STRUCTURAL BARRIERS TO THE USE OF FORMAL IN-HOME SERVICES BY ELDERLY LATINOS

We examined data on elderly Latinos to identify structural barriers th at influence the use of a visiting nurse, home health aide, and/or hom emaker, and to investigate possible cultural influence on use. Data ar e from the 1988 Commonwealth Fund Commission's national survey of 2,29 9 Latinos age 65 and over. Logistic equations m e estimated for all el derly Latinos, those,vith a hospitalization in the past year, and thos e without a hospitalization. Need factors consistently increase the od ds of using services. The significance of Medicaid and poverty income demonstrates income barriers to community-based care. Living arrangeme nts improve our models only for those with a hospitalization in the pa st year. Acculturation has no independent effect, although some other findings can be interpreted as cultural preferences. We conclude that a universal, public long-term care program would substantially reduce barriers faced by elderly Latinos, but that nonfinancial barriers are likely to continue.