Objective: This study aimed to investigate the relation between social support and health services utilization among elderly aged at 65 or more, and try to explore the factors affecting utilization with outpatient, emergency and hospitalization service.
Methods: Data came from the research project ?Successful aging of the elderly in Taiwan (II)? 2004, granted by the National Science Counsil. Six towns in Miaoli County, including the business, mountain and sea regions were selected. Three- stage Stratified Method and PPS (Probability Proportional to Size) was used for sampling. 720 meeting the inclusion criteria and 584 (with completion rate of 81.4%) completed the questionnaire-guided interview. Predisposing, enabling, needs, and social support factors were assumed to affect health service utilization, and the effects were examined by logistic regression and Poisson regression analysis.
Results: Of the 584 subjects, 60.9% was Hakka, 48.7% was female. The mean age was 74.58?6.17 years. Most of the subject didn?t have sufficient school education, 32.1% of them reporting illiteracy and another 49.3% receiving school education below six years. Those elderly with low instrumental social support had higher utilization in outpatient service (IRR=1.28). Those with low emotional social support had higher utilization in hospitalization (IRR=1.43). Compared to the elderly having fixed caregiver, those who without any caregiver had higher utilization in outpatient service (IRR=1.96) and hospitalization (IRR=1.54), yet using lower utilization in emergency (IRR=0.15). However, the elderly who perceived no need for care showed no significant difference in services utilization.The elderly who were female (IRR=1.48~1.91), low education level (IRR=1.11~1.38), ethnic groups of FuChien (IRR=1.39~1.89) and Mainland provinces (IRR=1.76~2.14), having one or more diseases (IRR=1.97~2.88), and disabled in activities of daily living (IRR=3.25~5.80), used more medical services.
The elderly with cognition function disability used less services in outpatient (IRR=0.73) but more in hospitalization (IRR=1.52). Those with depression symptoms had higher utilization in outpatient (IRR=1.27) and emergency (IRR=1.52).
Conclusions: Instrumental and emotional social support of the elderly may play a buffer role in health services utilization. The result supported the ?substitutioanl model? for the effect social support in part of health services utilization, but the effect was limited. The policies in elderly care, community resources
development, investment of emotional and instrumental social support from the family should be strengthed in the future, in order to achieve the goal of
successful aging for the elderly.
