In this monograph the author uses data from his study with ANDERSON [A decade of health services. Social survey trends in use and expenditure, Chicago 1967, Abstr. Hyg., 1969, v. 44, abstr. 3151] to develop a three-stage model in which predisposing, enabling, and need components are used in an attempt to explain families' widely differing use of medical care services.

It postulates that use takes place (1) where a family is predisposed to receive medical care,(2) where conditions make health services available to the family and (3) where the family perceives a need for these services and responds to it. Use is then the fourth and resultant component. Degrees of discretion exercised in using hospital, physician and dental services, the three major categories of care, are differentiated. Finally hypotheses derived from the model are summarized. A common unit of use is developed, the aim being to allow comparisons and summations of use across services. The model is then applied, and by an empirical analysis an examination is made of the interrelationships between its components and families' varying use of health services, and their differential importance for the three major care categories. Each component includes sub-components, all of which are measured empirically by selected variables. The final chapter then returns to consider the implications of this analysis for modifying the model and for social policies on distribution of services.