THE INFLUENCE OF INSURANCE STATUS AND INCOME ON HEALTH-CARE USE AMONGTHE NONMETROPOLITAN ELDERLY

The objective of this research is to examine the influence of income a nd type of insurance coverage on the use of health services among the nonmetropolitan elderly. A model of health service utilization is used as the foundation for examining this issue with data from a telephone survey of a randomly selected sample of residents from four nonmetrop olitan countries in Pennsylvania. Results indicated that those elders with Medicaid coverage were less likely to visit a doctor than respond ents with private insurance or Medicare only, even after controlling f or income and other relevant factors. Further, lower income respondent with Medicare were less likely to visit the dentist than those with p rivate insurance (Medicare does not cover dental care). In contrast, n either income nor insurance predicted hospital use. As such, the healt h and dental care needs of many lower income nonmetropolitan elders ma y potentially be going unmet. In general, findings highlight the conti nued relevance of economic barriers to the use of such services among the nonmetropolitan elderly.