The Moderating Effect of Welfare States on Health and Service Utilization - Comparison of Taiwan and European Countries

Project: A - Government Institutionb - National Science and Technology Council

Project Details


The improvement of elderly health and the decrease of long-term care service utilization have significant impact on health care expenditure, and thus, are policy priorities for developed countries. It is now widely acknowledged that welfare states are important determinants of population health (i.e., mortality, morbidity, and life expectancy). However, previous studies on the influence of welfare state regimes rarely focused on elderly health, nor did they include East Asian countries. The purpose of this study is to include Taiwan in assessing whether the predictors of elderly health and of long-term care service utilization differ among welfare state regimes. Comparisons among welfare state regimes and assessing the moderating effect of welfare state regimes will be the main focus of this research. Data for this research will come from Survey of Health, Ageing and Retirement in Europe (SHARE), and the Survey of Health and Living Status of Elderly in Taiwan (台灣地區中老年 身心社會狀況長期追蹤調查). SHARE is a multidisciplinary and cross-national panel database of micro data on health, socio-economic status and social and family networks of more than 45,000 individuals aged 50 or over Eleven countries contributed data to the 2004 SHARE baseline study. The second and third wave of data was collected in 2006 and 2008, respectively. The Survey of Health and Living Status of Elderly in Taiwan is a longitudinal panel study, with baseline data collected in 1989. Subsequent waves of data were collected every 3 or 4 year. Outcome variables of interests are self-rated health, physical functions, and the use of long-term care services. Demographic variables, such as age, gender, educational level, living arrangement, occupation status, and health behavior variables will be included as control variables.Countries will be categorized into one of the following welfare state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern European, and Eastern European welfare regimes. Given the categorical nature of dependent variables, multinominal logistic regression analysis will be used to assess associations between the predictors and outcome variables. The regressions models will be run for each welfare regime, as well as for Taiwan, separately to explore possible welfare regime differences in the effects of the predictors. As the population ages in Taiwan, and its percentage of elderly is fast approaching the level of European countries, results of this research can provide a glimpse of what elderly health and elderly care will be like in the future and provide some important information for long-term care policy formulation.
Effective start/end date8/1/137/31/14


  • welfare state
  • health policy
  • international comparison
  • elderly health


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