Equity in Health Services

Andersen, Ronald; Kravits, Joana; Anderson, Odin W.

doi:10.1097/00004010-197602010-00017

Cited by 19 publications

(26 citation statements)

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“…The Andersen model has long been the model of choice for those who study the use of medical care services (Andersen 1995; Andersen, Kravis, and Andersen 1975). The original model conditions conventional medical care use on three sets of factors: the need for health care, the predisposition to use health care, and mechanisms that enable health care utilization, such as health insurance.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…The need for care is one of the most robust predictors of conventional medical care use (Andersen et al 1975; Green and Pope 1999; Noelker et al 1998; Rew 1998) and reflects poor health or concern about health. Need is generally operationalized by objective measures, such as the presence of one or more medical condition(s), symptoms, or specific diseases.…”

Section: Review Of the Literaturementioning

confidence: 99%

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Alternative Worldviews and the Utilization of Conventional and Complementary Medicine*

Hildreth

Elman

2007

Sociological Inquiry

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We use the Midlife in the United States (MIDUS) database and an expanded Anderson model that incorporates health beliefs, including sacred worldviews as predisposing factors, to explore conventional and complementary and alternative medical (CAM) service use. Findings are that health care need, especially the number of chronic conditions is positively associated with both conventional and CAM services use. However, net of need, health beliefs and sacred worldviews differentiate CAM users versus nonusers or the number of different CAM practices that are used. Higher self-rated spirituality is associated with being a CAM user and, if a user, with adopting a wider range of practices. Individuals with higher self-rated religiosity are not more or less likely to be CAM users but adopt significantly fewer techniques, if users. We discuss the attraction to very different faces of health care, on the basis of religiosity, spirituality, and other health beliefs, with implications for policymakers and care providers.

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Section: Review Of the Literaturementioning

confidence: 99%

Section: Review Of the Literaturementioning

confidence: 99%

Alternative Worldviews and the Utilization of Conventional and Complementary Medicine*

Hildreth

Elman

2007

Sociological Inquiry

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“…These most usually include two kinds of variables: individual predisposing characteristics (Andersen, Kravitz, & Anderson, 1975;Litwin, 1995) and framing environmental and social forces (Calsyn, Burger, & Roades, 1996;Krout, Cutler, & Coward, 1990). Following from this line of thought, it is incumbent upon the researcher to identify the collection of variables that impact, independently and…”

Section: Theoretical Perspectivesmentioning

confidence: 99%

The Provision of Informal Support by Elderly People Residing in Assisted Living Facilities

Litwin

1998

The Gerontologist

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This study examined factors facilitating support giving to members of the social network by elderly Jewish persons residing in assisted living facilities in Israel. A support provision score was regressed on two sets of background control variables: personal characteristics and housing factors; social network variables; and an exchange measure-perceived available support. The hierarchical multivariate results revealed that it was principally the perceived support measure along with two personal characteristics (younger age and nonreligious orientation) that explained the variance in the support provision score (IP = .52). The findings underscore the importance of reciprocity within the informal networks of this population. Although there exists a large and growing literature on the support networks of elderly people, the bulk of reported research tends to view older persons primarily as aid recipients (Dean, Kolodny, Wood, & Ensel, 1989;Penning, 1990;Stevens, 1992;Williams, 1995). Where support giving is addressed, the inquiry most often focuses on younger people as providers of assistance to the old (Johnson, 1995). Much less attention has been paid to the role of older persons as support providers, even though it is acknowledged that elders do reciprocate the aid they receive (Peters & Kaiser, 1985), and that they reciprocate in relation to all the types of relationships they maintain (Wentkowski, 1981).The relative lack of efforts to account for help provision by older adults-a necessary component of reciprocity-is troubling, in that reciprocity in the giving and receiving of help has been found to correlate with a range of important outcomes in later life. It is directly associated with older people's life satisfaction (Antonucci, Fuhrer, & Jackson, 1990;Black, 1985;Stevens, 1992), happiness (Antonucci & Akiyama, 1987), and self-esteem (Hawley & Chamley, 1986;Wentkowski, 1981). Correspondingly, lack of reciprocity is related to dissatisfaction (Rook, 1987), guilt (Schumaker & Jackson, 1979), limited willingness to ask for help on the part of older adults (Creenberg & Shapiro, 1971;Wenger, 1993), and low self-esteem (Stein, Linn, & Stein, 1982).This article addresses the important but relatively unaddressed question of what accounts for helping behavior on the part of older people. That is, it explores the factors that facilitate the provision of support by elders to other members of their social network. The discussion is drawn from a study of the 'Address correspondence to Howard Litwin, Paul Baerwald School of Social Work, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem IL-91905, Israel. E-mail: mshowie@pluto.mscc.huji.ac.il social networks of elderly residents of assisted living facilities in Israel, which was carried out in 1995-96.At the time of the study, about 1.4% of elderly Jewish Israelis resided in some 9,000 assisted units. These facilities serve older people who live independently but receive selected auxiliary services such as social activities, nurse on call, and so on. The assiste...

