The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.
OBJECTIVE
The purpose of this study was to explore the relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.


METHODS
Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey.


METHODS
Community-based study.


METHODS
A total of 4249 middle-aged and elderly subjects were recruited.


METHODS
None.


METHODS
Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively.


RESULTS
Adjusting for important confounding variables, the middle-aged and elderly with National Health Insurance (NHI) and commercial insurance compared with those with NHI alone tended to have outpatient visits. The middle-aged and elderly with longer time to access healthcare facilities were less likely to shop in pharmacy stores compared with those with <30 min. The middle-aged and elderly who perceived inconvenient to access health care tended to shop in pharmacy stores compared with those with perceived convenience.


CONCLUSIONS
Our study of Taiwan's experience could provide a valuable lesson for countries that are planning to launch universal health insurance system, locate budgets in health care and transportation. The middle-aged and elderly who were facing more challenges in accessing health care, no matter in perceived accessibility or real time to access health care, had less outpatient visits and more drug stores shopping. Strategic policies are needed to improve accessibility in increasing patients' perception on access and escalating convenience of transportation system for improving accessibility.
Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan Golden Dream Think Tank and Research Center, Taiwan.
Ya-Ting
YT
Yang
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
Usman
U
Iqbal
Golden Dream Think Tank and Research Center, Taiwan School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Hua-Lin
HL
Ko
Golden Dream Think Tank and Research Center, Taiwan School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Chia-Rong
CR
Wu
Golden Dream Think Tank and Research Center, Taiwan Department of Public Health, China Medical University, Taichung, Taiwan.
Hsien-Tsai
HT
Chiu
Golden Dream Think Tank and Research Center, Taiwan School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Yi-Chieh
YC
Lin
Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan.
Wender
W
Lin
Golden Dream Think Tank and Research Center, Taiwan School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Yi-Hsin
YH
Elsa Hsu
D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013624:Taiwan
accessibility; healthcare quality; medical care utilization; middle-aged and elderly; patient safety