Provider variables and the utilization of ambulatory care services

This paper attempts to show the importance of including variables relating to providers of care in a full explanation of utilization of ambulatory care services. Data were obtained via interviews in a sample survey of Rhode Island households conducted in 1974. The concept of an affiliation with a medical care provider is developed and the number of affiliations is used as a provider or pattern of care variable to include in a multiple regression equation to explain utilization of ambulatory care services. The 2 key predictors of utilization are the number of affiliations and the number of conditions. Other important variables are total family income and a dummy variable representing whether or not a person has some form of government aid (such as Medicare or Medicaid) in paying for health costs. As the number of affiliations and number of conditions increases, utilization increases. Having a government-sponsored form of aid also increases utilization. A negative relationship is found between income and utilization. Together the variables included in the regression equation explain 40.4% of the variance, thus indicating the importance of including variables relating to affiliations and to how people actually obtain care in future attempts to explain utilization.