VISITS TO SPECIALISTS UNDER MEDICARE - SOCIOECONOMIC ADVANTAGE AND ACCESS TO CARE

This study examines the relationship between socioeconomic advantage a nd the likelihood of receiving specialty care in a nationally represen tative sample of older Americans participating in fee-for-service Medi care. In 1992, 62.9 percent of Americans aged 65 and older visited a s pecialist physician at least once. Being white, having more education, and having a higher income were each independently associated with a higher likelihood of visiting a specialist. Having insurance to supple ment basic Medicare coverage was also independently associated with an increased likelihood of visiting a specialist; disadvantaged elders a re less likely to have such supplemental insurance. Therefore, based b oth upon socioeconomic disadvantage and a lack of insurance to supplem ent the basic Medicare benefit, black, less educated and low-income el ders are less likely to receive specialty services under fee-for-servi ce Medicare. As the program wolves, it will be important to continue t o monitor access to specialty care in vulnerable, socioeconomically di sadvantaged populations.