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Cited by 165Health Promotion and Cardiovascular PreventionPrimary Care and Health OutcomesHealthcare Policy and Management

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

Open access
Xu, K. Tom·2002·Health Services Research
DOI 10.1111/1475-6773.10524PMC PMC1464041
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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.

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  • Having a regular primary care provider, as opposed to only having a usual source of care or regular practice, is associated with more preventive care, better chronic disease and medication management, and improved access to care.

    “previous studies have found that having a regular primary care provider, as opposed to only having a usual source of care or regular practice, is associated with more preventive care [75, 76], better chronic disease and medication management [77], and improved access to care [3].”

    From Improved access to and continuity of primary care after attachment to a family physician: longitudinal cohort study on centralized waiting lists for unattached patients in Quebec, Canada (2022) · cites this paper as [76]

    The Results and Discussion (page unavailable) find that a regular doctor was associated with greater use of blood pressure and cholesterol checks than a regular site. They found no significant advantage for flu shots, mammograms, or Pap smears, so the unqualified claim of more preventive care is broader than this source supports. This citation is attached to the preventive-care portion of the sentence, not the chronic-disease or access claims. (LLM, conf=0.88)

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Research works printed but not linked: 5

  1. Chen M, Lyttle CS. “Multivariate Analysis of Access to Care.”. In: Anderson FM, Aday LA, Lyttle CS, Cornelius LS, Chen MS, editors. Ambulatory Care and Insurance Coverage in an Era of Constraint. Chicago: University of Chicago, Center for Health Administration Studies; 1987. [Google Scholar]
  2. Cohen J. MEPS Methodology Report No 1. Rockville, MD: AHCPR; 1997. “Design and Methods of the Medical Expenditure Panel Survey Household Component.”.publication No 97-0026 [Google Scholar]
  3. Greene WH. Econometric Analysis. 2d. New York: Macmillan; 1993. pp. 713–4. [Google Scholar]
  4. Robert Wood Johnson Foundation. Updated Report on Access to Health Care for the American People. New Brunswick, NJ: Robert Wood Johnson Foundation; 1983. [Google Scholar]
  5. Vistnes JP, Monheit AC. MEPS Research Findings No 1. Rockville, MD: AHCPR Pub No 97-0030; 1997. “Health Insurance Status of the US Civilian Noninstitutionalized Population 1996.”. [Google Scholar]

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Authors
Xu, K. T.
Affiliations
Texas Tech University (US)
Corresponding author
Xu, K. Tom
Venue
Health Services Research
Publisher
Wiley
Published
2002-12
Volume
37
Issue
6
Pages
1509-1529
ISSN
  • 0017-9124 (ISSN-L)
  • 1475-6773
DOI
10.1111/1475-6773.10524
PMC
PMC1464041
OpenAlex
W2133759840
Cited by
165
References
69
Citations by year
2026: 5 · 2025: 5 · 2024: 4 · 2023: 13 · 2022: 14 · 2021: 9 · 2020: 5 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 9 · 2015: 5 · 2014: 8 · 2013: 5 · 2012: 10
FWCI
5.25
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 17 d)
Locations
  • Health Services Research (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
usual source of care, preventive services, physician-patient relationship, mammography, Pap smear, cholesterol screening, influenza vaccination, behavioral models, endogeneity, health care utilization
MeSH terms
Adolescent, Adult, Blood Pressure Determination, Cholesterol, Continuity of Patient Care, Decision Making, Female, Health Services Research, Humans, Male, Mammography, Middle Aged, Patient Acceptance of Health Care, Preventive Health Services, Probability, United States, Vaginal Smears, Health Behavior, Papanicolaou Test

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