Utilization of Health Services among the Elderly in Taiwan

Abstract

This study presents and empirically evaluates a structural model of health services utilization among the aged in Taiwan. As a reflection of the medical pluralism in Taiwan, five dimensions of health services utilization are specified involving the use of services provided by: (1) physicians trained in western biomedicine, (2) western pharmacies, (3) physicians trained in traditional Chinese medicine, (4) traditional Chinese drug stores, and (5) hospitals. Data came from the 1989 Survey of Health and Living Status of the Elderly in Taiwan, involving 3,846 respondents. The proposed model was supported in terms of both overall and component goodness-of-fit and estimates of free parameters. 28% to 32% of the variance in the use of health services provided by physicians of biomedicine and 12% to 15% of the variance in the use of services provided by western pharmacies are explained by the model. Study findings indicate that the older Chinese with more self-reported illness, poorer self-rated health, and more education are more likely to utilize physicians of biomedicine. In addition, the male and the elderly with more self-reported illness and less education have a higher propensity to use western pharmacies. The use of Chinese drug stores is negatively related to education. Age is negatively related to the use of hospitals. Finally, there is no direct effect of economic status on utilization, whereas, economic status through its influence on self-reported illness and self-rated health was found to have an indirect effect on utilization.