32 2006 6 83-121

Journal of Population Studies

No. 32, June 2006, pp. 83-121

**
***

**

E-mail:
scwu@ha.mc.ntu.edu.tw

94/03/2495/05/05

84

Andersen

1,789

85

Factors Affecting Caregivers Willingness to

use Long-Term Care Services
Chen-Fen CHEN* and Shwu-Chong WU**
Abstract
This study is based upon the conceptual framework of
Andersen model to examine the factors affecting selection
strategies of long-term care service for the elderly, which include
nursing home, assisted living, community service and home care.
Data was collected from a survey of 1,789 caregivers live in
San-Yin area and Chia-I city in Taiwan. Results of multiple
logistic regressions with control of other variables indicated that
responsibility expectation and care loading are key factors for
service selection. Previously stated, physical need of disabled
population was the most important predictor of service using for
the disable. Current results additionally indicated that care loading
and expectation of responsibility of caregivers were strongly
correlated with service selection, especially when physical loading,
emotional and time pressure occurred, and family responsibility
was not necessarily insisted. In general, family care is still a
mainstream of long-term care model. However, caregivers will
expect assistance from formal service systems while they are
suffering a considerable pressure. This expectation will elevate
rapidly with the increasing need of long-term care. The
*
**

Ph.D. Candidate, Department of Social Welfare, National Chung-Cheng University

Professor, Graduate Institute of Health and Policy and Management, College of Public
Health, National Taiwan University, Correspondence author, E-mail: scwu@ha.mc.ntu.edu.tw

86

government should develop various long-term care resources to

support the disabled and their caregivers for releasing living
burden.
Key Words: Long-term care, Caregiver, Caregiver burden,
Willingness to use

87

(Center for
Strategic and International Studies and Watson Wyatt Worldwide, 2000)
1993

life-or-death

Ikegmi and Campbell, 2002

Piercy
Blieszner1999
McCullough 1993

Brubaker1987

88

co-client

Cohen et al., 1993McCullough et al., 1993Morris el al., 1988Pearlin

et al., 19902002

Colerick and George, 1986

Cohen et al., 1993Fisher and Lieberman, 1999Whitlatch et al., 2001
Gaugler et al., 2003
aging in place

Bookwala et al.,
2004Houde, 1998Noelker et al., 1998

AndersenAndersen
and Newman, 1973Health Behavioral Model
Wan, 1989Wolinsky and Johnson, 1991Keysor et al.,
1999

predisposing characteristic

enabling factor

need factor

89

Andersen 1970 1980

2005 Krause1990

Miller & Weissert, 2000

20002002

Spitze and Logan, 1989

Andersen

Andersen Bass and

Noeiker, 1987Travis, 1995
Bass Noeiker1987 Andersen

Gill1998
Penning1995 Houde1998

Miller and McFall, 1991

90

McFall and Miller, 1992

Callahan et al., 1994Badger1998

Brubaker and Brubaker, 19891995

1999

65
18 2 9.7%
92.4% 78.5%2000

2000

65 20 1.26
2003 9.4% 2024 18.8%2004

2000

91

aging in place

care managers

2001

92

26 16
2001 7 1
20

activities of daily living, ADLsinstrumental

activities of daily living, IADLs ADLs

IADLs

Guralnik and Simonsick, 1993Wiener, 1993

2002
Mini-Mental State ExaminationMMSE
Hasegawa Dementia Scale
Short Portable Mental Status QuestionnaireSPMSQ
Pfeiffer, 19752002 SPMSQ
Pfeiffer
10 SPMSQ 6

93

SPMSQ

Wu, 1998

2000
ADL IADL
ADL IADL
5,429
4,021 74.1%
1,408 25.9%

5,429 339
20 365
2467 304
3,954
3,341 84.5%
2,205 1,946
157 3
1,789

Andersen
2

activities of daily living, ADLs

instrumental activities of daily living, IADLs

ADL

94

IADL

1-2 ADL

3-4 ADL 5 ADL

4
/

1998

95

1. 2

6
2. 4

12
3. 5

15
4. 5

15

5. 2

Kane and Kane, 19871998

96

U. S. Department of Health and Human Serviceassisted living

Allen, 1999

1. --
24
2.

