Culturally competent, community-based care for women is needed to increase Pap smear screening among minority groups, especially Hispanic immigrant and Hispanic American women.

This research tested the hypothesis that the percent of variance explained in use of health care services by the health care services utilization model could be significantly increased by including measures of past use of health care services and of past health status. Data from older women who participated in the Social Security Administration's Longitudinal Retirement History Survey (N = 1894) were analyzed by means of regression analysis. The results revealed that measures of previous use of health care services were more strongly related to current use of health care services in 1979 than were measures of previous health status. Inclusion of previous use and previous health status variables almost doubled the amount of variance explained by current predictors in number of physician visits, and more than doubled the explained variance in having to put off health care while the amount of variance explained in number of hospital episodes and in number of hospitalized nights was increased by approximately one-third.

No abstract

The effects of Health Maintenance Organization membership on the use of physicians and hospitals. by older adults was examined using data from the 1975 National Health Interview Survey. Comparison of the HMO and non-H MO groups revealed that the HMO members differed on several demographic variables. While the HMO members tended to have more frequent physicians' visits than the nonmembers, the two groups did not differ in their number of hospitalized days or hospital episodes. In both populations, use of physician's services was most strongly influenced by poor health, although the effects were stronger in the HMO than the non-HMO group, indicating the physicians' services were more accessible by older adults in HMOs than in fee-for-service systems. Hospital utilization was affected equally strongly by poor health in both groups.