Utilization of health care services by elderly people with National Health Insurance in Taiwan: The heterogeneous health profile approach

Objectives: Taiwan is now facing an increased prevalence of aging related diseases escalating healthcare costs. Within the context of the health care system and NHI in Taiwan, the aim of this study was to examine the health profiles of elderly people by using Latent Class Analysis to determine the effects of different health profiles on the health care services utilization and expenditures, and to examine the factors associated with by controlling for the health profiles of elderly people. Methods: Data came from the 2005 National Health Interview Survey in Taiwan. Among those who were interviewed, 2449 elderly individuals with available health indicators were identified, and 1491 of these had complete socio-economic data and linkage to their utilization of health care services from 2004 to 2007 were analyzed. Results: Four health profiles were identified. The effect of the different health profiles of elderly people on the likelihood of utilization and expenditure on health care services was significant. While comparing with Relative Healthy group, the High Comorbidity group tended to utilize more services in the ambulatory care. The functional impairment group had relatively high probabilities of needing care assistance and the Frail group had higher health care expenditures. Age and gender did not have a significant effect and other associated socio-economic factors were also discussed. Conclusions: The health status of elderly people includes a variety of health indicators. We suggest that a person-centered approach is needed in order to satisfy needs and forecast expenditures in the future. Crown Copyright (C) 2012 Published by Elsevier Ireland Ltd. All rights reserved.