BioMed Central Health Services Research
Utilization of specialty care may not be a discrete, isolated behavior but rather, a behavior of sequential movements within the health care system. Although patients may often visit their primary care physician and receive a referral before utilizing specialty care, prior studies have underestimated the importance of accounting for these sequential movements. The sample included 6,772 adults aged 18 years and older who participated in the 2001 Survey on Disparities in Quality of Care, sponsored by the Commonwealth Fund. A sequential logit model was used to account for movement in all stages of utilization: use of any health services (i.e., first stage), having a perceived need for specialty care (i.e., second stage), and utilization of specialty care (i.e., third stage). In the sequential logit model, all stages are nested within the previous stage.
Lee, Chioun; Ayers, Stephanie L L.; Kronenfeld, Jennie Jacobs; Frimpong, Jemima A.; Rivers, Patrick A.; and Kim, Sam S., "The Importance of Examining Movements within the US Health CareSystem: Sequential Logit Modeling" (2010). Open Dartmouth: Faculty Open Access Articles. 618.