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    Please use this identifier to cite or link to this item: http://asiair.asia.edu.tw/ir/handle/310904400/111321


    Title: 不同年代台灣老年人糖尿病、高血壓及心臟病新發個案之存活分析
    Authors: 李政倫
    Contributors: 健康產業管理學系健康管理組
    Keywords: 慢性病、慢性病人口擴張、健康不平等、社經地位、chronic diseases、chronic disease population expansion、health inequality、socioeconomic conditions
    Date: 2018
    Issue Date: 2018-08-14 15:40:22 (UTC+8)
    Publisher: 亞洲大學
    Abstract: 許多國內外的研究皆指出,隨著人類平均餘命的延長,老年人口的整體健康可能朝向「長壽」或「人口老化」的方向發展,而台灣是人口老化速度最快的國家之一,老年人口的比例及數目的增加將使得社會整體的疾病及失能照護負擔的增加,從全民健康保險的支出逐年上昇以及相關之老年人口健康研究結果顯示台灣的老年人口可能是偏向「慢性病人口逐漸擴張」的現象。本研究將利用具全國代表性的老人長期追蹤調查資料,分別檢視1993、1996及1999年之常見慢性病新發個案之8年之間的存活情形,以了解台灣老年人口的健康趨勢。
    本研究利用「台灣中老年人長期追蹤調查資料」1989至2007年之調查及存活資料。1993年之高血壓、糖尿病及心臟病之新發個案 (N=446)已排除前一波(1989年調查)時已罹患此三種老人常見慢性病之個案,追蹤此446個案8年之存活情形至2001年底。以相同程序篩選出1996(N=327)及1999年(N=589)之新發個案,分別追蹤其存活情形至2004及2007年底。我們以Cox Regression Models進行存活分析,並將相關之影響死亡的人口、社經地位及健康變項納入為控制變項。除了個別分析不同年代新發個案8年存活之相關因素外,我們也將三個年代合併以檢視不同年代新發慢性病個案8年之間的死亡風險。
    研究結果顯示,相較於1993年之新發慢性病個案,1999年之新發慢性病個案其8年內死亡的風險比(Hazard Ratio, HR)顯著較低(HR=0.71, p<.05),代表1999年罹患慢性病的個案其存活時間較長,以此推論,台灣社會在1990到2000年代這段時間,老年人口健康的變化似乎是向「長壽卻不健康」的方向發展的;另一值得注意的是本研究發現幼年社經地位(父親教育程度)在本研究中僅在1993年篩選之個案中有達顯著,後續在1996及1999年皆未有顯著,代表針對高血壓、糖尿病及心臟病之新發個案其後8年內的存活率在1996年及1999年並未受幼年社經地位而有影響,也間接證明我國衛生政策對於此三類疾病照護資源提供之可近性皆有成長且達一定水平。
    Population aging has been portrayed as a triumphant gain to the society. However, as the burden of caring for an aging population increases, it also constitutes a looming challenge to the society’s long-term care and healthcare systems. When the life expectancy is prolonged, two possible population health transitions will follow: Compression or Expansion of morbidity. In the case of Taiwan, both previous studies and the soaring National Health Insurance expenditure seem to point to the Expansion of morbidity. We use data from a national representative survey to examine eight-year mortality of incident cases of 3 chronic disease (hypertension, heart disease, and diabetes) in 1993, 1996 and 1999, in order to gain a better understand the health transitions among the elderly in Taiwan.
    Data were taken from the Taiwan Longitudinal Survey on Aging (TLSA), which was launched in 1989. A total of 446 incident cases of hypertension, heart disease, and diabetes were identified in 1993 and the numbers of incident cases of the 3 diseases in1996 and 1999 were 327 and 589 respectively. For the incident cases in 1993, we followed their survival status through the end of 2001. For the 1996 and 1999 incident cases, they were followed through the end of 2004 and 2007. Cox Regression models were used to analyze the data and demographic variables and other health variables were taken into control in the models.
    The results show that, comparing to the incident cases of the 3 diseases in 1993, incident cases in 1999 were less likely to die (Hazard ratio = .71, p< .05) over an 8-year follow-up period. In other words, Taiwanese elders who contracted the 3 diseases later in time survived longer. Our findings seem to be consistent with an expansion of morbidity among the elderly in Taiwan, at least between the 1990s and 2000s.
    Appears in Collections:[健康產業管理學系] 博碩士論文

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