Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-08T14:30:24.772Z Has data issue: false hasContentIssue false

Predictors of Family Physician Use Among Older Residents of Ontario and An Analysis of the Andersen-Newman Behavior Model

Published online by Cambridge University Press:  29 November 2010

Linda G. Houle
Affiliation:
Laurentian University
Alan W. Salmoni
Affiliation:
Laurentian University
Raymond W. Pong
Affiliation:
Laurentian University
Simon Laflamme
Affiliation:
Laurentian University
Gloria A. Viverais-Dresler
Affiliation:
Laurentian University

Résumé

Les données sur l'utilisation des médecins de famille par les personnes âgées (65 ans et plus) de l'Enquête sur la santé en Ontario (1990) nous ont permis d'examiner les variables prédictives de leur utilisation selon les groupes d'âge et le sexe. À l'instar des études antérieures, les variables prédictives les plus importantes étaient le nombre de problèmes de santé et la perception de l'état de santé. Toutefois, en dépit des efforts en vue d'améliorer la force prédictive du modèle de comportement Andersen-Newman, ces variables n'ont expliqué que 29 pour cent de la variation de l'utilisation des médecins de famille lorsque le modèle a été appliqué aux personnes âgées interrogées dans le cadre de cette enquête. En outre, le niveau de variation expliqué est demeuré relativement bas lorsque des analyses ont été effectuées selon les groupes d'âge et le sexe. Bien que ce modèle de comportement soit le cadre conceptuel le plus fréquemment utilisé, la présente étude suggère qu'il n'est peut-être pas le plus approprié pour l'examen de l'utilisation des médecins de famille par les personnes âgées au Canada.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andersen, R.M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36, 110.CrossRefGoogle ScholarPubMed
Andersen, R.M., & Newman, J.F. (1973). Societal and individual determinants of medical care utilization in the United States. Millbank Memorial Fund Quarterly, 51, 95124.CrossRefGoogle ScholarPubMed
Arking, R. (1998). Biology of aging: Observations and principles. Sunderland, MA: Sinauer Associates Inc.Google Scholar
Arling, G. (1985). Interaction effects in a multivariate model of physician visits by older people. Medical Care, 23(4), 361371.CrossRefGoogle Scholar
Berg, S., Mellstrom, D., Persson, G., & Svanborg, A. (1981). Loneliness in the Swedish aged. Journal of Gerontology, 36(3), 342349.CrossRefGoogle ScholarPubMed
Binstock, R.H. (1999). Challenges to United States policies on aging in the new millennium. Hallym International Journal of Aging, 1(1), 313.CrossRefGoogle Scholar
Branch, L., Jette, A., Evashwich, C., Polansky, M., Rower, G., & Diehr, P. (1981). Towards understanding elder's health services utilization. Journal of Community Health, 7(4), 8091.CrossRefGoogle Scholar
Byles, J., Byrne, C., Boyle, M.H., & Offord, D.R. (1988). Ontario child health study: Reliability and validity of the general functioning subscale of the McMaster Family Assessment Device. Family Process, 27, 97104.CrossRefGoogle ScholarPubMed
Carrière, Y., & Pelletier, L. (1995). Factors underlying the institutionalization of elderly persons in Canada. Journal of Gerontology: Social Sciences, 50B, S164–S172.CrossRefGoogle Scholar
Chappell, N.L. (1990). About Canada: The aging of the Canadian population. Winnipeg, MB: Ministry of Supply and Services Canada.Google Scholar
Chappell, N.L. (1994). Home care research: What does it tell us? The Gerontologist, 34(1), 116120.CrossRefGoogle ScholarPubMed
Chappell, N.L., & Blandford, A.A. (1987). Health service utilization by elderly persons. Canadian Journal of Sociology, 12(3), 195215.CrossRefGoogle Scholar
Connidis, I.A., & McMullin, J.A. (1992). Social support and service needs of older adults: Targeting groups at risk. Final report submitted to the Ministry of Community and Social Services, Toronto, ON.Google Scholar
Coulton, C., & Frost, A. (1982). Use of social and health services by the elderly. Journal of Health and Social Behavior, 23, 330339.CrossRefGoogle ScholarPubMed
Cox, C. (1986). Physician utilization by three groups of ethnic elderly. Medical Care, 24(8), 667676.CrossRefGoogle ScholarPubMed
Eastman, B.D. (1984). Interpreting mathematical economics and econometrics. London: MacMillan Education Ltd.CrossRefGoogle Scholar
Elliot, G. (1996). Facts on aging in Canada. Hamilton, ON: The Office of Gerontological Studies, McMaster University.Google Scholar
Evashwick, C., Rowe, G., Diehr, P., & Branch, L. (1984). Factors explaining the use of health care services by the elderly. Health Service Research, 19, 357382.Google ScholarPubMed
