Factors associated with health status and medical utilization: An 18 year longitudinal panel study

Objectives: This study was aimed to analyze factors associated with elderly health behaviors, health conditions, and healthcare utilization. Methods: This study adopted the “Survey of health and living status of middle aged and elderly in Taiwan” (1989-2007) which was constructed and designed by the Bureau of Health Promotion, Department of Health. The total survey sample contained cumulatively 8110 persons, and matched with National Health Insurance databases.Longitudinal panel study design was used to explore the relationship between health behaviors, health status, and healthcare utilizationthe of elderly. Results: Generalized estimating equations(GEE) model showed that, persons who had regularly disease screening behaviors had worse health conditions. For those who quitted smoking had worse health conditions as well as worse self-rated health conditions, higher depression tendency; for those who had drinking habits had better health conditions. Persons who regularly check blood pressure and blood exams tended to utilize ambulatory services, and had higher healthcare expenditure; persons who had body exams and exercise habits tended to use more preventive medicine; persons who quitted smoking have higher hospitalization; persons who quitted smoking or had smoking behaviors tended to utilize more emergency room(ER) services and less preventive medicine services. Conclusions: The model indicated that elderly started to note the health behaviors after being diagnosed with diseases, and which were not preventive approaches. In addition to health behavior promotions, empowering the elderly knowledge regarding to information of disease self cognition and self care could thereby make the elderly implement health behaviors.