Access to health care. Part 3: Older adults.

Objectives: This report examines access to health care for older adults, 65 years of age and over. In the United States for 1993. Access indicators include having a regular source of care, place of care, main reason for no regular source of care, unmet health care needs, and use of clinical and preventive services. Sociodemographic characteristics include sex, age, race, income, health status, and health insurance coverage.

Methods: Data are from the 1993 Access to Care, Health insurance, and Year 2000 Surveys of the National Health interview Survey (NHIS), a continuing household survey of the civilian noninstitutionalized population of the United States. The sample for the Access to Care and Health insurance surveys contained 61,287 persons in 24,071 households. The sample for the Year 2000 survey was 21,028 persons.

Results: Persons with Medicare and private or Medicare and public coverage were more likely to have a regular source of medical care than elderly persons with Medicare only. Over 3.3 million elderly persons had at least one unmet need in 1993. Older adults on Medicare and public or Medicare only coverage were twice as likely to have unmet medical needs than those with Medicare and private coverage. Persons with Medicare and private coverage were more likely to receive immunizations than elderly persons with Medicare and public coverage or Medicare only.

Conclusions: Although the majority of older adults have Medicare, this only provides a basic level of access to the health care system. Older adults who do not supplement Medicare with private coverage are at the greatest risk of having unmet health care needs.