This study examines predictors of Western physician utilization using the Andersen's Behavioral Model of Health Services Use for Chinese elders who reside in Shanghai and immigrant Chinese elders who reside in the US Chinese elders are under-studied relative to their population size and in the US are known to underutilize the healthcare system. Underutilization is highly correlated with poor health and well-being. A unique dataset allowed us to examine predictors of physician utilization for Chinese elders who resided in different countries, in an effort to determine how being an immigrant affects utilization. One hundred and seventy-seven Chinese elders in Boston and 420 Chinese elders in Shanghai participated in the survey. Multiple regression analyses were conducted separately for each sample. Predictors of physician visits for the Boston sample are insurance status, health, and social network, and for the Shanghai sample, use of Chinese medicine, health, and marital status predicted physician visits. We found that access to care variables significantly affects physician utilization for immigrant elders, and that Chinese elders in Shanghai utilize a bicultural system of care. The results indicate that in order to create effective healthcare practices for elder Chinese, alternative healthcare beliefs should be understood by Western physicians. © 2007 Elsevier Ltd. All rights reserved.

China immigrants Healthcare utilization older people Traditional Chinese medicine Physician visits USA

China immigrant Eurasia Chinese regression analysis Massachusetts multiple regression health insurance human wellbeing Health Behavior immigration Asia controlled study social network health status Far East Aged social support alternative medicine health care practice Shanghai marriage predictor variable United States North America population size Humans Asian Americans male Emigrants and Immigrants environmental factor Socioeconomic Factors Chinese medicine female cultural factor health services Article health care data set health care utilization physician attitude major clinical study health care access Office Visits outcome assessment health care system age specific care Health Services Accessibility Boston health survey