Physician utilization among the elderly: An analysis using structural equation modeling

The purpose of this research was to examine physician utilization among the elderly within the framework of the Andersen behavioral model. The general research aim guiding this project was to determine which characteristics of individuals and their social environment predict physician use and to examine how these characteristics are interrelated.Using data from Version 3 of the Longitudinal Study on Aging, need, enabling, and predisposing factors were tested as predictors of physician use among a sample of community dwelling elders.Five latent variables were identified in three measurement models: social support network, health beliefs, perceived health, evaluated health, and chronic conditions in addition to remaining directly observed variables. The measurement models demonstrated a good fit between the three measurement models and the data. The clarification of these measurement issues helped to alleviate potential measurement problems in later specific aims.The analysis of the Andersen model based on the current literature revealed an R\sp2 of.20. The findings reported in the analysis for Specific Aim 4 support the idea that only analyzing the direct effects of predisposing, enabling, and need characteristics on physician use does not present a completely clear picture. The model developed had a reasonable fit and provided an improvement in the explained variance of physician use (R\sp2 =.25).The relative importance of major predictor variables in this model is consistent with the literature on health services use among the elderly. The inclusion of indirect effects of predisposing and enabling characteristics added clarification to understanding their roles in explaining health services use among the elderly. The full model incorporating structural equation and measurement models was tested and demonstrated that including the measurement component of predictor variables added to the understanding of the Andersen model. The full model revealed an R\sp2 of.25. Further clarification is still needed

Health as a Factor in Institutionalization Disparities between African Americans and Whites

The purpose of this article is to examine African American and White disparities in factors associated with institutionalization and differences in the effects of health on the use of this form of long-term care. The research was conceptualized within the context of the double-jeopardy hypothesis. Data for this study were taken from the first and third wave of the Longitudinal Study on Aging (N = 7,440 persons aged 70 and older). Results showed that African Americans were in poorer health than Whites. Help received from relatives for IADL's did not vary by race. However, African Americans received less help from relatives for ADLs than did their White peers. Despite poorer health and less reliance on help from relatives, African Americans were less likely than Whites to be institutionalized. Further research is called for that examines the interconnections between race, discrimination, culture, and the later life experiences and opportunities of the elderly

Families with disabilities in the United States /

"September 1996.""Prepared with funding from the National Institute on Disability and Rehabilitation Research under award number H133B3000Z."Includes bibliographical references (p. 15).Mode of access: Internet