Health Care Utilization and Access

Abstract

Wolinsky (1980) has summarized the various types of categorical models of health services utilization that have been used to explain why people do or do not use health care resources: (1) demographic models, relating utilization to such factors as age, sex, marital status, and family size; (2) social structural models, which tend to emphasize educational levels, occupation, and ethnicity; (3) social psychological models, which tend to focus on the perceived susceptibility to the illness, the perceived gravity of the illness, the anticipated benefits of action, and the existence of a cue to action; (4) family resource models, which examine variables of family income, health insurance, and the existence of a regular source of care; (5) community resource models, which are often economic supply models; and (6) organizational models, which often address the style of medical practice, the system for the delivery of care, the site at which services are provided, and the type of health workers who provide the care. None of these models has been adequate by itself to explain variations in utilization of treatments, procedures, or services. Health systems models are essentially a composite of these individual models. 67