Racial patterns in disabled elderly persons' use of medical services.
OBJECTIVE
This study examines the extent that older persons experience patterns of health service use that vary by race.


METHODS
Using the 1989 NLTCS database, researchers estimate ten binomial logistic regressions of community medical service use by disabled White and Black older persons. Chow tests and Oaxaca decomposition analysis inform why racial differences continue to exist, although most elderly persons have Medicare.


RESULTS
With similar medical conditions, Blacks are less likely to use services, particularly prescription medications and physician services. Use of some medical services is more likely for elderly Black persons who live in rural areas, small cities, and Western states, or who have more IADLs, joint and breathing problems, and broken parts. An Oaxaca decomposition indicates that differences in personal characteristics (e.g., income and health) do not fully explain racial differences in use of prescriptions and physician services.


CONCLUSIONS
For reasons that are unrelated to financial assets, blacks remain vulnerable in their ability to access services commonly used by older persons. To remedy racial disparities in medical utilization, public policy must expand its focuses beyond health finance issues and consider differences in availability, accessibility, and acceptability.
White-Means
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Department of Economics, Fogelman College of Business and Economics, University of Memphis, Tennessee 38152, USA. swhitmns@cc.memphis.edu
D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged / Q000523:psychology*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D014481:United States