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Y = X[beta] + [y.sub.1][I.sub.d] + [y.sub.2][I.sub.s] + [mu]where X represents the vector of predisposing, needs, and other enabling factors. Incorporating the selection using the control function model, we haveY = X[beta] + [y.sub.1][I.sub.d] + [y.sub.2][I.sub.s] + [[alpha].sub.0](1 - [I.sub.d] - [I.sub.s])[[lambda].sub.0] + [[alpha].sub.d][I.sub.d][[lambda].sub.d] + [[alpha].sub.s][I.sub.s][[lambda].sub.s] + vThe [lambda]''s are the transformations of the probabilities predicted from the first stage (Heckman 1978; 1979; 1990; Lee 1982; 1983). They are the correction factors similar to the correction factor (inverse Mill''s ratio) in a Heckman correction model where the response variable in the first stage is binary rather than multicategorical (Heckman 1979; 1990). Vella and Verbeek (1999) showed that testing for the presence of endogeneity is equivalent to testing whether [alpha]''s are zero. With the incorporation of the endogeneity control, the effects of having a regular doctor ([I.sub.d]) and having a regular site ([I.sub.s]), conditional on the choice of a usual source of care, are [y.sub.1]+([[alpha].sub.d][[lambda].sub.d]- [[alpha].sub.0],[[lambda].sub.0]) and [y.sub.2]+([[alpha].sub.s][[lambda].sub.s] - [[alpha].sub.0][[lambda].sub.0]), respectively.* A single-equation estimation that regresses utilization over having a usual source of care would provide biased results of the effect of having a usual source of care because of the omitted correction terms.

An individual has a choice between a regular site and a regular doctor (and no usual source of care), as indicated by the two arrows starting at the decision node. This choice is determined by predisposing, enabling, and need factors. The chosen usual source of care, a regular doctor or site, along with predisposing, enabling, and need factors, affects discrete preventive service use (mammogram is shown for illustration purpose). However, the effect of having a regular doctor on service use (solid arrows) may be different from that of having a regular site (dashed arrows). Furthermore, unobservable preferences of the consumers, such as their risk aversion and health conscientiousness, affect both the use of preventive services and the choice of a usual source of care. That is, the consumers who are likely to use prevention may be those who are likely to have a usual source of care, controlling for their observable characteristics. Figure 1 demonstrates that the unobservable preferences cause the endogeneity o f the choice of a usual source of care.

The Midwest Business Group on Health (MBGH), a prominent, non-profit business health coalition based in Chicago, and DoctorQuality, a leading provider of healthcare quality and patient safety services, have agreed to jointly sponsor a project to help consumers choose their doctors.The initiative, called "The Doctor Data Project," will assess the impact and usability of doctor ratings and other health information for employees of selected member employers and local coalitions.MBGH has been instrumental in promoting value purchasing of healthcare services by employers, and for striving to improve the quality of care. In 1998, the MBGH Consumer Information and Education Committee began phase one of the Doctor Data Project to assess the ability of the marketplace to provide employees with desired information about individual doctors.

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