Pathways to Medicine Use

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Abstract
Although path analysis has been used to explain physician and hospital use, it has never before been applied to medicine use. This analysis assesses direct and indirect relationships among predisposing, enabling and need-for-care factors on use of prescribed and nonprescribed drugs. Data are drawn from 2378 adults in the Baltimore SMSA survey of the WHO study of medical care utilization. Principal findings in terms of direct effects are: females and whites are more likely to use both prescribed and nonprescribed medicines; age is positively related to prescribed drug use and negatively related to nonprescribed drug use. Of six enabling factors, only perceived availability of care has a significant, direct effect on drug use (positive for prescribed and inverse for nonprescribed). Perceived morbidity (a need-for-care factor) is the strongest predictor in the model on both outcome variables. Anxiety and physician visits have significant direct effects on prescribed use. The pattern of indirect effects is also discussed. Overall, the model is a better predictor of prescribed than of nonprescribed medicine use, and the analysis suggests that nonprescribed medicine use may substitute for entry into the formal medical care system.

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