Health services accessibility among Spanish elderly.

Area of Science:

• Gerontology
• Health Services Research
• Public Health Policy

Background:

• Understanding factors influencing healthcare utilization in aging populations is crucial for effective health policy.
• Andersen's model provides a framework for analyzing healthcare access, distinguishing between predisposing, enabling, and need factors.
• Previous research indicates varied determinants for different types of healthcare service utilization.

Purpose of the Study:

• To identify key variables predicting healthcare service use in individuals aged 65 and over in Spain.
• To differentiate predictors for various health services, including medical consultations, emergencies, hospitalizations, and dental care.
• To assess potential inequities in access to discretionary healthcare services among older adults.

Main Methods:

• Utilized data from the 1993 Spanish National Health Survey (ENSE 93).
• Employed bivariate and multivariate statistical analyses, specifically the SPSS-X Discriminant Procedure.
• Applied Andersen's behavioral model of health services utilization as the conceptual framework.

Main Results:

• Different sets of variables predict the utilization of distinct health services.
• Need-related variables are primary predictors for non-discretionary services (medical consultations, emergencies, hospitalizations).
• Predisposing and enabling factors are more significant for discretionary services (dental care), indicating potential access disparities.

Conclusions:

• Healthcare service utilization patterns among older adults are multifaceted and service-specific.
• Need is the dominant driver for essential healthcare services, aligning with Andersen's model.
• Discretionary services like dental care show evidence of inequity, influenced more by access factors than by need.