2001

97

3.
1

4.

multiple logistic regression

40

64

98

164.6%
41 64 53.4%

30% 65 75 9.3%

33.9%
17.5%16.4%
79.2%

55.6%

38.3%

64 35%
85 15.2%
54.4%
35.2%

32.2%

99

40
41-64
65-74
75

3
3-5
5

634
1155

35.4
64.6

315
956
352
166

17.6
53.4
19.7
9.3

606
243
313
293
155
179

33.9
13.6
17.5
16.4
9.7
10.0

1416
373

79.2
20.8

364
628
300
497

20.3
35.1
16.8
27.8

676
1113

37.8
62.2

1025
764

57.3
42.7

954
475
319

55.6
26.6
17.8

583
520
686

32.6
29.1
38.3

100

997
792

55.7
44.3

1415
356

79.1
19.9

1587
192

89.3
10.7

763
1017

42.6
56.8

1083
702
1789

60.5
39.2
100.0

64
65-74
75-84
85

874
915

48.9
51.1

626
423
468
272

35.0
23.6
26.2
15.2

756
639
394

42.3
35.7
22.0

825
964

46.1
53.9

577
1212

32.2
67.7

101

IADL
1-2 ADL
3-4 ADL
5 ADL

802
973
14

44.8
54.4
0.8

538
326
295
630
1789

30.1
18.2
16.5
35.2
100.0

3 %

39
40-64
65-74
75

13.1
16.1
*
9.2
14.5
16.2
17.5
***
11.6
19.9
14.1
13.7
8.4
21.3

24.5
26.5

14.2
14.2
**
18.2
16.3
11.7
10.1
***

24.8
25.7
23.6
26.5
**
22.4
33.3
24.0
22.9
25.8
29.1
24.4
28.2
27.2
23.6
26.0
25.4
***

%
*
31.1
26.5
*
32.7
29.0
24.1
22.9
***
23.3
37.4
32.6
23.5
28.4
31.3

27.9
29.0
*
26.9
24.8
29.0
32.6
***

29.3
32.7

32.5
28.7
31.7
29.2
28.1
35.5
28.9
29.2
32.6
27.0
33.5
32.4

28.0
29.0
30.7
32.4
***

102

3
3-5
5

*p<0.05

** p<0.01

%
9.9
16.8

%
18.0
29.6

%
22.0
31.8

%
21.7
35.0

15.7
12.4
11.9

27.3
27.6
31.3

30.1
27.5
30.7

12.0*
13.1
16.8

25.1
24.0
27.0
*
22.1
24.2
28.6

27.6
28.3
28.4

27.1
31.3
31.5

***
7.7
22.3
***
10.6
28.2
***
13.0
24.1
***
7.6
19.2
***
10.5
19.9

***
19.5
32.4
***
21.3
41.3
***
23.5
39.6
***
18.2
30.7
***
21.4
31.2

***
21.5
36.5
***
23.0
48.3
***
25.5
49.5
***
19.0
35.0
***
23.1
35.9

***
21.9
40.3
***
25.4
48.3
***
27.81
48.4
***
18.1
39.0
***
23.8
39.6

*** p<0.001

64
65-74

%
*
12.5
15.9
16.4
12.5

%
*
27.1
23.4
**
29.6
24.6

28.7
27.5
***
33.0
26.5

29.3
30.7
30.7
30.3

103

75-84
85

IADL
ADL
ADL
ADL
*p<0.05

** p<0.01

%
13.2
13.2

%
21.6
22.4

%
25.6
22.4

%
30.8
26.8

16.0
13.8
11.3
**
11.7
16.3
***
18.1
12.3
*
16.3
11.4
***
7.2
19.6
***
11.0
11.7
13.2
18.7

25.8
23.9
26.1
*
22.9
27.2
**
29.3
23.3

28.6
25.8
31.0
***
24.4
31.3
***
33.1
25.7

29.0
29.1
33.5

25.5
24.9
***
21.7
29.0
**
21.4
21.5
29.2
28.6

28.7
27.4
***
22.7
32.3
*
25.3
23.9
31.2
31.3

30.2
29.7
***
23.9
34.7
***
21.7
23.9
29.2
40.6

28.6
31.2
31.2
29.5

*** p<0.001

18.2
% 10.1%

19.9% 21.3%
11.6% 8.4%

9.9%
16.8%

104

15.9%
12.5%
16.3% 11.7%

18.1%
16.3%

2001

Andersen

19.6%

12.0%
13.1% 16.8%

105

106

107

40 65
65-74 2.10175
3.136
2.267
3.310
3.079

1.387
0.631

1.860

2.054
2.009 1.614

33.3% 29.1%
29.6%

108

27.1% 23.4%65
29.4%

29.0%
IADLADL
21.4% 21.5

29.2%

0.697

1.703

1.443

109

1.420

1.3941.860 1.342

31.1%
26.5%

39 32.7%

31.8%22.0%

33.1%
25.7%

110

1.308

1.59161.9961.4251.480 1.407

35.0%21.7%

40
75
1.965
0.547
1.734

111

1.408

1.381

2.001

1.5991.8091.922 1.491

112

Rose2000

1999
Andersen model

Andersen model
Andersen model

Palley and
Oktay, 1983 Travis, 1995

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Kinney et al., 1995Smerglia & Delomling, 1997

Whitlatch 1997

Bass and Nolker, 1987Miller and McFall, 1991

1
Piercy1999

Lebowitz1985 Brubaker and Brubaker,

114

1989

Miller McFall1991

73.1%, 69.8%, 61.6% 60%

60%

115

Piercy1999

--

willingness
to pay

Deutscher, 1966
1995

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