Predicting the need of formal care in Taiwan: analysis of a national random sample.

The study aimed to examine the determinants of needing formal care and the factors impacting care arrangements in elderly Taiwanese by analyzing the 1999 and 2003 data of "The Survey of Health and Living Status of the Elderly in Taiwan", a prospective cohort study of older Taiwanese. For the purpose of this study, only participants 70 years or older were analyzed. The association of sociodemographic, lifestyle and health-related variables with care need and care arrangements at baseline and four years later were analyzed. Results showed that the major predictors of needing formal care in elderly Taiwanese were old age, cognitive impairment and functional disability. Self-perceived poor health and prior nursing-home admission were marginally significant. Results also showed that the traditional culture dictated care arrangement. Most elderly Taiwanese preferred to have private home carers (usually from neighboring countries) over institutionalization. The ratio of private care vs. institutionalization increased from 1:3 in 1999 to 1:1 in 2003 as the government allowed introducing more foreign carers. Results suggest that the major determinants of needing formal care in elderly Taiwanese are old age, and cognitive and functional impairments, similar to that observed in Western countries. However, culture and public policy impact care options.