explore the association between health examination abnormalities and health services utilization among a representative sample of elders in Taiwan. Data were taken from the "Social Environment and Biomarkers of Aging Study, SEBAS." A total of 1023 Taiwanese elders aged 54 and over in 2000 were surveyed and invited to take health examination in contracted hospitals. In the 2006 follow-up, a total of 757 cases from the 2000 study had completed the second health examination and survey. Andersen’s socio-behavioral model was employed in selecting the factors predicting three types of health services use, hospitalization, emergency visits and health check-ups. Descriptive statistics, chi-square test and logistic regression were used to analyze the data. We found that the relevant factors associated with emergency outpatient visits were gender, area of residence, self-rated health, and number of chronic diseases. Gender, number of chronic diseases, and abnormalities in urine and blood tests were significantly associated with hospitalization use. Age, birthplace, the number of chronic diseases, disabilities in Activities of Daily Living (ADL) and Instrumental ADL, and abnormalities in urine and blood tests were associated with the utilization of health check-ups. Based on the results, we recommend that health care system can focus on the elderly preventive healthcare measures and health promotion. Future studies can further explore the related factors between the ADLs、IADLs and health examination and medical utilization