Urban/rural differences in health service utilization by elderly persons in the United States.

This paper presents the results of a longitudinal analysis of differences between urban and rural elderly persons in the use of hospital, nursing home, and physician services. Multivariate logistic and Tobit utilization models were estimated with data from the National Center for Health Statistics' Longitudinal Study of Aging (a national survey of more than 5,000 elderly, 70 years of age and older) and health resource data from the Bureau of Health Professions' Area Resources File. The research investigated the independent effect of residential location on both the frequency of service use and the likelihood of using a service over the period 1984-1986. Under a trichotomous definition of urban/rural residency and controlling for differences in predisposing, enabling, and need characteristics, the analysis revealed that the utilization pattern of hospital, nursing home, and physician services was unrelated to either rural or urban residential location or the availability of health resources in those areas.