Exploring disparities in access to physician services among older adults: 2000-2007

Abstract

Objectives: To compare racial/ethnic disparities in access to physician services among older adults in 2000 and 2007 and to identify potential factors driving the changes observed.

Method: Using 2000 and 2007 Medical Expenditure Panel Survey data, we examine 2 measures of access for adults aged 65 and older: whether the individual reports of having a usual source of care (USC) and whether he/she made any physician visits during the past year. We model the determinants of access using logistic regressions and then calculate disparities in access between older African Americans and older Whites and between older Hispanics and older Whites applying a disparity definition suggested by the Institute of Medicine.

Results: In both 2000 and 2007, significant racial/ethnic disparities were evident in having no USC and in having no physician visits. Over the period, the disparity in having no physician visits diminished by 6.16% (p = .003) for African Americans, but it worsened by 5.28% (p = .021) for Hispanics. These changes were associated with a positive shift in the distribution of education among older African Americans and an erosion in Medicare among Hispanic seniors.

Conclusion: Among older adults, disparities in access to physician services have diminished for African Americans but have grown worse for Hispanics.