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The ability of elderly individuals to care for themselves and their actual patterns of long-term care services utilization were assessed. Such information is necessary to establish eligibility for access to the long-term care services network. A purposive sample of eight community-based, in-home/home health, and institutional care providers was selected. We gathered data for 547 of the 1,439 elderly consumers and obtained subjective and evaluative measures of level of functioning, including assessments of activities of daily living, instrumental activities of daily living, and demographic characteristics. Four methods of determining eligibility were compared and contrasted. Methodological issues and policy and practice implications are discussed.

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The relationship of medical insurance, utilization and health status indicators was examined for 463 elderly individuals. The uninsured were less well and tended to utilize the health care system more often than those with more types of coverage. Need was found to be the best predictor of utilization. A profile describing those with above average levels of well-being also was developed. Methodological issues and health care policy recommendations are discussed.