台灣老年人居住選擇與健康狀況之實證研究

Abstract

台灣現今社會醫療進步及國民營養的改善，使得國民存活率提高，平均餘命延長。再加上生育率逐漸下降，造成老化指數快速上升。根據內政部指出，台灣在民國106年4月，65歲以上的老年人口占總人口的比例已達13.4%，即將進入高齡社會，因此老年人口的議題備受關注。傳統社會老人皆與子女同住，隨著時代的變遷，老人的居住型態也趨向多元，然而，居住安排並非固定不動的狀態，會隨著健康狀況而變動，因此，本研究探討60歲以上之老年人在居住選擇與健康狀況的互相影響關係。 本論文資料來自於衛生福利部國民健康署的「台灣地區老年身心社會生活狀況長期追蹤調查」資料庫，使用自民國78年至民國92年共五波的調查資料，希望瞭解60歲以上的老年人居住狀態對於健康狀況的影響，研究議題包含比較上一期至本期居住轉變對健康的影響，以及本期健康狀況對下一期居住選擇的影響。由於健康狀況為一不可觀測之變數，因此本研究採用結構方程模型分析，並且將樣本以年齡區分為五群，分別為60-64歲、65-69歲、70-74歲、75-79歲以及80歲以上，藉此比較不同年齡在居住選擇與健康狀況的差異。 本研究的實證結果顯示相對於沒有居住轉變者， 75-79歲以及80歲以上從獨居轉為非獨居狀態的人健康狀況較差，而在各個年齡群從非獨居轉為獨居狀態對健康都沒有顯著影響。在健康狀況對下期居住狀態影響的部分， 70-74歲以及80歲以上健康狀況越好，就會增加下期獨居的機率；然而，在65歲以上，健康狀況越差，會增加下期住在安養院的機率。

Nowadays, the improvements in medical care and nutrition have increased the national survival rate as well as prolonging life in Taiwan. However, the fertility rate has been gradually decreasing. These phenomena have resulted in a rapid increase in the aging index. According to the Ministry of the Interior, the proportion of the aged population has now reached 13.4% as of April, 2017, and Taiwan is rapidly becoming an aging society; that is to say, the issue of an elderly population grows in stature. In a traditional Taiwanese society, the elderly live with their children, but the living arrangements of the elderly have recently diversified. The living arrangement is not static, but changes with the health status. Therefore, the purpose of this study is to investigate as to whether there is a mutual influence between the living arrangement and the health status for those aged above 60 years old. In this research paper, the Taiwan Longitudinal Study on Aging (TLSA) database was adopted to evaluate the mutual influence between the living arrangement and the health status. In the first part, we compared the influence to the health status between the different changes of the living arrangement. In the second part, we investigated how the health status influenced future living arrangement, and because the health status is a latent variable, the structural equation model was estimated for the mutual influence. Dividing the five groups by age, we can compare the differences of the mutual influence between these groups. Empirical findings show that from solitary living to non-solitary living has a negative impact on the health status for those aged above 75 years, and from non-solitary living to solitary living has had no significant impact on the health status for those aged above 60 years. The better health status will increase the probability of living alone in the future for those aged between 70 to 74, and above 80 years old. In addition, the results also revealed that the poorer health status will increase the prospect and probability of living in a nursing home for those aged over 65 years.