Kosloski K, Austin C, Borgatta E
Institute of Gerontology, Wayne State University, Detroit, MI 48202.
Med Care. 1987 Sep;25(9):830-46.
By the end of the decade, fully one half of American males aged 65 years and over will be veterans. In anticipation of the increased demand for medical services, the Veterans Administration recently commissioned a survey of the needs of aging veterans. From a national probability sample, approximately 34,500 households were screened to yield interviews with 3,013 veterans aged 55 years and over. Using multivariate regression analyses, the present study employed this data set for two purposes: 1) to identify covariates of past and present service utilization in the VA system, and 2) to identify the conditions under which veterans will declare an intention to use VA services in the future. Independent variables included medical diagnoses, ADLs, demographic and background characteristics, convenience and proximity to VA facilities, alternative forms of insurance coverage, VA eligibility, and attitudes about the quality of VA care. The results suggest markedly different predictors for current use versus likelihood of future use; however, income was related to both current and intended future utilization. The implications of these findings for policy development and utilization projections are discussed.
到本世纪末,65岁及以上的美国男性中将有整整一半是退伍军人。鉴于对医疗服务的需求增加,退伍军人管理局最近委托开展了一项针对老龄退伍军人需求的调查。从全国概率样本中,筛选了约34500户家庭,以便对3013名55岁及以上的退伍军人进行访谈。本研究使用多变量回归分析,将该数据集用于两个目的:1)确定退伍军人事务部(VA)系统过去和当前服务利用情况的协变量,以及2)确定退伍军人将来会声明有使用VA服务意向的条件。自变量包括医疗诊断、日常生活活动能力、人口统计学和背景特征、到VA设施的便利性和距离、替代保险形式、VA资格以及对VA护理质量的态度。结果表明,当前使用情况与未来使用可能性的预测因素明显不同;然而,收入与当前及未来预期使用情况均相关。文中讨论了这些发现对政策制定和使用预测的影响。