A Relevance Study of Health Depreciation Factors and Mortality in Older Adults：Comparisons among Outpatient Clinic, Hospitalization and Institutional Care

• Main Authors: LIN, CHIEN-SHOU, 林建守
• Other Authors: LIN,JWU-RONG
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/63x3dz

碩士 === 東海大學 === 高階經營管理碩士在職專班 === 107 === Survival curve of Taiwan gradually became rectangularization since 2006. It means that most death of people occurs in the old stage, and the survival rate declines significantly getting toward life end. So researching factors related to elderly death improves the health and life expectancy. Data of this study is obtained from the Center for Geriatrics and Gerontology of Taichung Veterans General Hospital including 1248 patients. This study aims at investigating the relationship among health depreciation and mortality. The health depreciation factor includes 9 intervals variables, 17 nominal variables and 4 control variables, and utilize empirical method of two independent populations (death or not), statistical hypothesis test, and binary logistic regression (regression coefficient, odds ratio and marginal probability). To mortality, the marginal probability of myocardial infarction, serum albumin, mini nutrition assessment and hemoglobin are 0.072, -0.037, -0.01 and -0.009. It shows that myocardial infarction most significantly increase mortality risk, but serum albumin, mini nutrition assessment and hemoglobin decrease mortality risk. We also discuss the relationship of health depreciation and elderly death among hospitalization, outpatient clinic and institutional care respectively. The result is as below：1. An increase of hemoglobin reduces elderly mortality in hospitalization (marginal probability -0.015). 2. Peptic ulcer and peripheral arterial disease elevate elderly mortality in outpatient clinic (marginal probability 0.005、0.041). 3. An increase of serum albumin reduces elderly mortality in institutional care (marginal probability -0.022). In conclusion, prevention of myocardial infarction, malnutrition, anemia and hypoalbuminemia improves mortality of elderly integrated health care system. To admission and institutional care, it should prevent anemia and hypoalbuminemia respectively. To outpatient clinic, it should prevent peptic ulcer and peripheral arterial disease. This study also discover the elderly mortality risk of institution is significantly lower than outpatient clinic and admission.