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A Different Perspective on Health and Health Services Utilization

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Annual Review of Gerontology and Geriatrics

Abstract

For more than a decade gerontologists interested in health and health behavior have called for the recognition of the marked heterogeneity that exists in these areas (e.g., Bloom & Soper, 1980; Butler, 1975; Evashwick, Rowe, Diehr, & Branch, 1984; Haug, 1981; Kovar, 1977, 1986; Shanas & Maddox, 1985; Soldo & Manton, 1985; Wan & Arling, 1983; Wolinsky & Coe, 1984), and a thoughtful examination of the most recent federal government publication on the subject supports their call (Havlik et al., 1987). These observations about heterogeneity (1) are consistent with both theory and research, (2) suggest a number of methodological problems, and (3) have important implications for public policy. We will illustrate all three points, devoting a separate section of this chapter to each.

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References

  • Andersen, R. M. (1968). A behavioral model of families’ use of health services. Chicago: Center for Health Administration Studies.

    Google Scholar 

  • Andersen, R., Lewis, S., Giachello, A., Aday, L. A., & Chiu, G. (1981). Access to medical care among the Hispanic population of the southwestern United States. Journal of Health and Social Behavior, 22, 78–89.

    Article  PubMed  CAS  Google Scholar 

  • Andersen, R., & Newman, J. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly, 51, 95–124.

    Article  CAS  Google Scholar 

  • Antonucci, T. C. (1985). Personal characteristics, social support, and social behavior. In R. H. Binstock & E. Shanas (Eds.), Handbook of aging and the social sciences ( 2nd ed. ) (pp. 94–128 ). New York: Van Nostrand Reinhold.

    Google Scholar 

  • Antonucci, T. C., & Akiyama, H. (1987). Social networks in adult life and a preliminary examination of the convoy model. Journal of Gerontology, 42, 519–527.

    Article  PubMed  CAS  Google Scholar 

  • Berki, S., Lepkowski, J., Wyszewianski, L., Landis, J. R., Magilavy, M. L., McLaughlin, C., & Murt, H. (1986). High-volume and low-volume users of health services: United States, 1980 (DHHS Publication No. 86–20402 ). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Binstock, R. H. (1985). The oldest old: A fresh perspective or compassionate ageism revisited. Milbank Memorial Fund Quarterly, 63, 420–451.

    Article  CAS  Google Scholar 

  • Bloom, B. S., & Soper, K. A. (1980). Health and medical care for the elderly and aged population: The state of the evidence. Journal of the American Geriatrics Society, 28, 451–455.

    PubMed  CAS  Google Scholar 

  • Branch, L., Jette, A., Evashwick, C., Polansky, M., Rowe, G., & Diehr, P. (1981). Toward understanding elders’ health service utilization. Journal of Community Health, 7, 80–92.

    Article  PubMed  CAS  Google Scholar 

  • Butler, R. N. (1975). Why survive? Being old in America. New York: Harper & Row. Cafferata, G. L. (in press). Marital status, living arrangements, and the use of health services by elderly persons. Journal of Gerontology, 43.

    Google Scholar 

  • Callahan, D. (1987). Setting limits: Medical goals in an aging society. New York: Simon & Schuster.

    Google Scholar 

  • Cantor, M., & Little, V. (1985). Aging and social care. In R. H. Binstock & E. Shanas (Eds.), Handbook of aging and the social sciences ( 2nd ed. ) (pp. 745–781 ). New York: Van Nostrand Reinhold.

    Google Scholar 

  • Cleary, P. D., & Angel, R. (1984). The analysis of relationships involving dichotom- ous dependent variables. Journal of Health and Social Behavior, 25, 334–348.

    Article  PubMed  CAS  Google Scholar 

  • Cornoni-Huntley, J. C., Foley, D. J., White, L. R., Suzman, R., Berkman, L. F., Evans, D. A., & Wallace, R. B. (1985). Epidemiology of disability in the oldest old: Methodologic issues and preliminary findings. Milbank Memorial Fund Quarterly, 63, 350–376.

