title: Health-related services use and the onset of functional disability: 10 year follow-up study.
abstract: This study aimed to examine the effect of health-related service use on the development of functional disability in an older adult Taiwanese cohort. The sample population consisted of 871 participants without Instrumental Activities of Daily Living (IADL) disabilities, 1061 participants without Activities of Daily Living (ADL) disabilities and 817 participants without IADL and ADL disabilities at baseline. The onset of IADL and ADL disabilities were estimated as the follow-up survey year that these functional disabilities were first noted, or the follow-up survey year that the participant was noted as having died. A Cox proportional hazards model, with time-dependent covariates, was used to analyze the association between the time of onset of the functional disabilities and the health-related service use, after controlling for age, gender, education, marital status and time varying chronic disease status. This study found that an increase in the number of services used by the participants resulted in fewer IADL and ADL disabilities. Furthermore, participants who attended recreational programs, regular health examinations, and who received the information assistance and meal preparation were significantly less likely to develop disabilities. Participants who used one or more services were 55-77% less likely to be IADL disabled, and were 54-81% less likely to be ADL disabled, and were also 59-89% less likely to develop IADL and ADL disabilities as compared to those who used none. In the present study therefore, as the number of health services used increased the likelihood of developing a functional disability decreased.
authors.affiliation: Department of Health Care Management, University of Kang Ning, Tainan, Taiwan.
authors.forename: Chun-Min
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Graduate Institute of Health Care, Meiho University, Ping-Tung, Taiwan.
authors.forename: Yung-Yu
authors.initials: YY
authors.lastname: Su
authors.affiliation: Graduate Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tzuo-Yun
authors.initials: TY
authors.lastname: Lan
authors.affiliation: Graduate School of Medicine, University of Wollongong, New South Wales, Australia.
authors.forename: Judy
authors.initials: J
authors.lastname: Mullan
authors.affiliation: Department of Healthcare Administration and Health Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hon-Yi
authors.initials: HY
authors.lastname: Shi
authors.affiliation: Department of Healthcare Administration and Health Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: chiu@kmu.edu.tw.
authors.forename: Herng-Chia
authors.initials: HC
authors.lastname: Chiu
mesh_terms: D000203:Activities of Daily Living; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012959:Socioeconomic Factors
keywords: ADL; Cohort; IADL; Onset of disability; Service use