An explanatory model of older persons' use of dental services. Implications for health policy

With increasing numbers of people keeping their teeth into their later years, regular dental care should be a health behavior practiced by all older persons. National surveys show, however, that older people use dental services at a much lower rate than other age groups. Even when low-cost dental services are provided, a significant number of eligible elderly do not seek dental care. A survey was conducted among 116 elderly utilizers of low-cost dental services and 142 comparable elderly who had not sought care in 3 or more years. Andersen and Newman's (1973) model was expanded in include attitudes as predisposing factors. The revised model explained 32% of variance in dental utilization; perceived need and two components of attitudes were among the eight significant variables. A follow-up of nonutilizers 6 months later revealed that 27.4% had subsequently sought dental care. The best predictors of the decision to seek care were attitudinal variables, accounting for 21% of the variance. Implications for planning dental services for low-income elderly, developing health education programs, and policies are discussed.