title: Gender and ethnic/racial disparities in health care utilization among older adults.
abstract: OBJECTIVE
  We examine the role of economic access in gender and ethnic/racial disparities in the use of health services among older adults.
  
  
  METHODS
  Data from the 1993-1995 study on the Asset of Health Dynamics Among the Oldest Old (AHEAD) were used to investigate differences in the 2-year use of health services by gender and among non-Hispanic White versus minority (Hispanic and African American) ethnic/racial groups. Analyses account for predisposing factors, health needs, and economic access.
  
  
  RESULTS
  African American men had fewer physician contacts; minority and non-Hispanic White women used fewer hospital or outpatient surgery services; minority men used less outpatient surgery; and Hispanic women were less likely to use nursing home care, compared with non-Hispanic White men, controlling for predisposing factors and measures of need. Although economic access was related to some medical utilization, it had little effect on gender/ethnic disparities for services covered by Medicare. However, economic access accounted for minority disparities in dental care, which is not covered by Medicare.
  
  
  CONCLUSIONS
  Medicare plays a significant role in providing older women and minorities access to medical services. Significant gender and ethnic/racial disparities in use of medical services covered by Medicare were not accounted for by economic access among older adults with similar levels of health needs. Other cultural and attitudinal factors merit investigation to explain these gender/ethnic disparities.
authors.affiliation: Institute for Health Services Research and Policy Studies, Northwestern University, Evanston, Illinois 60208, USA. ddunlop@nwu.edu
authors.forename: Dorothy D
authors.initials: DD
authors.lastname: Dunlop
authors.forename: Larry M
authors.initials: LM
authors.lastname: Manheim
authors.forename: Jing
authors.initials: J
authors.lastname: Song
authors.forename: Rowland W
authors.initials: RW
authors.lastname: Chang
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D012959:Socioeconomic Factors; D014481:United States; D014600:Utilization Review; D044465:White People / Q000706:statistics & numerical data*