Wu Chen-Yi, Hu Hsiao-Yun, Huang Nicole, Fang Yi-Ting, Chou Yiing-Jeng, Li Chung-Pin
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan ; Department of Dermatology, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan.
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan ; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
PLoS One. 2014 Feb 19;9(2):e89213. doi: 10.1371/journal.pone.0089213. eCollection 2014.
The aim of the study was to investigate determinants of long-term care use and to clarify the differing characteristics of home/community-based and institution-based services users.
Cross-sectional, population-based study.
Utilizing data from the 2005 National Health Interview Survey conducted in Taiwan.
A national sample of 2,608 people (1,312 men, 1,296 women) aged 65 and older.
The utilization of long-term care services (both home/community- and institution-based services) was measured. A χ(2) analysis tested differences in baseline characteristics between home/community-based and institution-based long-term care users. The multiple-logistic model was adopted with a hierarchical approach adding the Andersen model's predisposing, enabling, and need factors sequentially. Multiple logistic models further stratified data by gender and age.
Compared with users of home/community-based care, those using institution-based care had less education (p = 0.019), greater likelihood of being single (p = 0.001), fewer family members (p = 0.002), higher prevalence of stool incontinence (p = 0.011) and dementia (P = .025), and greater disability (p = 0.016). After adjustment, age (compared with 65-69 years; 75-79 years, odds ratio [OR] = 2.08, p = 0.044; age ≥80, OR = 3.30, p = 0.002), being single (OR = 2.16, p = 0.006), urban living (OR = 1.68, p = 0.037), stroke (OR = 2.08, p = 0.015), dementia (OR = 2.32, p = 0.007), 1-3 items of activities of daily living (ADL) disability (OR = 5.56, p<0.001), and 4-6 items of ADL disability (OR = 21.57, p<0.001) were significantly associated with long-term care use.
Age, single marital status, stroke, dementia, and ADL disability are predictive factors for long-term care use. The utilization was directly proportional to the level of disability.
本研究旨在调查长期护理使用的决定因素，并阐明居家/社区护理和机构护理服务使用者的不同特征。
基于人群的横断面研究。
利用2005年在台湾进行的国民健康访谈调查数据。
2608名65岁及以上的全国性样本（1312名男性，1296名女性）。
测量长期护理服务（包括居家/社区护理和机构护理服务）的使用情况。采用χ(2)分析检验居家/社区护理和机构长期护理使用者在基线特征上的差异。采用多逻辑模型，采用分层方法依次加入安德森模型的易患因素、促成因素和需求因素。多逻辑模型进一步按性别和年龄对数据进行分层。
与居家/社区护理使用者相比，机构护理使用者受教育程度较低（p = 0.019），单身可能性更大（p = 0.001），家庭成员较少（p = 0.002），大便失禁（p = 0.011）和痴呆症（P = 0.025）患病率较高，残疾程度更高（p = 0.016）。调整后，年龄（与65 - 69岁相比；75 - 79岁，比值比[OR] = 2.08，p = 0.044；年龄≥80岁，OR = 3.30，p = 0.002）、单身（OR = 2.16，p = 0.006）、城市居住（OR = 1.68，p = 0.037）、中风（OR = 2.08，p = 0.015）、痴呆症（OR = 2.32，p = 0.007）、日常生活活动（ADL）有1 - 3项残疾（OR = 5.56，p < 0.001）以及ADL有4 - 6项残疾（OR = 21.57，p < 0.001）与长期护理使用显著相关。
年龄、单身婚姻状况、中风、痴呆症和ADL残疾是长期护理使用的预测因素。使用率与残疾程度成正比。
