ACCESS TO HEALTH-CARE AMONG 3 COHORTS OF OLDER AMERICANS RESIDING IN A RURAL STATE

Three cohorts of older Americans are examined to determine how they pe rceive the likelihood of being able to access health care in the futur e. A modified Andersen (1968) model provides the framework for the stu dy. A representative sample of 2,404 noninstitutionalized midwestern o lder persons separated into three age cohorts (60-69, 70-79, and 80+) was used. Predisposing, enabling, and need factors were examined by lo gistic regression. Significant differences were found between age coho rts. with !he perceptions of the oldest-old and the youngest-old appea ring to be markedly more sensitive than those of the middle-old. Need factors of health and the respondents' perceptions of help they needed with instrumental activities of daily living, and enabling factors of community community size and the barrier imposed by lack of transport ation combined to explain the perceptions of the oldest-old. For the y oungest-old, the significant variables were bills, gender, barriers im posed by inadequate insurance, lock of transportation. and a perceptio n that physicians charged more than allowed by Medicare. Recommendatio ns are made for health care policy with respect to different age cohor ts among the elderly, their families, and the rurality of the populati on.