Jm. Mercier et Mc. Shelley, ACCESS TO HEALTH-CARE AMONG 3 COHORTS OF OLDER AMERICANS RESIDING IN A RURAL STATE, Policy studies journal, 25(1), 1997, pp. 140-156
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.