[Comparisons of home care utilization between insured and not-insured patients]

In the Andersen-Newman model, utilization of medical services behavior affected by the three factors of need, enabling, and predisposing. Many studies on medical services behavior adapting this model obtained the same results. Our study aimed to describe the difference of insured and non-insured patients using home care, to examine the factors that explain the long-term utilization of home care by using Andersen-Newman model, and to survey the expenditure on home care. Our study collected 486 cases by questionnaires through home interview from various home care units from Sep. 1 to Dec. 31 1994. The response rate was 68.1%. Chi-square and multiple regression tests from SAS computer program performed data analysis. Our results showed there was a significant difference in four months' utilization between insured and non-insured patients (2.38/month vs 1.72/month, p < 0.01). However, if the utilization number per month was less than two, no significance between the two groups was found. Regarding utilization behavior in home care, there were some differences among the need, enabling, and predisposing factors. Our findings demonstrated young patients, patients with chronic illness, and the Fukienese with families involving for care were willing to pay for home care despite the fact that they did not have full support from the family. The determining factors affecting long-term utilization of home care were the Fukienese, patients owning an independent house, patients with health insurance, and patients who lived in mid- or east-Taiwan. In addition, patients with an elevated number of utilizations per month and poor daily activity used home care. All dependent variables could explain 62.38% of variance. The results proposed to the authorities concerned, health institutions and medical professionals for reference in developing home care program.