The number of elderly minorities is growing faster than the elderly in general. Their lower health status, observed under-representation in nursing homes, and population growth bring about a major policy issue: minority elderly suffer from inequitable access to a major long term care (LTC) service. Other forms of LTC such as home and community care, underestimated in the past, play an increasingly important role in the continuum of care for the functionally dependent elderly. Yet, few, if any, efforts are undertaken to compare the use of the spectrum of care for the elderly in general and minority elderly in particular. The main aim of this project is to explain the observed differences in utilization of LTC services between minority and white elderly. This project will help identify the sources of inequity in access to LTC services for minority elderly and provides the basis for practical and valuable policy decisions. The 1987 National Medical Expenditure Survey (NMES) is used to achieve this goal. NMES is a multistage, area probability survey that oversamples the minority, elderly, poor, and those with functional difficulties. The survey focuses on the utilization of LTC services. The sample is limited to a cross-section of the elderly 65 years of age and over living in the community and in nursing homes and board and care facilities. Using Aday and Andersen's model of health care utilization and access, population characteristics such as insurance, income, attitudes towards health care, social support, and region are used to explain differences in the use of home care, community services, and nursing home use. A multi-nomial logistic regression model is used to identify which factors have the greatest impact on utilization of LTC services.
