| Summary: | 碩士 === 中國醫藥大學 === 醫務管理學系碩士班 === 101 === Purposes: Prior research reported that married couples might suffer from common diseases. Family members share common risks from their living environments, therefore, if one spouse suffers from illness, the odds of aother spouse for illness will be escalating. Such common diseases might be noninfectious. Thus, a comprehensive investigation on the varieties of concordant diseases and the risk factors among couples is certainly needed. In view of the considerable impacts on public health and health insurance financing by catastrophic illness and chronic diseases, prevention for concordant diseases with the family approach becomes extraordinarily important. However, there is a dearth of nationally-representative study on this domain in Taiwan. This study sought to examine the concordant systemic diseases and the associated factors and to analyze the prevalence of concordant diseases among couples. Hence, study results can provide valuable information for advancing preventive medicine and healthcare practices on family units.
Methods: The study used the retrospective cohort design. Longitudinal, secondary data analysis was conducted by utilizing the data extracted from 1,000,000 randomly sampled beneficiaries recorded in the 2002-2010 Taiwan National Health Insurance Research Database, which include 3,344 couples (6,688 individuals) identified. The systemic diseases were classified by ICD-9-CM. Analysis methods include McNemar’s test, binomial and multinomial logistic regression, and cluster analysis performed in SAS 9.2.
Results: Concordant systemic diseases among married couples include metabolism, psychiatry, neurology, circulation, respiration, digestion, dermatology, and orthopedics, with the overall prevalence rate 0.23％. The factors associated with the concordance include age, beneficiary category, premium, region, and urbanization. The results of matching indicated that married couples were more likely to encounter concordant diseases than non-married couples did.
Conclusion: That married couples tend to suffer from concordant diseases echoes with the Ecological System Theory. In the midst of the Family Physicians System and capitation reimbursement scheme being launched, the authorities and healthcare organizations should further deliberate upon the characteristics of family members of the cared individuals and target the persons of high risk, in the attempt to conduct effective medical interventions for preventing concordant diseases.
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