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The most noticeable patterns in Table 4 are that, after controlling for endogeneity, (1) having a regular doctor has a greater impact on only two services than having a regular site and is as effective as having a regular site for the other three services, and (2) the magnitude of the impact of having a usual source of care differs by service. In descending order of the impact magnitude, having a regular doctor affected: cholesterol level checkups, pap smears, blood pressure checkups, flu shots, and mammograms. The ordered sequence for the impact magnitude of having a regular site was: pap smears, cholesterol level checkups, mammograms, blood pressure checkups, and flu shots. A regular doctor outperformed a regular site in ensuring that individuals have blood pressure and cholesterol level checkups. No significant differences were found in the effects of having a regular doctor and having a regular site on an individual''s receiving flu shots, mammograms, and pap smears.

The ASUI displayed evidence of reliability and validity as an outcome measure for clinical trials and cost-effectiveness studies of asthma. As designed, the patient scores were well distributed across the 0 to 1.0 scale. In contrast, the range of scores on the HUI2 was relatively narrow, with a substantial number of the patients scoring a perfect 1.0. Mean HUI2-derived utility score of 0.84 ([+ or -]0.17) in this sample was remarkably similar to the SG score of 0.87 ([+ or -]0.13) reported by Rutten-van Molken et al.[12] ASUI scores were relatively stable and reproducible over a 2-week time period.

The sample composition of the 15,501 individuals is shown in Table 1. Predisposing variables were age, gender, race, ethnicity, education, marital status, region of residence, and MSA (Metropolitan Statistical Area) status. For need variables, individuals'' general health status was used. Family poverty level and insurance status were included as enabling factors. Having insurance was defined as having coverage for physician and hospital services. Insurance status was grouped into: no insurance for 12 months, insured for 1-11 months, insured for 12 months by different types of plans, and insured for 12 months by the same plan. The probabilities of having no usual source of care, having a regular doctor, and having a regular site in the first stage were estimated by a multinomial logit model. In the selection stage, a reduced-form estimation was employed. The probabilities of having no usual source of care, a regular doctor, and a regular site were predicted for each individual. These probabilities were then transformed into the endogeneity correction terms. Whether an individual had children and the total number of conditions the children had were included as two additional exogenous variables appearing only in the selection stage.

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