Medical care needs for patients receiving home healthcare in Taiwan: Do gender and income matter?

doi:10.1371/journal.pone.0247622

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Title:	Medical care needs for patients receiving home healthcare in Taiwan: Do gender and income matter?
Authors:	Huang, Fang-Yi Ho, Chung-Han Liao, Jung-Yu Hsiung, Chao A. Yu, Sang-Ju Zhang, Kai-Ping Chen, Ping-Jen
Contributors:	Yuan Ze Univ, Dept Social & Policy Sci Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Taipei Med Univ, Wan Fang Hosp, Canc Ctr Kaohsiung Med Univ, Dept Publ Hlth Natl Hlth Res Inst, Inst Populat Hlth Sci Home Clin Dulan Home Clin Dulan UCL, Marie Curie Palliat Care Res Dept, Div Psychiat Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Family Med Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Div Geriatr & Gerontol Kaohsiung Med Univ, Sch Med
Keywords:	UNITED-STATES DISABILITY TRENDS COMPRESSION POPULATION MORBIDITY MORTALITY SERVICES INTERVENTION EXPECTANCY
Date:	2021
Issue Date:	2023-11-11 11:54:19 (UTC+8)
Publisher:	PUBLIC LIBRARY SCIENCE
Abstract:	Studies about medical care needs for home healthcare (HHC) previously focused on disease patterns but not gender and income differences. We used the Taiwan National Health Research Insurance Database from 1997 to 2013 to examine trends in medical care needs for patients who received HHC, and the gender and income gaps in medical care needs, which were represented by resource utilization groups (RUG). We aimed to clarify three questions: 1. Are women at a higher level of medical care needs for HHC than men, 2. Does income relate to medical care needs? 3. Is the interaction term (gender and income) related to the likelihood of medical care needs? Results showed that the highest level of medical care need in HHC was reducing whereas the basic levels of medical care need for HHC are climbing over time in Taiwan during 1998 and 2013. The percentages of women with income-dependent status in RUG1 to RUG4 are 26.43%, 26.24%, 30.68%, and 32.07%, respectively. Women were more likely to have higher medical care needs than men (RUG 3: odds ratio, OR = 1.17, 95% confidence interval, CI = 1.10-1.25; RUG4: OR = 1.13, 95% CI = 1.06-1.22) in multivariates regression test. Compared to the patients with the high-income status, patients with the income-dependent status were more likely to receive RUG3 (OR = 2.34, 95% CI = 1.77-3.09) and RUG4 (OR = 1.98, 95% CI = 1.44-2.71). The results are consistent with the perspectives of fundamental causes of disease and feminization of poverty theory, implying gender and income inequalities in medical care needs. Policy-makers should increase public spending for delivering home-based integrated care resources, especially for women with lower income, to reduce the double burden of female poverty at the higher levels of medical care needs for HHC.
Relation:	PLOS ONE, v.16, n.2, e0247622
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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