The goal of this literature review is to identify key issues in the patterns of medical care utilization of services for seniors as a contribution to the National Consensus process on designing and delivering health care reforms which foster seniors' independence (Shapiro & Havens, 2000). A search strategy used to identify the relevant literature since 1985 focussing mainly on peer-reviewed journal articles is described and the results of the search strategy are summarized. Key articles are identified, analysed and synthesized based on Canadian and American evidence covering patterns of institutional care, physician use, ambulatory care and the determinants of utilization of these services.