Determinants of ambulatory physician utilization among adults with chronic diseases in Quebec.
OBJECTIVE
To test the explanatory power of a model of ambulatory service use and to determine the relative roles of the main determinants of physician utilization for two chronic medical conditions in adults in Quebec.


METHODS
A behavioral model based on Andersen's model was developed and tested by linking two databases: the Quebec health survey as regards patient characteristics, and the Quebec health insurance board data on physician characteristics and service use. Path analysis was used for data analysis.


RESULTS
The model explained a little less than 20% of the variation in service use. The number of hospitalizations, physician's specialty and perceived health were the most important predictors of the volume of visits.


CONCLUSIONS
Further specification of utilization, relating it to a particular medical condition, does not necessarily lead to an increase in the explanatory power of the model. We recommend that future research should put more emphasis on provider-related determinants rather than focusing on the type and purpose of utilization.
Baris
E
E
International Development Research Centre, Ottawa.
Champagne
F
F
Rivard
M
M
D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D005544:Forecasting; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011792:Quebec / Q000453:epidemiology; D012737:Sex Factors; D012959:Socioeconomic Factors