The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan

• Published in: International journal for quality in health care Vol. 27; no. 3; pp. 222 - 231
• Main Authors: YANG, YA-TING, IQBAL, USMAN, KO, HUA-LIN, WU, CHIA-RONG, CHIU, HSIEN-TSAI, LIN, YI-CHIEH, LIN, WENDER, HSU, YI-HSIN ELSA
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.06.2015
• Subjects: Aged; Cross-Sectional Studies; Female; Health Behavior; Health Services - utilization; Health Services Accessibility - statistics & numerical data; Health Status; Humans; Longitudinal Studies; Male; Middle Aged; National Health Programs - statistics & numerical data; Socioeconomic Factors; Taiwan; Taiwan; healthcare quality; patient safety; accessibility; medical care utilization; middle-aged and elderly
• ISSN: 1353-4505; 1464-3677; 1464-3677
• DOI: 10.1093/intqhc/mzv024

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. Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey. Community-based study. A total of 4249 middle-aged and elderly subjects were recruited. None. Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively. 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. 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.