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Risk Factor of Fallings and the Associated Medical Utilization among Elderly in Taiwan
|Keyword:||老年人,跌倒,危險因子,醫療使用,Probit Model,負二項模型,Tobit Model,|
elderly,falls,risk factor,medical utilization,Probit Model,Negative Binomial Model,Tobit Model,
|Publication Year :||2012|
本研究利用「台灣地區中老年身心社會生活狀況長期追蹤調查」1999與2003年的追蹤資料，針對臺灣50歲以上之中老年有效樣本共2,108人，針對資料不同的特性，分別以Probit Model、負二項模型與Tobit Model分析。實證結果發現顯著的老人跌倒危險因子中，年齡、女性、抑鬱指數與過去慢性疾病數目皆會提高跌倒發生機率；運動、日常生活活動能力的提升則有降低跌倒機率的效果。醫療使用方面，跌倒的發生對於各項醫療使用皆有負面影響，意即老年人的跌倒事件會顯著增加所有醫療資源的耗用；但跌倒次數與醫療資源使用的關係則隨著不同性別與不同的醫療部門而有所差異。若比較跌倒之影響程度，在住院相關醫療使用上，男性跌倒之影響大於女性；其他醫療費用及急診次數，男性跌倒之影響效果則明顯低於女性。
Due to the progress of medical technology, the average life expectancy extends and the elderly population is increasing rapidly. To date, aged population has become an important issue around the world. According to the statistics, 'falling' is the most common cause of death and hospitalization among elderly people. The impact of falling is not only on physical and mental health, but also on the medical utilization. However, most of the existing studies only focus on risk factors of fallings. Nowadays, the analysis of relationship between falls and medical utilization still lacks in Taiwan, and the subject mostly appears in the field of public health, less complete and quantified analysis of a nationally representative sample. To remedy the gap of the existing studies, one purpose of this paper is to test common risk factors of falls among elderly, another is to estimate the effects of falling on the medical utilization and medical costs in Taiwan.
In total, 2,108 older people drawn from Taiwan Longitudinal Study on Aging in 1999 and 2003 were selected for empirical analysis. The Probit model, Negative Binomial model and Tobit model were estimated for the risk factors and associated medical costs that are assoicated with fallings, respectively. Results show that age, female, depression score, and number of chronic disease would increase the probability of falling; the enhance of exercise, activities of daily living will reduce fall probability. The results also reveal that falling has a significant positive impact on all types of medical utilization in total and female sample; older man’s falls are more significantly associated with inpatient-related medical utilization. Comparing the impact of falls between men and women, the effect on inpatient utilization for males is larger than females; the effect of male falls on other medical expenditures and emergency department visits is obviously lower than the female’s.
According to these results, we can conclude that fallings among the elderly have increased various medical utilization, and fallings are indeed a major cause of increase in medical costs. Therefore, in order to reduce the medical expenditure and the economic burden of the country, the government should strengthen medical support measures and promote health education in prevention of falling.
|Appears in Collections:||農業經濟學系|
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