    Article  CAS  Google Scholar 

  • Coulton, C., & Frost, A. (1982). Use of social and health services by the elderly. Journal of Health and Social Behavior, 23, 330–339.

    Article  PubMed  CAS  Google Scholar 

  • Davis, K. (1985). Health care policies and the aged: Observations from the United States. In R. H. Binstock & E. Shanas (Eds.), Handbook of aging and the social sciences (2nd ed.) (pp. 727–744). New York: Van Nostrand Reinhold.

    Google Scholar 

  • Estes, C. L., & Newcomer, R. J. (1983). Fiscal austerity and aging: Shifting government responsibility for the elderly. Beverly Hills: Sage.

    Google Scholar 

  • Evashwick, C., Rowe, G., Diehr, P., & Branch, L. (1984). Factors explaining the use of health care services by the elderly. Health Services Research, 19, 357–382.

    PubMed  CAS  Google Scholar 

  • Eve, S. B. (1982). Use of health maintenance organizations by older adults. Research on Aging, 4, 179–203.

    Article  Google Scholar 

  • Eve, S. B. (1984). Age strata differences in utilization of health care services among adults in the United States. Sociological Focus, 17, 105–120.

    Article  Google Scholar 

  • Eve, S. B., & Friedsam, H. (1980). Multivariate analysis of health care services utilization among older Texans. Journal of Health and Human Resources Administration, 3, 169–191.

    PubMed  CAS  Google Scholar 

  • Federal Council on Aging. (1981). The need for long term care: Information and issues. Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Feldstein, P. J. (1983). Health care economics ( 2nd ed. ). New York: Wiley.

    Google Scholar 

  • Fuchs, V. (1974). Who shall live? Health economics and social change. New York: Basic Books.

    Google Scholar 

  • Haug, M. R. (1981). Age and medical care utilization patterns. Journal of Gerontology, 36, 103–111.

    Article  PubMed  CAS  Google Scholar 

  • Havlik, R. J., Liu, B. M., Kovar, M. G., Suzman, R., Feldman, J. J., Harris, T., & Van Nostrand, J. (1987). Health statistics on older persons, 1986 (DHHS Publication No. 87–1409 ). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Heise, D. (1975). Causal analysis. New York: Wiley.

    Google Scholar 

  • Homan, S. M., Haddock, C. C., Winner, C. A., Coe, R. M., & Wolinsky, F. D. (1986). Widowhood, sex, labor force participation, and the use of physician services by elderly adults. Journal of Gerontology, 41, 793–796.

    Article  PubMed  CAS  Google Scholar 

  • Hyman, H. (1983). Of time and widowhood. Durham, NC: Duke University Press. Jackson, J. J. (1967). Social gerontology and the Negro: A review. The Gerontologist, 7, 168–178.

    Google Scholar 

  • Jackson, J. J. (1985). Race, national origin, ethnicity, and aging. In R. H. Binstock & E. Shanas (Eds.), Handbook of aging and the social sciences ( 2nd ed. ) (pp. 264–303 ). New York: Van Nostrand Reinhold.

    Google Scholar 

  • Kahn, R. L. (1979). Aging and social support. In M. Riley (Ed.), Aging from birth to death (pp. 77–91 ). Boulder, CO: Westview.

    Google Scholar 

  • Kahn, R. L., & Antonucci, T. C. (1980). Convoys over the life course: Attachment, roles, and social support. In P. Baltes & O. Brim (Eds.), Life-span development and behavior (pp. 253–286 ). New York: Academic Press.

    Google Scholar 

  • Keith, V. K., & Ellis, S. ( 1987, August). Utilization of health services by the black and white elderly. Paper presented at the annual meeting of the Society for the Study of Social Problems, Chicago.

    Google Scholar 

  • Kovar, M. G. (1977). Health of the elderly and use of health services. Public Health Reports, 92, 9–19.

