Physician Utilization by Three Groups of Ethnic Elderly

Determinants of physician utilization were examined among three groups of ethnic elderly, Vietnamese, Portuguese, and Hispanic, living in Santa Clara, California. Andersen and Newman's behavioral model provided a framework for the analysis. Univariate analysis described and compared the three groups in terms of predisposing, enabling, and need factors as well as factors related to ethnicity such as language and language of the physician. Least squares regression compared the predictors of utilization for the samples. The results showed that need is the common determinant of physician care but that the definition of need varies with ethnicity. The samples had similar rates of chronic illnesses and made equal physician visits, but the needs and factors predicting utilization differed. Contrasts were found between groups in the role of marital status on utilization. For the Portuguese, being married was a significant predictor; while for the Hispanics, being unmarried was significant. The most important predictor for the Vietnamese was satisfaction with their medical care, a factor that was not significant for the other samples. This may indicate that the physician's role transcends that of being just a health care provider for this population. The results suggest that ethnicity is not necessarily a barrier to care but that providers must be sensitive to the cultural diversities of patients and the effects they can have on utilization.