Transition of Self-care and the Impact to Health and Medical Utilization among Elderly with Chronic Conditions

Objectives: This study is aimed to understand the association of self-care knowledge and management behaviors of elderly with chronic diseases and health status to clarify essentiality of self-care. Methods: This research utilizes Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan from 1989 by Bureau of Health Promotion, Department of Health. This survey applied longitudinal panel data and explored self-care, health status and medical utilizations of elderly. Results: Overall self-care situation in 2007 showed that, elderly showed the highest confidence about following physicians' compliance, and less confidence about controlling of physical and emotional distress from suffered chronic diseases. Two third elderly were on a diet and kept a regular lifestyle to manage their chronic conditions. Worse self-care performance related with disability, depression tendency, worse self-rated health, and more medical utilizations. Longitudinal data analysis showed that self-care performance had positive effect on preventive services utilization, but had no significant effect on health status and emergency room or hospitalization. Conclusions: Self-care is an important modifiable factor to health by intervention. Self-care performance did not have impact on health and medical utilization, however, we found out that self-care performance had highly positive relationship with education level, and education influenced health status and medical use significantly in GEE model. Therefore, empowering self-care knowledge for elderly will be expected to enhance health status and decrease medical resources.