給付標準的設定會引導民眾對社區式服務的利用嗎?: 以居家服務為例

Su Fen Tzeng, Kun Yang Chuang, Chen Fen Chen, Nai Chen Yeh, Swu Chung Wu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: To investigate the use of home care services and the possible effects of reimbursement levels and other factors associated with the use of services. Methods: Six home care services providers, all under contractual agreement with the City of Taipei to provide services, were selected. Data (n=454), in the form of documents and clients records, was collected from the providers from January 2000 to March 2001. After the elimination of inappropriate data, the final number included for analysis was 440. Results: (1) About 63.4% of the cases used 16 hours of services a month. Among the 16-hour users, 13.8% were from low-income households. (2) Among the low-income users, 70% used more than 16 hours per month. Some (13.8%) used as many as 96 hours a month. For cases not in the low-income group, only 7.8% used more than 16 hours. (3) Logistic regression showed that, after controlling for other variables, the low-income (OR=50.8), severely disabled (OR=7.6), and the unmarried (OR=15.9) were more likely than their counterparts to use more than 16 hours of services per month. Furthermore, being younger, and having more family care resources were associated with using fewer hours. Conclusions: Level of reimbursement has significant impacts on the use of services, as indicated by the wide disparity in services hours used between low-income users and others. In planning for long-term care insurance, in order to avoid the skewing of needs for the use of services towards the low-income group, the design of reimbursement schemes should take into account both the ability to pay and also their level.

Original languageEnglish
Pages (from-to)221-234
Number of pages14
JournalTaiwan Journal of Public Health
Volume23
Issue number3
DOIs
Publication statusPublished - Jun 2004

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Home Care Services
Long-Term Care Insurance
Aptitude
Logistic Models

Keywords

  • Home care services
  • Reimbursement level
  • Utilization

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

給付標準的設定會引導民眾對社區式服務的利用嗎? : 以居家服務為例. / Tzeng, Su Fen; Chuang, Kun Yang; Chen, Chen Fen; Yeh, Nai Chen; Wu, Swu Chung.

In: Taiwan Journal of Public Health, Vol. 23, No. 3, 06.2004, p. 221-234.

Research output: Contribution to journalArticle

Tzeng, Su Fen ; Chuang, Kun Yang ; Chen, Chen Fen ; Yeh, Nai Chen ; Wu, Swu Chung. / 給付標準的設定會引導民眾對社區式服務的利用嗎? : 以居家服務為例. In: Taiwan Journal of Public Health. 2004 ; Vol. 23, No. 3. pp. 221-234.
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abstract = "Objectives: To investigate the use of home care services and the possible effects of reimbursement levels and other factors associated with the use of services. Methods: Six home care services providers, all under contractual agreement with the City of Taipei to provide services, were selected. Data (n=454), in the form of documents and clients records, was collected from the providers from January 2000 to March 2001. After the elimination of inappropriate data, the final number included for analysis was 440. Results: (1) About 63.4{\%} of the cases used 16 hours of services a month. Among the 16-hour users, 13.8{\%} were from low-income households. (2) Among the low-income users, 70{\%} used more than 16 hours per month. Some (13.8{\%}) used as many as 96 hours a month. For cases not in the low-income group, only 7.8{\%} used more than 16 hours. (3) Logistic regression showed that, after controlling for other variables, the low-income (OR=50.8), severely disabled (OR=7.6), and the unmarried (OR=15.9) were more likely than their counterparts to use more than 16 hours of services per month. Furthermore, being younger, and having more family care resources were associated with using fewer hours. Conclusions: Level of reimbursement has significant impacts on the use of services, as indicated by the wide disparity in services hours used between low-income users and others. In planning for long-term care insurance, in order to avoid the skewing of needs for the use of services towards the low-income group, the design of reimbursement schemes should take into account both the ability to pay and also their level.",
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