Health and Welfare Canada. (1993a). Canada's health promotion survey 1990: Technical report. Ottawa: Minister of Supply and Services Canada.Google Scholar
Health and Welfare Canada. (1993b). Ageing and independence: Overview of a national survey. Ottawa: Minister of Supply and Services Canada.Google Scholar
Heise, D. (1969). Problems in path analysis and causal inference. In Borgatta, E. (Ed.), Sociological methodology. San Francisco: Jossey-Bass.Google Scholar
Kart, C.S., & Engler, C.A. (1995). Self-health care among the elderly: A test of the Health Behavior Model. Research on Aging, 17(4), 434458.CrossRefGoogle Scholar
McEachreon, S., Salmoni, A.W., Pong, R., Garg, R., & Viverais-Dresler, G. (2000). Anticipated choices among self-, informal, and formal care by older Canadians. Journal of Health Psychology, 5(4), 457472.CrossRefGoogle ScholarPubMed
Mutchler, J.E., & Bullers, S. (1994). Gender differences in formal care use in later life. Research on Aging, 16(3), 235250.CrossRefGoogle Scholar
National Advisory Council on Aging. (1989). 1989 and beyond — Challenges of an aging Canadian society. Ottawa: Minister of Supply and Services Canada.Google Scholar
Northcott, H.C. (1992). Aging in Alberta: Rhetoric and reality. Calgary, AB: Detlelig Enterprises Ltd.Google Scholar
Ontario Ministry of Health. (1991). Redirection of long-term care and support services in Ontario — A public consultation paper. Ottawa: Minister of Supply and Services Canada.Google Scholar
Ontario Ministry of Health. (1992a). Ontario health survey 1990: Highlights.Google Scholar
Ontario Ministry of Health. (1992b). Ontario health survey 1990: User's guide Volume 1, Documentation.Google Scholar
Ontario Ministry of Health. (1992c). Ontario health survey 1990: User's guide Volume 2, Microtape.Google Scholar
Roos, N.P. (1989). How a universal health care system responds to an aging population. Journal of Aging and Health, 1(4), 411429.CrossRefGoogle Scholar
Roos, N.P., & Shapiro, E. (1981). The Manitoba Longitudinal Study on aging. Medical Care, 19(6), 644657.CrossRefGoogle ScholarPubMed
Roos, N.P., Shapiro, E., & Roos, L.L. (1984). Aging and the demand for health services: Which aged and whose demand? The Gerontologist, 24, 3136.CrossRefGoogle ScholarPubMed
Roos, N.P., Shapiro, E., & Tate, R. (1980). Does a small minority of elderly account for a majority of health care expenditures? A sixteen-year perspective. The Milbank Quarterly, 67, 347369.CrossRefGoogle Scholar
Strain, L.A. (1990). Physician visits by the elderly: Testing the Andersen-Newman framework. Canadian Journal of Sociology, 15(1), 1935.CrossRefGoogle Scholar
Strain, L.A. (1991). Use of health services in later life: The influence of health beliefs. Journal of Gerontology, 46(3), S143–S150.CrossRefGoogle ScholarPubMed
Trypuc, J.M. (1994). Women's Health. In Bolaria, B.S. & Dickinson, H.D. (Eds.), Health, illness, and health care in Canada. Montreal, PQ: Harcourt Brace & Company.Google Scholar
Wan, T. (1989). The behavioral model of health care utilization by older adults. In Ory, M.G. & Bond, K (Eds.), Aging and health care — Social science and policy perspectives. New York: Routledge.Google Scholar
Wan, T., & Arling, G. (1983). Differential use of health services among disabled elders. Research on Aging, 5(3), 411431.CrossRefGoogle Scholar
Wan, T., & Odell, B. (1981). Factors affecting the use of social and health services for the elderly. Aging and Society, 1(1), 95115.CrossRefGoogle Scholar
Wolinsky, F.D. (1990). Health and health behavior among elderly Americans. New York: Springer Publishing Company.Google Scholar
Wolinsky, F.D., & Coe, R.M. (1984). Physician and hospital utilization among non-institutionalized elderly adults: An analysis of the Health Interview Survey. Journal of Gerontology, 39, 334351.CrossRefGoogle Scholar
Wolinsky, F.D., Coe, R.M., Miller, D.R., Prendergast, J.M., Creek, M.J., & Chavez, M.N. (1983). Health service utilization among the non-institutionalized elderly. Journal of Health and Social Behavior, 24, 325337.CrossRefGoogle Scholar
Wolinsky, F.D., Culler, S.D., Callahan, C.M., & Johnson, R.J. (1994). Hospital resource consumption among older adults: A prospective analysis of episodes, length of stay, and changes over a seven year period. Journal of Gerontology: Social Sciences, 49(5), S240–S252.CrossRefGoogle Scholar
Wolinsky, F.D., & Johnson, R.J. (1991). The use of health services by older adults. Journal of Gerontology, 46(6), S345S357.CrossRefGoogle ScholarPubMed