Visits to specialists under Medicare: socioeconomic advantage and access to care

J Health Care Poor Underserved. 1998 May;9(2):153-69. doi: 10.1353/hpu.2010.0451.


This study examines the relationship between socioeconomic advantage and the likelihood of receiving specialty care in a nationally representative sample of older Americans participating in fee-for-service Medicare. In 1992, 62.9 percent of Americans aged 65 and older visited a specialist physician at least once. Being white, having more education, and having a higher income were each independently associated with a higher likelihood of visiting a specialist. Having insurance to supplement basic Medicare coverage was also independently associated with an increased likelihood of visiting a specialist; disadvantaged elders are less likely to have such supplemental insurance. Therefore, based both upon socioeconomic disadvantage and a lack of insurance to supplement the basic Medicare benefit, black, less educated and low-income elders are less likely to receive specialty services under fee-for-service Medicare. As the program evolves, it will be important to continue to monitor access to specialty care in vulnerable, socioeconomically disadvantaged populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Economics, Medical*
  • Female
  • Health Care Surveys
  • Health Services Accessibility / economics*
  • Health Services for the Aged / economics*
  • Health Services for the Aged / statistics & numerical data
  • Health Status
  • Humans
  • Insurance, Health
  • Male
  • Medicare / statistics & numerical data*
  • Medicine / statistics & numerical data
  • Socioeconomic Factors
  • Specialization*
  • United States