Determinants of service use among the elderly: the Sydney Older Persons Study

Objectives: To examine the determinants of service use in a community dwelling sample aged 75 or over. Methods: Subjects (n = 537) were interviewed about use of community and medical services and the provision of unpaid support from their social network. Measures of disease and disability, detailed network support data and factors that may either enable or predispose subjects to service use were obtained and their prediction of service use examined. Results: Unpaid support and community service use were predicted predominantly by disability, with disease providing little additional prediction. Medical service use was predicted by both disease and disability. With disease and disability controlled for, other variables did not significantly predict medical service use or unpaid support; but did predict small additional variation in some community service use. Conclusions: Disability and disease are the major determinants of service use with other factors contributing to the use of some community services.