Usual Source of Care in Preventive Service Use: A Regular Doctor versus a Regular Site

Abstract

OBJECTIVE: To compare the effects of having a regular doctor and having a regular site on five preventive services, controlling for the endogeneity of having a usual source of care. DATA SOURCE: The Medical Expenditure Panel Survey 1996 conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. STUDY DESIGN: Mammograms, pap smears, blood pressure checkups, cholesterol level checkups, and flu shots were examined. A modified behavioral model framework was presented, which controlled for the endogeneity of having a usual source of care. Based on this framework, a two-equation empirical model was established to predict the probabilities of having a regular doctor and having a regular site, and use of each type of preventive service. PRINCIPAL FINDINGS: Having a regular doctor was found to have a greater impact than having a regular site on discretional preventive services, such as blood pressure and cholesterol level checkups. No statistically significant differences were found between the effects a having a regular doctor and having a regular site on the use of flu shots, pap smears, and mammograms. Among the five preventive services, having a usual source of care had the greatest impact on cholesterol level checkups and pap smears. CONCLUSIONS: Promoting a stable physician-patient relationship can improve patients' timely receipt of clinical prevention. For certain preventive services, having a regular doctor is more effective than having a regular site.