Patterns of rural Hispanic and non-Hispanic white health care use - The San Luis Valley Health and Aging Study

This cross-sectional study examines utilization of health care resources, i ncluding nursing homes, among 1,433 rural Hispanic and non-Hispanic White p articipants in the San Luis Valley Health and Aging Study. Results show sub stantially greater non-Hispanic White residence in nursing homes, greater H ispanic use of professional home nursing services, but little ethnic differ ence in outpatient care or hospitalization. Analyses based on the behavior model of utilization find health care use strongly associated with need fac tors. In particular, outpatient care correlated with disease and instrument al daily living activity dependence, home nursing care with basic daily liv ing activity dependence, and nursing home use with daily living activity de pendence and cognitive impairment. Predisposing characteristics (age, marit al status, education) and enabling supports and barriers (insurance, availa bility of no- or low-cost care, transportation difficulties) also influence d utilization. The differential ethnic pattern of nursing home use persiste d after controlling for these important characteristics.