title: Effects of self-care behaviors on medical utilization of the elderly with chronic diseases - A representative sample study.
abstract: BACKGROUND
  Research indicates that self-care affects lifestyle and health behaviors; however, little is known about whether or not self-care affects medical utilization.
  
  
  OBJECTIVE
  Exploring the effects on self-care behaviors to medical utilizations by elderly with chronic conditions.
  
  
  METHODS
  Data from the Taiwanese National Survey of Health and Living Status of Older Adults and the National Health Insurance claim databases in 2007 were used. Indicators of self-care were disease management behavior and self-care confidence of the elderly. We considered hospital admissions, emergency room services, and avoidable hospitalizations as representing utilization of medical services.
  
  
  RESULTS
  In total, 2531 cases were recruited. After controlling for demographic factors and health status, a logistic regression showed that higher self-care confidence and beginning an exercise program decreased avoidable hospitalizations. Furthermore, beginning an exercise program decreased hospital admissions and also decreased utilization of emergency services.
  
  
  CONCLUSIONS
  Self-care behavior and confidence decreased avoidable hospitalization, hospital admission and emergency services. More research is needed to identify the interaction between self-care literacy, self-care behavior and health services that may clarify the effective means and provide appropriate intervention programs.
authors: School of Gerontology Health Management, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan.
authors: I-Hui
authors: IH
authors: Chen
authors: School of Gerontology Health Management, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan; Master Program of Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan. Electronic address: mjchi@tmu.edu.tw.
authors: Mei-ju
authors: MJ
authors: Chi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006304:Health Status; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012648:Self Care / Q000523:psychology*; D013624:Taiwan / Q000453:epidemiology
keywords: Disease management; Medical utilization; Self-care behaviors; Self-care confidence; Taiwan