Physician Visits by the Elderly: Testing the Andersen-Newman Framework

Abstract

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

“…However, an alternative explanation is that perhaps the lack of salience in the traditional enabling variables stems from faulty operationalization of variables. For instance, although income is generally considered to be an important enabling factor, it has been suggested by Strain (1990) that a difference in physician use according to income likely reflects inequities in health rather than inequities in access. This is particularly evident within the Canadian health care system where universal medical coverage, as well as coverage for prescription drugs and aides for daily living, are available to all residents.…”

“…In this model, utilization is conceptualized as a function of predisposing factors (e.g., demographic characteristics, attitudes and beliefs about health and illness, and health habits), enabling factors (e.g., availability of manpower and facilities, and accessibility of services), and need for care factors (e.g., perceived health status and number of health problems). In general, need factors have consistently emerged as the most powerful predictors of family physician use by older adults (Arling, 1985;Branch et al, 1981;Coulton and Frost, 1982;Cox, 1986;Evashwich, Rowe, Diehr, & Branch, 1984;Strain, 1990;Strain, 1991;Wan & Arling, 1983;Wan & Odell, 1981;Wolinsky, 1990;Wolinsky & Coe, 1984;Wolinsky et al, 1983;Wolinsky & Johnson, 1991), with enabling and predisposing variables playing a much smaller role. Despite its prominent position, the Andersen-Newman Behavioral Model has been found to explain a relatively modest proportion of the total variance in service use.…”

“…Notably absent in the utilization literature are Canadian studies that are based on a large representative sample of the older population. With the exception of one study by Chappell and Blandford (1987) and two studies by Strain (1990Strain ( , 1991, all of the variables that have been cited as important factors influencing family physician use are based on American data. This makes results limited in their generalizability particularly because in Canada, universal medical coverage, including physician and hospital services, as well as coverage for prescription drugs and aides for daily living are available to all residents aged 65 and over.…”

Understanding Health Care Utilization in Custody: Situation of Canadian Penitentiaries

“…The first is the Andersen-Newman model (Strain, 1990;Andersen & Newman, 1973) and the second is the Health Beliefs model (Janz & Becker, 1984;Rosenstock, 1974;Becker, 1974). Because the former includes, in part, the latter model, only the Andersen-Newman framework will be discussed here.…”

Fréquentation des groupes d'aîné(e)s et recours aux services sociaux et de santé

“…D'autres les ont considerees comme variables facilitantes (notamment: Calsyn & Roades, 1993;Mitchell, 1995). Des chercheurs n'ont observe aucune correlation entre ces variables et le recours aux services (Chappell & Blandford, 1987;Strain, 1990). Par contre, d'autres chercheurs ont constate que des variables de comportement social etaient significativement correlees au recours a des services sociaux et de sante particuliers.…”