A mediator-moderator model for understanding how concern about the costs of health care and age affect access to health care

Research has shown that access to health care is influenced by health status and health coverage. Concern over the costs of care is a major reason for access to care problems; concern may also be age related. This study asks if concern about health care costs mediates the relationships between health status and access to care and health coverage and access to care. This study also asks whether age moderates these mediated relationships. Data for this study will come from the Center for Studying Health System Change, Community Tracking Study Household Survey (CTS) 2003. Mplus version 4 software will be used to analyze the data using structural equation modeling. It is hypothesized that concern over the costs of care accounts partially or totally for the relations between health status and health coverage on access to care. It is further hypothesized that concern is more likely to mediate health status on access to care and health coverage on access to care for working-age Americans than elderly Americans. Results from this study will offer insight into the appropriateness of the mediator-moderator model to explore how psychological and personal factors function as mediating or moderating effects on access to health care. This study is expected to have policy implications for federal and state administered health care.