PHP11: USE OF THE ANDERSEN HEALTH CARE SERVICES UTILIZATION BEHAVIORAL MODEL TO UNDERSTAND THE RELATIONSHIP BETWEEN HEALTH INSURANCE COVERAGE AND HEALTH CARE SERVICES UTILIZATION AMONG THE ELDERLY

Abstract

OBJECTIVES: The purpose of this study was to determine the relationship between health insurance coverage (Medicare, Medicaid, other public, employer-sponsored, and other private) and health care services utilization (i.e., physician visits, hospitalizations, and the ability to get needed prescription medications) among the elderly. METHODS: The 1996 National Health Interview Survey and its supplements were utilized as the data sources. Elderly persons (>65 years) who had Medicare coverage (N = 27,727,536) were included in the study. The Andersen Health Care Services Utilization Behavioral Model provided the study framework and was used to understand the effect of health insurance coverage on health care services utilization while controlling for other variables. The framework models the relationship between predisposing (age, gender, living status, race, and education), enabling (income, health insurance coverage, usual source of care, geographic location, and out-of-pocket spending), and need for care (health status, activity limitation, restricted bed days, and comorbidities) factors and health care services utilization. RESULTS: Elderly persons with additional public health insurance coverage (Medicare plus Medicaid or Medicare plus other public health insurance) had significantly more physician visits than those with Medicare only (p = 0.0159 and 0.0258, respectively). Elderly persons who had Medicare plus other public health insurance and Medicare plus other private health insurance were significantly more likely to be hospitalized than those who had Medicare only (p = 0.0341 and 0.0327, respectively). Elderly persons with Medicare plus employer-sponsored insurance were more likely to get needed prescription medication(s) (p = 0.0076) than those with Medicare only. CONCLUSIONS: Elderly persons who had additional health insurance coverage (i.e., in addition to Medicare) were more likely to have more physician visits, hospitalizations, and they were more likely to obtain needed prescription medications. Additional health insurance coverage may be beneficial in increasing access to health care services among the elderly.