Table 4.
Results from Analysis of Visit Utilization
| Emergency Department Visits | Physician Visits | NP/PA/Midwife Visits | ||||
|---|---|---|---|---|---|---|
| Any (Logit) | Number (Censored Poisson) | Any (Logit) | Number (Censored Poisson) | Any (Logit) | Number (Censored Poisson) | |
| Medicaid HMO market share | −1.015** | −0.741* | −0.449 | −0.095 | 0.030 | 0.832* |
| (0.394) | (0.309) | (0.666) | (0.103) | (0.913) | (0.413) | |
| Medicaid PCCM market share | 0.716 | 0.285 | 1.093 | 0.415** | 1.744** | 1.505** |
| (0.389) | (0.250) | (0.721) | (0.081) | (0.433) | (0.260) | |
| Age (years) | ||||||
| 0 | −0.342 | −0.255 | 1.366** | 0.430** | 0.860* | 0.709** |
| (0.322) | (0.156) | (0.366) | (0.049) | (0.389) | (0.161) | |
| 1 | 0.490 | 0.275* | 1.512** | 0.670** | 1.070** | 0.548** |
| (0.262) | (0.137) | (0.449) | (0.048) | (0.345) | (0.172) | |
| 2, 3 | 0.414* | 0.345** | 1.496** | 0.363** | 0.402 | 0.333* |
| (0.212) | (0.113) | (0.270) | (0.044) | (0.298) | (0.150) | |
| 4–6 | −0.224 | −0.195 | 0.845** | 0.126** | 0.352 | 0.047 |
| (0.181) | (0.118) | (0.256) | (0.043) | (0.330) | (0.150) | |
| 7–10 | −0.288 | −0.028 | 0.805** | 0.194** | 0.171 | 0.120 |
| (0.188) | (0.108) | (0.242) | (0.041) | (0.333) | (0.140) | |
| 11–14 | −0.175 | −0.189 | 0.738** | −0.018 | −0.107 | −0.220 |
| (0.215) | (0.121) | (0.243) | (0.045) | (0.299) | (0.157) | |
| Male | 0.100 | 0.096 | −0.122 | −0.057** | −0.056 | 0.020 |
| (0.112) | (0.060) | (0.130) | (0.021) | (0.131) | (0.076) | |
| Year=1998/1999 | −0.051 | −0.047 | −0.085 | −0.008 | 0.002 | −0.025 |
| (0.123) | (0.062) | (0.173) | (0.022) | (0.154) | (0.079) | |
| Black | −0.370** | −0.327** | −0.327 | −0.370** | −0.222 | −0.132 |
| (0.133) | (0.079) | (0.234) | (0.029) | (0.151) | (0.098) | |
| “Other” race | −0.651** | −0.478** | −0.393 | −0.171** | −0.619** | −0.576** |
| (0.149) | (0.089) | (0.237) | (0.029) | (0.236) | (0.111) | |
| Highest education (years) | ||||||
| ≤12 | −0.081 | −0.055 | 0.570** | 0.138** | 0.321 | 0.293** |
| (0.168) | (0.080) | (0.196) | (0.029) | (0.189) | (0.101) | |
| 13–15 | 0.363** | 0.258** | 0.533 | 0.168** | 0.140 | 0.097 |
| (0.133) | (0.089) | (0.278) | (0.033) | (0.190) | (0.121) | |
| 16 | 0.104 | −0.098 | 0.986* | 0.117* | −1.040** | −0.868** |
| (0.254) | (0.157) | (0.387) | (0.051) | (0.405) | (0.258) | |
| >16 | −0.541 | −0.666* | 0.903 | 0.351** | 0.019 | 0.380 |
| (0.398) | (0.317) | (0.616) | (0.076) | (0.307) | (0.281) | |
| Any current smoker in household | 0.113 | 0.035 | −0.285 | −0.021 | −0.200 | −0.218** |
| (0.106) | (0.064) | (0.158) | (0.022) | (0.162) | (0.081) | |
| Family income | ||||||
| $5,000–$9,999 | 0.120 | 0.098 | 0.023 | 0.118** | 0.288 | 0.128 |
| (0.155) | (0.093) | (0.242) | (0.035) | (0.216) | (0.121) | |
| $10,000–$19,999 | −0.111 | −0.169 | 0.114 | 0.056 | −0.003 | 0.101 |
| (0.143) | (0.095) | (0.263) | (0.034) | (0.233) | (0.118) | |
| $20,000–$29,999 | −0.246 | −0.270* | −0.062 | 0.024 | −0.089 | −0.116 |
| (0.190) | (0.117) | (0.309) | (0.041) | (0.254) | (0.150) | |
| $30,000–$39,999 | −0.330 | −0.066 | −0.210 | −0.121* | −0.388 | −0.116 |
