The amenability of residential area differences in medical care utilization to amelioration

Abstract

This study is directed toward an examination of the difference in the utilization of medical care services between areas of residence.

It is hypothesized that observed differences in utilization between specified areas of residence may be due entirely to the difference in population characteristics and, further, those characteristics may be non-manipulable. From this, it can be determined whether policy action designed to change utilization can be successful and, if so, which direction it should take.

Data used in this study is a 10,000 sub-sample taken from the 1970 Health Interview Survey (HIS). Dental visits per person per year, physician visits per person per year, and short stay hospital days per person per year are used as measures of use of service in separate analyses. p]The findings indicate that the difference in dental service utilization can be explained (statistically) by the difference in the educational levels of the residents of the areas. This suggests that changes in utilization can be effected by adopting programs designed to equalize educational levels between areas. For physician visits, the findings indicate that the difference in utilization between areas can be explained (statistically) by the difference in the sex of the residents of the areas. This suggests that changes in utilization are not possible or would only result from inappropriate use. For hospital days, the findings indicate that the difference in utilization between areas can be explained (statistically) by the difference in the limitation of activity due to chronic conditions (need) of the residents of the areas. This suggests that changes in utilization in the short run are not possible or would only result from inappropriate use. Long run changes could be affected by changes in medical technology that would impact on the amount of need in the populations.

The importance of these findings lie in the implication that differences in utilization between areas of residence may persist in spite of policy action that is directed at equalizing the availability of services between areas.