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

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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.