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In addition to improving access and utilization of medical care, having a usual source of care can facilitate the use of clinical prevention services in the population. It appears that adequate clinical prevention, such as immunization and cancer screening, can be better achieved through a usual source of care because the care provider has a more comprehensive understanding of a patient''s health needs. Specifically, empirical evidence found that individuals with a usual source of care were more likely to receive timely immunizations (Flocke, Stange, and Zyzanski 1998; Frank et al. 1995; Mark and Paramore 1996) and that women who had a usual source of care were more likely to receive breast and cervical cancer screening (Bindman et al. 1996; Ettner 1996; KagawaSinger and Pourat 2000; O''Malley et al. 1997; Zambrana et al. 1999). In addition, one study demonstrated that having a usual source of care promoted healthier behaviors, such as exercise and quitting smoking (Ettner 1999). Although many studies have investigated the effect of having a usual source of care on an individual''s care-seeking behavior, most do not distinguish between having a regular doctor and having a regular site. Because of the positive association between having a regular doctor and improved access to care (Alpert et al. 1970; Becker, Drachman, and Kirscht 1974; Dietrich and Marton 1982; Starfield 1992), patients'' preferences to see their usual physicians were included as one of the four domains in the Components of Primary Care Instrument (Flocke 1997). In two earlier studies comparing the effects of having a regular site and having a regular doctor (Marcus and Stone 1984; Scitovsky, Benham, and McCall 1979), it was found that having a regular doctor resulted in a higher frequency of physician visits relative to having a regular site.
DoctorQuality.com, Inc., the world''s first Quality Benefits Management Company, provides Internet-based products and services to measure, select, purchase and improve the quality of healthcare. DoctorQuality has been featured as the cover story of Modern Healthcare magazine and has been mentioned in numerous other media, including the Wall Street Journal and the Industry Standard. http://www.doctorquality.com.It has been well established that continuity of care is an important component of the quality of medical care (Starfield 1992). Lack of a usual source of care not only interrupts continuity of care but also imposes a significant barrier to receiving medical treatment. Having a usual source care is similar to having health insurance in the sense that both facilitate timely and adequate receipt of needed medical care (Baker, Stevens, and Brook 1994; Chen and Lyttle 1987; Davis and Rowland 1983; Donelan et al. 1996; Rask et al. 1994; Robert Wood Johnson Foundation 1983; Saver and Peterfreund 1993; Weissman and Epstein 1993). In the Andersen-Aday behavioral model, both are considered enabling factors. Because both lack of a usual source of care and lack of insurance hinder care-seeking, Sox et al. (1998) attempted to compare the power of having a regular physician and having insurance in predicting individuals'' access to health services. They concluded that, compared to having health insurance, having a regular p hysician was a stronger and more consistent predictor of patients'' delay in seeking care, having no physician visits, and having no emergency department visits.
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