Differential Use of Health Services among Disabled Elderly

Abstract
In order to facilitate program planning for the chronically ill, it is essential to understand their propensity to use health and social services. This study has systematically examined the use of ambulatory services among the noninstitutionalized elderly (N = 772) who reported with one or more activity-limiting chronic conditions in a statewide survey of older Virginians in 1979. The determinants of differential use of physician services are investigated. The independent variables included in the analysis are: (1) personal attributes that may predispose individuals to seek care; (2) need for care factors as evidenced by the number of health disorders, physical functioning limitations, and perceived health; and (3) enabling factors such as income, insurance status, regular source of care, perceived service needs, and transportation barriers. Findings show that a significantly large number of physician visits may be generated in response to the psychological needs of disabled elderly. The eighteen predictors accounted for a relatively larger amount of variance (39%o) in use of social services than in physican visits (14%o). Furthermore, there is a strong complementary relationship between physician visits and use of social services.