| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 94 === Objective: The objective of this study was to use path analysis to examine the effect of social support, depressive symptoms, actual need, self-perceived need and accessibility evolved from religious involvement toward medical utilization of persons aged 55 and over.
Methods: The author used secondary data, namely 1999 Suvey of Health and Living Status of the Elderly in Taiwan. In the study, there were 3875 subjects living in the community aged 55 and over. Besides, this was a cross-sectional and retrospective study. Finally, We employed AMOS 5.0 to analyze data.
Results: Overall fit indexes of the final models, including Medical admission, Average Length of Stay, and outpatient, revealed that all models are accepted. The total effects of all models show that the inffluence of religious involvement toward medicl utilization was statistically significant. What’s more, such an inffluence was formed by intermediary mechanism. The five paths were the same in the all final models; however, the final model of outpatient services additionally have other four paths. The significant paths are as follow (Paths1-5 include tree types of medical utilization; paths 6-9 only comprise the outpatient; paths 8-9 are new discoveries, they do not represent all the paths in the conceptual framwork):
1.religious involvement → emotional social support
→ actual need → increased utilization
2.religious involvement → emotional social support
→ self-perceived need → decreased utilization
3.religious involvement → emotional social support
→ depressive symptom
→ perceived-self need → decreased utilization
4. religious involvement → emotional social support → depressive symptom
→ actual need → decreased utilization
5. religious involvement → actual need → decreased utilization
6. religious involvement → depressive symptom → self-perceived need
→ decreased utilization
7. religious involvement → depressive symptom → actual need → decreased utilization
8. religious involvement → depressive symptom → decreased utilization
9. religious involvement → emotional social support → increased utilization
Conclusion: By and large, religious involvement decreases medical utilization. indirectly As we expected, actual need and self-perceived need affect medical use directly; however, we found accidently that emotional social support and depressive symtoms inffluence the clinical utilizaiton directly as well. In addition, religious activities indirectly decrease medical use through social support and depressive symtoms and play an essential role in a intermediary mechanism.
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