PREDICTORS OF THE UTILIZATION OF HOME HEALTH CARE IN TAIWAN (ELDERLY).
Contributors: Indiana University School of Nursing.
Published: 1994
Number of pages: 242
Subjects: Health Sciences, Nursing.; Health Sciences, Public Health.
Description: The demand for long-term care (LTC) in Taiwan is growing due to the greater number of elderly people. By 1994, it is estimated that the elderly will make up 7.11% of Taiwan's entire population. Home health care (HHC) will be the core service of LTC because HHC is consistent with Chinese culture. HHC will allow the elderly to remain at home where home care services and informal support can assist them and insure their dignity. Lack of data or research to predict or estimate the demand of HHC is the major problem for policy makers in forecasting the feasibility of developing HHC. This study was conducted to understand HHC patients' utilization behaviors and their correlates and furthermore to predict the demand of HHC in Taiwan.

A retrospective record description survey was used in this study. Two convenience HHC agencies were involved in the study; one was from the urban area and the other was from the rural area in Taiwan. In total, there were 215 HHC records that were reviewed; 115 were from the urban agency and 100 were from the rural agency. The instrument for collecting data was based upon and modified from the Behavioral Model of Health Services Use (Andersen & Newman, 1974) and a review of related studies by the current researcher. Three major components for predicting HHC utilization in the conceptual framework were predisposing, enabling, and need variables.

Some of the predisposing variables, such as age, marital status, and religious preference were directly related to HHC utilization. Patients who were older, married, and had a religious preference of Buddhism or Taoism tended to receive more HHC services. Some of the enabling variables, such as the type of agency, the travel time from agency to patient's home, and whether covered by HHC insurance were directly related to HHC utilization. Patients who lived in rural areas, had less travel time from the agency to their home, and paid for the services by their own out-of-pocket spending tended to receive more HHC services. Some of the need variables, such as medical diagnosis, ADL score, and disability days prior to receiving services were directly related to HHC utilization. Patients who had neoplasms as their medical diagnosis, a higher ADL score, and a smaller number of disability days prior to receiving services tended to receive more HHC services.

Results suggest that there is a need to initiate community supportive services for HHC patients, such as home health aide, home makers, day care, and respite care, especially in the rural areas and to shorten the distance between the agency and patient's home through adding HHC services in public health centers in the communities. Lack of available supportive services for HHC patients and their families, and the longer distance from agency to patient's home were the barriers of utilization for HHC services, especially for rural areas.
Notes: Source: Dissertation Abstracts International, Volume: 55-05, Section: B, page: 1803.

Thesis (D.N.S.)--INDIANA UNIVERSITY SCHOOL OF NURSING, 1994.

School code: 0815.