Research On The Relationship Between Physical Activity Of The Elderly And Medical Utilization As Well As Quality Of Life

Hiking medical expenses caused by the aging population has become one of the hidden concerns for the sustainability of the Health Insurance. According to the statistics of Taiwan’s Bureau of National Health Insurance, outpatient consultation and inpatient medical expenses incurred by individuals over the age of 65 years old in Taiwan accounted for 33.2% of the total medical expenditure in 2007. It is estimated that the ratio of elderly medical expenses will continue to increase in the future in accompany with the aging population. Medical care for the elderly has cast a heavy burden on the society. Moreover, economic development and advancement of medical technology have contributed to the extension of people’s life span. However, living longer does not necessarily mean living better. In 2004, the World Health Organization estimated that elders’ potential need of long-term care was 7~9 years. They need to be taken care of by others in their daily life, which adversely impacts their quality of life. The Organization for Economic Co-operation and Development(OECD) recommends that all countries should, in their promotion of aging policies, maintain elders’ physical, psychological and social development adequately so they can actively participate in the society with sound physical and mental health and lead a free and independent life of good quality.In order to promote quality of life of the elderly, increasing physical fitness is an effective strategy. By ways of exercise and physical activity, not only can the deterioration of physical functions be slowed down, but psychological comfort can be also improved, which will lead to proactive lifestyle and improvement of life quality. Some scholars believe that the types of activities elders undertake are not as important as their energy expenditure. As long as their physical activity reaches certain frequency and hours, there will be positive effects on their health. As far as the elderly are concerned, physical activity is a key factor to the maintenance of their health and functions. Moreover, it also plays an important role in terms of physical recovery, physiotherapy or prevention of risk factors associated with chronic diseases.This research examines the impacts of elderly physical activity on medical utilization as well as quality of life. Physical Activity Scale for the Elderly(PASE) and SF-36 Quality of Life Scale are adopted and the research subjects are individuals aged 65 and older who live in a small town in central Taiwan. The results of the questionnaire survey are as follows:The average score plus or minus standard deviation of PASE of the elderly in the small town is 113.92±65.47. 524 individuals fall between 0 and 120 points, accounting for 58.4%. The majority of elders have low physical activity and extended family is the main family structure. Most elders even need to share domestic labor. 63.9% of elders in the small town exercise at least three days a week. Walking is the most common exercise which accounts for 84.5% of all activities. The most used venues for exercise are places near their homes with the promotion of health being the dominant reason for doing exercise.Their major pattern of medical visits is western medicine and most visits are made to regional hospitals and private clinics. Only 6.6% think medical services is inconvenient and 66.6% elders take part in preventive health examination. Over the past six months, the average number of medical visits was 5.58 visits. 63.3% elders suffer from at least more than one chronic disease, hypertension and diabetes being the most common diseases.In terms of SF-36 Scale average scores of the elderly in small towns, the four physical components are ranked as Role Physical(RP), Bodily Pain(BP), Physical Function(PF) and General Health(GH) from highest to the lowest. With respect to the four mental components, Social Function(SF) has the highest score, followed by Role Emotion(RE), Mental Health(MH) and Vitality(VT) respectively.Elders in small towns with the following characteristics do more physical activity: participating in exercise clubs, taking part in health examination for the elderly, suffering from no chronic disease, not being hospitalized, having part-time jobs, having high social support, enjoying high social status and still receiving income. However, females between 75 and 79 years old who exercise less than one day a week, participate in health examination, suffer from chronic diseases, are hospitalized, have no jobs and receive low social support in small towns record greater number of medical visits.Those who participate in exercise clubs, are not hospitalized, suffer from no chronic disease, have full-time jobs, receive medium or high social support, enjoy middle or high social status, exercise more than five days a week, pay no medical visits and still have income score higher in PCS. However, males who participate in exercise clubs, take part in health examination, are not hospitalized, suffer from no chronic disease, have part-time jobs, receive medium or high social support, enjoy high social status, exercise more than five days a week, pay no medical visits and still receive income in the small town achieve higher scores in MCS.There is significant negative correlation between physical activity of the elderly in small towns and the number of medical visits. The more physical activity the elderly do, the lower the number of medical visits is. Significant positive correlation is also revealed between physical activity and PCS as well as MCS. This shows that elders who have high physical activity record lower number of medical visits and lead better quality of life. If viewed from the number of days of doing exercise, elders in the small town who exercise more than three days a week only perform better in MCS. However, if the number of days of doing exercise reaches five days a week, or even everyday, the positive effects of daily exercise will be fully manifested with better scores in not only MCS and PCS, but also the number of medical visits.There is significant negative correlation between the number of medical visits and PCS as well as MCS. This represents elders in small towns who pay greater number of medical visits have poorer quality of life, particularly after the age of 75. Their PCS and the number of medical visits both show sudden deterioration, which means that the age of 75 is a key aging point.The number of medical visits is in fact an intervening variable between physical activity and quality of life. To increase physical activity of the elderly can reduce the number of medical visits and enhance the quality of life. This is particularly true if elders can exercise more than five days a week, or even everyday, it can effectively reduce the number of medical visits and enhance the quality of life.Therefore, it is recommended that the government should support the promotion of exercise clubs for the elderly, cultivate exercise instructors to assist the elderly in conducting leisure bodily movement and install exercise facilities extensively to enable elders to use such nearby facilities. Furthermore, by way of health education tour, health examination for the elderly should be conducted to advocate health education on chronic diseases of the elderly and prevent deterioration of these diseases. At the same time, a well-designed elderly pension system should be constructed to protect the economic well-being of the elderly. In addition, attention should also be drawn to social education whereby the impacts of aging society can be fully appreciated.