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Research on Aging, Vol. 23, No. 1, 37-60 (2001)
DOI: 10.1177/0164027501231003

Patterns of Rural Hispanic and Non-Hispanic White Health Care Use

The San Luis Valley Health and Aging Study

Judith Baxter

University of Colorado School of Medicine, judy.baxter{at}uchsc.edu

Lucinda L. Bryant

University of Colorado School of Medicine

Sharon Scarbro

University of Colorado School of Medicine

Susan M. Shetterly

University of Colorado School of Medicine

This cross-sectional study examines utilization of health care resources, including nursing homes, among 1,433 rural Hispanic and non-Hispanic White participants in the San Luis Valley Health and Aging Study. Results show substantially greater non-Hispanic White residence in nursing homes, greater Hispanic use of professional home nursing services, but little ethnic difference in outpatient care or hospitalization. Analyses based on the behavior model of utilization find health care use strongly associated with need factors. In particular, outpatient care correlated with disease and instrumental daily living activity dependence, home nursing care with basic daily living activity dependence, and nursing home use with daily living activity dependence and cognitive impairment. Predisposing characteristics (age, marital status, education) and enabling supports and barriers (insurance, availability of no-or low-cost care, transportation difficulties) also influenced utilization. The differential ethnic pattern of nursing home use persisted after controlling for these important characteristics.


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