    PubMed  CAS  Google Scholar 

  • Kovar, M. G. (1986). Expenditures for the medical care of elderly people living in the community in 1980. Milbank Memorial Fund Quarterly, 64, 100–132.

    CAS  Google Scholar 

  • Lewis-Beck, M. S. (1981). Applied regression. Berkeley: Sage.

    Google Scholar 

  • Lubitz, J., & Prihoda, R. (1984). Use and costs of Medicare services in the last years of life. In Health, U.S., 1983 (DHHS Publication No. 84–1232). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Marshall, V. (1986). Personal communication.

    Google Scholar 

  • Mechanic, D. (1979). Correlates of physician utilization: Why do major multivariate studies of physician utilization find trivial psychosocial and organizational effects? Journal of Health and Social Behavior, 20, 387–396.

    Article  PubMed  CAS  Google Scholar 

  • Mechanic, D. (1980). The experience and reporting of common physical complaints. Journal of Health and Social Behavior, 21, 146–155.

    Article  PubMed  CAS  Google Scholar 

  • Mossey, J. M., Havens, B., & Wolinsky, F. D. (in press). The consistency of formal health care utilization. In M. Ory & K. Bond (Eds.), Aging and the use of formal health services. New York: Tavistock Publications.

    Google Scholar 

  • Mossey, J. M., & Roos, L. (1987). Using claims to measure health status: The illness scale. Journal of Chronic Diseases, 40 (Suppl. 1), 41–54.

    Article  Google Scholar 

  • Mossey, J. M., & Shapiro, E. (1985). Physician use by the elderly over an eight-year period. American Journal of Public Health, 75, 1333–1334.

    Article  PubMed  CAS  Google Scholar 

  • Mutran, E., & Ferraro, K. J. (in press). Medical need and use of health services among older adults: Examination of gender and racial differences. Journal of Gerontology, 43.

    Google Scholar 

  • Neugarten, B. L. (1974). Age groups in American society and the rise of the young old. Annals of the American Academy of Political and Social Science, 415, 187–198.

    Article  Google Scholar 

  • Neugarten, B. L. (1979). Age or need entitlement. In J. Hubbard (Ed.), Aging: Agenda for the eighties (pp. 48–52 ). Washington, DC: Government Research Corporation.

    Google Scholar 

  • Neugarten, B. L. (1982). Policy for the 1980s: Age or need entitlement? In B. L. Neugarten (Ed.), Age or need? (pp. 19–32 ). Beverly Hills: Sage.

    Google Scholar 

  • Polissar, L., & Diehr, P. K. (1982). Regression analysis in health services research: The use of dummy variables. Medical Care, 20, 959–974.

    Article  PubMed  CAS  Google Scholar 

  • Report of the Secretary’s Task Force on Black and Minority Health. (1985). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Roos, N. P., Montgomery, P., & Roos, L. L. (1987). Health care utilization in the years prior to death. Milbank Memorial Fund Quarterly, 65, 231–254.

    CAS  Google Scholar 

  • Russell, L. (1981). An aging population and the use of medical care. Medical Care, 19, 633–643.

    Article  PubMed  CAS  Google Scholar 

  • Saenz, R., & Aguirre, B. E. (1988). Mexican descent and ethnic self-conception. Mimeo, Department of Sociology, Texas A&M University, College Station, Texas.

    Google Scholar 

  • Schur, C. L., Bernstein, A. B., & Berk, M. (1987). The importance of distinguishing Hispanic subpopulations in the use of medical care. Medical Care, 25, 627–641.

    Article  PubMed  CAS  Google Scholar 

  • Shanas, E., & Maddox, G. L. (1985). Health, health resources, and the utilization of care. In R. H. Binstock & E. Shanas (Eds.), Handbook of aging and the social sciences ( 2nd ed. ) (pp. 697–726 ). New York: Van Nostrand Reinhold.

    Google Scholar 

  • Snider, E. L. (1981). Young-old versus old-old and the use of health services: Does the difference make a difference? Journal of the American Geriatrics Society, 29, 354–358.

