CHANGES IN PHYSICIAN UTILIZATION OVER TIME AMONG OLDER ADULTS

Although much is known from cross-sectional studies about the use of p hysician services among older adults, little is known about the consis tency of or changes in that utilization over time. Hierarchical multiv ariable regression analysis of data oil the 2,430 older adults who wer e enrolled in the LSOA and successfully reinterviewed in 1986, 1988, a nd 1990 is used to model changes in the number of physician visits bet ween 1984 and 1990 based on the predisposing, enabling, and need (incl uding functional status) characteristics measured in 1984, and subsequ ent changes in functional status. Overall, 19 percent of the variance in physician utilization is explained, with 8 percent coming from the introduction of the need characteristics, 4.7 percent from the subsequ ent introduction of the number of physician visits at baseline, and 4. 9 percent from the subsequent introduction of changes in functional st atus. Declines in each Of the functional status measures are significa ntly associated with increases ill physician utilization, although imp rovements are fundamentally unrelated.