In this project, we propose to extend an analysis of the effectiveness of the receipt of specific types of health care in promoting, maintaining, and improving the health and social functioning of elderly people. Work on this topic was undertaken initially in the Norwood-Montefiore Aging Study (NMAS I), funded by the National Institute on Aging under Grant No. PO1 AG03424. This extension involves three years of semi-annual follow up interviews with NMAS I respondents (N=l,000, approximately) and with a new sample of 2225 respondents, living in the same geographic area.
The specific aims of this project are to: (1) Continue to study changing patterns in the use of health care services, and related explanatory variables, including health, the availability of social support, life events, health behaviors, sociodemographic and economic characteristics of elderly people in the Bronx, among those whose primary source of care is: (1) a group medical practice program, (2) local general care hospitals, (3) private fee-for-service physicians, (4) some other care source or (5) no source at all. (2) Analyze the relationship between characteristics of the elderly, their patterns of use of health services, and health outcomes including measures of physical health mental health, functional status and morbidity and mortality. (3) Examine the implications of transitions in living arrangements and social circumstances, including changes in household composition, moves to other dwelling or institutions such as nursing homes, and changes in formal and informal support systems on the health and well being of elderly respondents. (4) Extend the analysis of patterns of health service use, and of transitions, to a sample of 500 black elderly respondents living in the same general neighborhood.
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