When a Usual Source of Care and Usual Provider Matter: Adult Prevention and Screening Services
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To examine whether the usual source of preventive care, (having a usual place for care only or the combination of a usual place and provider compared with no usual source of preventive care) is associated with adults receiving recommended screening and prevention services.
Using cross-sectional survey data for 24,138 adults (ages 18–64) from the 1999 National Health Interview Survey (NHIS), we estimated adjusted odds ratios using separate logistic regression models for receipt of five preventive services: influenza vaccine, Pap smear, mammogram, clinical breast exam, and prostate specific antigen.
Having both a usual place and a usual provider was consistently associated with increased odds for receiving preventive care/screening services compared to having a place only or neither. Adults ages 50–64 with a usual place/provider had 2.8 times greater odds of receiving a past year flu shot compared with those who had neither. Men ages 50–64 with a usual place/provider had nearly 10 times higher odds of receiving a PSA test compared with men who had neither. Having a usual place/provider compared with having neither was associated with 3.9 times higher odds of clinical breast exam among women ages 20–64, 4.1 times higher odds of Pap testing among women ages 21–64, and 4.8 times higher odds of mammogram among women ages 40–64.
Having both a usual place and usual provider is a key variable in determining whether adults receive recommended screening and prevention services and should be considered a fundamental component of any medical home model for adults.
- Health Resources and Services Administration. Maternal and Child Health Bureau web page, Achieving and Measuring Success: A National Agenda for Children with Special Health Care Needs. Available at: http://mchb.hrsa.gov/programs/specialneeds/measuresuccess.htm. Accessed: June 18, 2007
- Damiano PC, Momany ET, Tyler MC, et al. Cost of outpatient medical care for children and youth with special health care needs: investigating the impact of the medical home. Pediatrics. 2006;118:e1187–94. CrossRef
- Starfield B, Shi L. The medical home, access to care, and insurance: a review of evidence. Pediatrics. 2004;113suppl1493–98.
- Smith PJ, Santoli JM, Chu SY, et al. The association between having a medical home and vaccination coverage among children eligible for the vaccines for children program. Pediatrics. 2005;116:130–9. CrossRef
- Xu KT. Usual source of care in preventive service use: a regular doctor versus a regular site. Health Serv Res. 2002;37:1509–29. CrossRef
- Barr M, Ginsburg J. The advanced medical home: A patient-centered, physician-guided model of health care. Policy Monograph. Philadelphia PA: American College of Physicians; 2006. Available at: http://www.acponline.org/hpp/adv_med.pdf
- DeVoe JE, Fryer GE, Phillips R, et al. Receipt of preventive care among adults: insurance status and usual source of care. Am J Public Health. 2003;93:786–91. CrossRef
- Ettner SL. The relationship between continuity of care and the health behaviors of patients: does having a usual physician make a difference? Med Care. 1999;37:547–55. CrossRef
- Smith RA, Cokkinides V, Eyre HJ. Cancer screening in the United States, 2007: a review of current guidelines, practices, and prospects. CA Cancer J Clin. 2007;57290–104.
- StataCorp. Stata Statistical Software; Release 9.0. College Station, TX: StataCorp LP; 2005.
- StataCorp. Survey Data Reference Manual. College Station, TX: Stata Press; 2005.
- Ettner SL. The timing of preventive services for women and children: the effect of having a usual source of care. Am J Public Health. 1996;86:1748–54.
- Doescher MP, Saver BG, Fiscella K, et al. Preventive care: Does continuity count? J Gen Intern Med. 2004;19:632–7. CrossRef
- Partnership for Prevention. Preventive Care: A National Profile on Use, Disparities and Health Benefits. Washington DC: Partnership for Prevention; August 2007. Available at: http://www.prevent.org/content/view/129/72/.
- When a Usual Source of Care and Usual Provider Matter: Adult Prevention and Screening Services
Journal of General Internal Medicine
Volume 23, Issue 9 , pp 1354-1360
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- source of care
- medical home
- usual provider
- preventive care
- health insurance
- Industry Sectors
- Author Affiliations
- 1. School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
- 2. University of Minnesota Medical School, Minneapolis, MN, USA