Geographic variation in primary care visits in Iowa

This study investigates the determinants of primary care office visit rates. Blue Cross and Blue Shield of Iowa subscriber information was sorted by residence into geographic health service areas. Cost-sharing information was also obtained from Blue Cross. Physician supply data were obtained from Th...

Full description

Saved in:

Bibliographic Details
Published in:	Health services research 1995-12, Vol.30 (5), p.657-671
Main Authors:	Briggs, L W, Rohrer, J E, Ludke, R L, Hilsenrath, P E, Phillips, K T
Format:	Article
Language:	eng
Subjects:	Adult Ambulatory care Ambulatory Care - classification Ambulatory Care - statistics & numerical data Ambulatory Care - utilization Ambulatory medical care Blue Cross Blue Shield Insurance Plans - statistics & numerical data Blue Cross Blue Shield Insurance Plans - utilization Catchment Area (Health) - statistics & numerical data Diagnosis-Related Groups - statistics & numerical data Diagnosis-Related Groups - utilization Female Geography Health Expenditures - statistics & numerical data Health Services Accessibility - statistics & numerical data Health Services Research Health services utilization Hospitals Humans Iowa Male Medical care Office Visits - statistics & numerical data Office Visits - utilization Physician services utilization Physicians - statistics & numerical data Physicians - supply & distribution Primary care Primary Health Care - statistics & numerical data Primary Health Care - utilization Regression Analysis Small-Area Analysis Statistics Studies Utilization Utilization review
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	This study investigates the determinants of primary care office visit rates. Blue Cross and Blue Shield of Iowa subscriber information was sorted by residence into geographic health service areas. Cost-sharing information was also obtained from Blue Cross. Physician supply data were obtained from The University of Iowa, Office of Community-Based Programs. Hospital data were reported by the Iowa Hospital Association. Cases were classified into ambulatory care groups (ACGs). Use rates were computed for each group in each service area. Ordinary least squares regression models were developed to model geographic variation in each ACG-specific primary care visit rate. Regression models were not significant for five out of eleven ACGs studied. Out-of-pocket expense significantly affected utilization in three out of six. The number of primary care practices per capita had a significant effect on utilization in two ACGs. The supply of hospital outpatient services was significant in one ACG. Study findings reveal that some ACGs are price-sensitive and some are not. Policies aimed at changing levels of primary care use should taken into account whether varying cost-sharing will influence consumer behavior in the desired direction.
ISSN:	0017-9124 1475-6773