The use of health and social services is influenced by economic, community, geographic, organizational, societal, and environmental factors. A study was conducted to examine predisposing, enabling, and need-for-care factors related to the use of home health care services by a stratified random sample of 400 older adults. Predisposing factors included age, sex, race, and employment status. Enabling factors included knowledge of home health care agencies and the type of insurance coverage available to the individual. Need-for-care variables included health status, illness-induced limitations of daily living activities, use of health appliances (walker, cane), and whether the individual stated a need for services. Respondents completed a selection of items from the Older Americans Resources and Services Functional Assessment Questionnaire, the Philadelphia Geriatric Center Multi-Level Assessment Instrument, and other items related to home health care. Results of the study revealed five variables which directly affected the use of home health services by the elderly: need for service, employment of health care appliances, limited activity due to illness, type of medical insurance coverage, and age. The findings suggest that people who express a need for home health care services and have knowledge of them tend to use services, and that others who have disabling conditions also will use the services independent of expressed need for services. Four pages of references conclude the document. (NRB)