Effects of self-care behaviors on medical utilization of the elderly with chronic diseases - A representative sample study

Background: Research indicates that self-care affects lifestyle and health behaviors; however, little is known about whether or not self-care affects medical utilization. Objectives: Exploring the effects on self-care behaviors to medical utilizations by elderly with chronic conditions. Method: Data from the Taiwanese National Survey of Health and Living Status of Older Adults and the National Health Insurance claim databases in 2007 were used. Indicators of self-care were disease management behavior and self-care confidence of the elderly. We considered hospital admissions, emergency room services, and avoidable hospitalizations as representing utilization of medical services. Results: In total, 2531 cases were recruited. After controlling for demographic factors and health status, a logistic regression showed that higher self-care confidence and beginning an exercise program decreased avoidable hospitalizations. Furthermore, beginning an exercise program decreased hospital admissions and also decreased utilization of emergency services. Discussion: Self-care behavior and confidence decreased avoidable hospitalization, hospital admission and emergency services. More research is needed to identify the interaction between self-care literacy, self-care behavior and health services that may clarify the effective means and provide appropriate intervention programs.