Markides K S, Levin J S, Ray L A
Med Care. 1985 Mar;23(3):236-46. doi: 10.1097/00005650-198503000-00005.
Determinants of physician utilization were examined using a three-generational sample of Mexican-Americans in San Antonio. A typical version of Andersen's causal behavioral model was moderately successful in predicting physician utilization in the middle and older generations and less successful in the younger generation. Consistent with the literature, need factors (health indicators) tended to affect utilization most directly. The authors also examined whether acculturation into the larger society positively influenced utilization regardless of need, as the literature suggested. While three separate measures of acculturation had no independent effects on physician utilization, acculturation did affect utilization indirectly via the need variables in the middle generation, although these effects were not consistently in the direction of greater utilization. Generational differences in determinants of physician utilization are discussed particularly in relation to the model's greater relevance for the middle and older generations.
利用圣安东尼奥市墨西哥裔美国人的三代样本，对医生利用情况的决定因素进行了研究。安德森因果行为模型的一个典型版本在预测中年和老年群体的医生利用情况方面取得了一定成功，而在年轻群体中则不太成功。与文献一致的是，需求因素（健康指标）往往对利用情况产生最直接的影响。作者还研究了如文献所提示的那样，融入更大社会的文化适应过程是否无论需求如何都对利用情况产生积极影响。虽然文化适应的三项独立衡量指标对医生利用情况没有独立影响，但文化适应确实通过中年群体的需求变量间接影响了利用情况，尽管这些影响并不总是朝着更高利用程度的方向。文中特别讨论了医生利用情况决定因素的代际差异，尤其是该模型对中年和老年群体更具相关性的情况。