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“…During the past three decades a considerable amount of research has been done which examines the structural relationships underlying health services utilization (for an extensive list of pertinent references and findings, see Andersen and Anderson, 1967;Andersen, 1968;McKinlay, 1972;Aday and Eichhorn, 1972;Flook and Sanazaro, 1973;Aday and Andersen, 1975;Andersen et al, 1975Andersen et al, , 1976Andersen and Anderson, 1979;Wolinsky, 1980). That research may be categorized under two major approaches in the health services use field: (1) the practical approach of predicting manpower and other health resource needs; and, (2) the academic approach of constructing explanatory causal models of who uses what health services, when, where, how, and why.…”

mentioning

confidence: 99%

“…Andersen and his associates have pioneered a widely used multivariate framework in which the predisposing, enabling, and illness-morbidity characteristics of the individual are used to predict health services utilization. This individual determinants framework has been submitted to empirical testing on several occasions, yielding mixed results (see Andersen, 1968;Andersen and Newman, 1973;Andersen, 1974, 1975;Wan and Soifer, 1974;Andersen et al, 1975Andersen et al, , 1976Berki and Kobashigawa, 1976;Wolinsky, 1976Wolinsky, , 1978. Andersen's multivariate framework is a static conceptualization; that is, it does not take into consideration any changes in the relationships of the variables over time.…”

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confidence: 99%

The Problems for Academic and Entrepreneurial Research in the Use of Health Services: the Case of Unstable Structural Relationships

Wolinsky

1981

The Sociological Quarterly

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Multiple regression analysis was used to determine the longitudinal stability of the structural relationships between the predisposing, enabling, and illness-morbidity characteristics of the population-at-risk and measures of health services utilization. The structural coefficients estimated from the 1971, 1972, and 1973 Health Interview Surveys were examined using the Relative Instability Ratio (RIR) presented in this paper. The RIR values indicate that-except for age, family size, occupation, and family income-all the predisposing, enabling, and illness-morbidity characteristics produce unstable structural relationships. In addition, a negative monotonic relationship was found between the temporal ordering of the groups of characteristics and their ability to produce stable structural relationships. These results demonstrate the need for entrepreneurial health manpower projection techniques and abstract academic explanatory models of health services utilization to become dynamic, rather than remaining in their present static states.During the past three decades a considerable amount of research has been done which examines the structural relationships underlying health services utilization (for an extensive list of pertinent references and findings, see ). That research may be categorized under two major approaches in the health services use field: (1) the practical approach of predicting manpower and other health resource needs; and, (2) the academic approach of constructing explanatory causal models of who uses what health services, when, where, how, and why. Eichhorn and Bice (1973) have labeled these two approaches respectively as health services research and academic research. Perhaps a more accurate pair of labels, following the lead of Bernstein and Freeman (1975), would be entrepreneurial and academic health services research. Entrepreneurial health services research is concerned primarily with increasing the explained variances of its prediction equations, while academic health services research is concerned primarily with understanding health related behavior through abstract explanatory models. Despite these differences, efforts representing both of these approaches have increased our understanding of the direct and indirect causes of health services use among 01981 by The Sociological Quarterly. All rights reserved. 0038-0253/81/1300-0207$00.75 for their commentS and suggestions. Mila Muller patiently and painstakingly typed the manuscript; her assistance is very much appreciated. Fredric D. Wolinsky's address is;

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Equity in Health Services

Cited by 19 publications

References 0 publications

Alternative Worldviews and the Utilization of Conventional and Complementary Medicine*

Alternative Worldviews and the Utilization of Conventional and Complementary Medicine*

The Provision of Informal Support by Elderly People Residing in Assisted Living Facilities

The Problems for Academic and Entrepreneurial Research in the Use of Health Services: the Case of Unstable Structural Relationships

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