Volume and distribution of AAA sponsored services and service use by disabled older adults.

Recent studies have suggested that a lower availability and lesser range of formal long term care services may, in part, explain lower rates of formal service use by older rural as compared to older urban residents. Studies of residence differences in the availability of Area Agency on Aging sponsored services, however, have not adjusted measures according to the size of service populations. This study assesses the volume of personal and home care services available to a national sample of disabled older persons through Area Agencies on Aging (AAA) and shows that nonmetropolitan respondents have a greater volume of AAA sponsored services available per capita than metropolitan respondents. Moreover, in general, per capita service availability ratios are not associated with formal service use over a two-year period among 2,800 disabled noninstitutionalized older adults. The importance of gathering data on services available at the community level in order to more effectively assess the role of social context in service use is discussed.