title: Patterns of older Americans' health care utilization over time.
abstract: OBJECTIVE
  We analyzed correlates of older Americans' continuous and transitional health care utilization over 4 years.
  
  
  METHODS
  We analyzed data for civilian, noninstitutionalized US individuals older than 50 years from the 2006 and 2008 waves of the Health and Retirement Study. We estimated multinomial logistic models of persistent and intermittent use of physician, inpatient hospital, home health, and outpatient surgery over the 2004-2008 survey periods.
  
  
  RESULTS
  Individuals with worse or worsening health were more likely to persistently use medical care and transition into care and not transition out of care over time. Financial variables were less often significant and, when significant, were often in an unexpected direction.
  
  
  CONCLUSIONS
  Older individuals' health and changes in health are more strongly correlated with persistence of and changes in care-seeking behavior over time than are financial status and changes in financial status. The more pronounced sensitivity to health status and changes in health are important considerations in insurance and retirement policy reforms.
authors.affiliation: Dental Public Health, University of Maryland School of Dentistry, Baltimore, MD 21201, USA. rmanski@umaryland.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Manski
authors.forename: John F
authors.initials: JF
authors.lastname: Moeller
authors.forename: Haiyan
authors.initials: H
authors.lastname: Chen
authors.forename: Jody
authors.initials: J
authors.lastname: Schimmel
authors.forename: Patricia A
authors.initials: PA
authors.lastname: St Clair
authors.forename: John V
authors.initials: JV
authors.lastname: Pepper
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006699:Home Care Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States