    PubMed  CAS  Google Scholar 

  • Soldo, B. J., & Manton, K. G. (1985). Changes in the health status and service needs of the oldest old: Current patterns and future trends. Milbank Memorial Fund Quarterly, 63, 286–323.

    Article  CAS  Google Scholar 

  • Stoller, E. P. (1982). Patterns of physician utilization by the elderly: A multivariate analysis. Medical Care, 20, 1080–1089.

    Article  PubMed  CAS  Google Scholar 

  • Suzman, R., & Riley, M. W. (1985). Introducing the “oldest old.” Milbank Memorial Fund Quarterly, 63, 177–186.

    CAS  Google Scholar 

  • Suzman, R., & Willis, D. (Eds.). (1988). The oldest old. New York: Oxford University Press.

    Google Scholar 

  • Travino, F. M., & Moss, A. J. (1984). Health indicators for Hispanic, black, and white Americans (DHHS Publication No. 84–1576 ). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Verbrugge, L. M. (1979). Marital status and health. Journal of Marriage and the Family, 41, 267–285.

    Article  Google Scholar 

  • Verbrugge, L. M. (1985). Gender and health: An update on hypotheses and evidence. Journal of Health and Social Behavior, 26, 157–177.

    Article  Google Scholar 

  • Wan, T. T. H., & Arling, G. (1983). Differential use of health services among disabled elderly. Research on Aging, 5, 411–431.

    Article  Google Scholar 

  • Wan, T. T. H., & Odell, B. G. (1981). Factors affecting the use of social and health services among the elderly. Ageing and Society, 1, 95–115.

    Article  Google Scholar 

  • Wolinsky, F. D. (1988). The sociology of health: Principles, practitioners, and issues ( 2nd ed. ). Belmont, CA: Wadsworth.

    Google Scholar 

  • Wolinsky, F. D., Aguirre, B. E., & Keith, V. M. (1986a). Ethnicity, aging, and the use of health services (DHHS Project Proposal RO1–AG06618). Mimeo, Department of Sociology, Texas A&M University, College Station, Texas.

    Google Scholar 

  • Wolinsky, F. D., & Arnold, C. L. (in press). A birth cohort analysis of dental contact among elderly Americans. American Journal of Public Health, 78.

    Google Scholar 

  • Wolinsky, F. D., Arnold, C. L., & Nallapati, I. V. (in press). Explaining the declining rate of physician utilization among the oldest-old. Medical Care, 26(5).

    Google Scholar 

  • Wolinsky, F. D., & Coe, R. M. (1984). Physician and hospital utilization among noninstitutionalized elderly adults: An analysis of the health interview survey. Journal of Geronotology, 39, 334–341.

    Article  CAS  Google Scholar 

  • Wolinsky, F. D., Coe, R. M., Miller, D. K., Prendergast, J. M., Creel, M. J., & Chavez, M. N. (1983). Health services utilization among the noninstitutionalized elderly. Journal of Health and Social Behavior, 24, 325–337.

    Article  PubMed  CAS  Google Scholar 

  • Wolinsky, F. D., Coe, R. M., Mosely, R. R., & Homan, S. M. (1985). Veterans’ and nonveterans’ use of health services: A comparative analysis. Medical Care, 24, 1358–1371.

    Article  Google Scholar 

  • Wolinsky, F. D., Mosely, R. R., & Coe, R. M. (1986b). A cohort analysis of the use of health services by elderly Americans. Journal of Health and Social Behavior, 27, 209–219.

    Article  PubMed  CAS  Google Scholar 

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George L. Maddox Ph.D. M. Powell Lawton Ph.D.

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Wolinsky, F.D., Arnold, C.L. (1988). A Different Perspective on Health and Health Services Utilization. In: Maddox, G.L., Lawton, M.P. (eds) Annual Review of Gerontology and Geriatrics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-38443-5_3

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  • DOI: https://doi.org/10.1007/978-3-662-38443-5_3

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