C

Project: Research project

Description

Studies show that elderly persons residing in rural areas receive
significantly less outpatient physician care than do urban elderly
residents. Although the differentials appear to be large and persistent,
surprisingly little research has been directed towards understanding
their root causes or assessing their impact on outpatient treatments that
require physician intervention including specialty referrals and the use
of prescription drugs. This study proposes a formal assessment of the
determinants of urban/rural differentials in ambulatory physician
contacts and medicine use during 1992 for a nationally representative
sample of community-dwelling elderly Medicare beneficiaries. This project
will use a database that links person-level information from the new
Medicare Current Beneficiary Survey (MCBS) with Medicare claims data and
place-of-residence characteristics from the Area Resource File (ARF) and
Census Bureau files. This project aims to measure the urban/rural utilization differentials
in both probability of use and level of use among elderly persons for
outpatient physician contacts (by site, physician specialty, referral
status, and medical reason for the visit) and prescription drug use (by
medical reason for the Rx and number of scripts per physician contact)
during 1992. In addition, the project plans to determine the sensitivity
of the differentials to alternative urban/rural typologies. The project
will employ a hierarchical regression procedure based upon Andersen's
behavioral model of health services utilization to explain the source of
those differentials, making use of extensive data on the place of
residence and the distance-to-care in the linked files. Finally, a series
of regression decompositions and simulation exercises will be used to
explore the impact of policy changes on health services utilization by
rural elderly persons.
StatusFinished
Effective start/end date8/25/947/31/96

Funding

  • National Institutes of Health

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physician
health care
human being
place of residence
utilization
contact
health service
medication
outpatient treatment
regression
physician's care
drug use
typology
rural area
census
medicine
determinants
resident
drug
simulation