| (0.229) | (0.139) | (0.327) | (0.053) | (0.395) | (0.186) | |
| $40,000–$49,999 | −0.105 | 0.030 | −0.447 | 0.169** | −0.223 | −0.393 |
| (0.294) | (0.168) | (0.374) | (0.060) | (0.403) | (0.258) | |
| ≥$50,000 | −0.254 | −0.253 | 0.038 | 0.011 | −0.020 | −0.075 |
| (0.256) | (0.151) | (0.376) | (0.053) | (0.364) | (0.190) | |
| Family type | ||||||
| Married/single, no children | 1.033* | 0.634* | 0.037 | −0.219 | −0.234 | −0.531 |
| (0.464) | (0.248) | (0.549) | (0.139) | (0.596) | (0.457) | |
| Married parents, w/children | 0.123 | 0.014 | −0.469 | −0.087* | −0.604* | −0.446** |
| (0.253) | (0.111) | (0.315) | (0.038) | (0.268) | (0.125) | |
| Single parent, w/children | 0.051 | 0.001 | −0.208 | −0.013 | −0.300 | −0.416** |
| (0.178) | (0.102) | (0.339) | (0.036) | (0.200) | (0.113) | |
| Family size | ||||||
| 3–5 | −0.156 | −0.179* | −0.020 | −0.073* | −0.084 | −0.152 |
| (0.123) | (0.085) | (0.165) | (0.030) | (0.138) | (0.107) | |
| 6–8 | −0.550* | −0.299* | −0.048 | −0.316** | 0.077 | −0.047 |
| (0.247) | (0.125) | (0.266) | (0.044) | (0.320) | (0.146) | |
| Child's health status | ||||||
| Very good | 0.076 | 0.117 | 0.236 | 0.119** | −0.244 | −0.359** |
| (0.163) | (0.077) | (0.184) | (0.027) | (0.169) | (0.106) | |
| Good | 0.377 | 0.282** | 0.151 | 0.426** | 0.336 | 0.354** |
| (0.213) | (0.085) | (0.204) | (0.029) | (0.203) | (0.101) | |
| Fair | 0.477* | 0.481** | 0.013 | 0.640** | 0.321 | 0.401** |
| (0.230) | (0.106) | (0.299) | (0.037) | (0.236) | (0.133) | |
| Poor | 0.524 | 0.405 | 0.025 | 0.924** | 0.853 | 0.889** |
| (0.655) | (0.231) | (0.596) | (0.066) | (0.490) | (0.203) | |
| Parent's health status | ||||||
| Very good | 0.260 | −0.069 | 0.418 | 0.143** | −0.667** | −0.538** |
| (0.192) | (0.105) | (0.231) | (0.037) | (0.229) | (0.128) | |
| Good | 0.353 | 0.055 | 0.563** | 0.105** | −0.451 | −0.149 |
| (0.200) | (0.102) | (0.215) | (0.037) | (0.301) | (0.120) | |
| Fair/poor | 0.566* | 0.282** | 0.366* | 0.141** | −0.440 | 0.001 |
| (0.244) | (0.103) | (0.188) | (0.038) | (0.276) | (0.124) | |
| Constant | −0.819* | −0.623** | 0.679 | 0.779** | −1.426* | −1.462** |
| (0.349) | (0.235) | (0.497) | (0.086) | (0.739) | (0.314) | |
| Observations | 2,602 | 2,602 | 2,602 | 2,602 | 2,602 | 2,602 |
| State dummies | Yes | Yes | Yes | Yes | Yes | Yes |
| Predictions, holding covariates at their sample means | ||||||
| HMO market share | ||||||
| 0.30 | 0.304 | 0.434 | 0.875 | 3.611 | 0.138 | 0.230 |
| 0.40 | 0.283 | 0.403 | 0.870 | 3.577 | 0.139 | 0.250 |
| 0.50 | 0.263 | 0.374 | 0.865 | 3.543 | 0.139 | 0.271 |
| 0.60 | 0.244 | 0.348 | 0.860 | 3.510 | 0.140 | 0.295 |
| PCCM share | ||||||
| 0.30 | 0.324 | 0.449 | 0.890 | 3.816 | 0.169 | 0.283 |
| 0.40 | 0.340 | 0.462 | 0.900 | 3.977 | 0.195 | 0.329 |
| 0.50 | 0.357 | 0.475 | 0.907 | 4.146 | 0.224 | 0.383 |
| 0.60 | 0.374 | 0.489 | 0.918 | 4.322 | 0.255 | 0.445 |
Note: Standard errors are in parentheses.
*
.01<p<.05.
**
p<.01.
NP, nurse practitioner; PA, physician assistant; HMO, health maintenance organization; PCCM, primary care case management.