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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. Because the questions regarding preventive service mount use were asked only of individuals aged 18 years and older, individuals aged 17 years and younger were excluded from the analyses. Also, to provide national estimates using the MEPS survey, individuals whose person weights were zero or negative, were excluded. There were 15,501 individuals satisfying these two selection criteria. Whether an individual had a regular doctor, a regular site, or no usual source of care was identified. Respondents who reported having a regular site, but also indicated seeing laurel a regular doctor at that site, were classified as having a regular doctor. Three gender-neutral services (flu shot, blood pressure checkup, and cholesterol level checkup) and two gender-specific preventive services (mammogram and pap smear) were examined. The MEPS asked the respondents when was the last time they received each preventive service. The responses were dichotomized into (1) Within the past two years and (0) before two years ago or never. Data and Key VariablesData used to identify the determinants of having a regular doctor or site and how having a regular doctor or site affects the utilization of prevention were extracted from the Medical Expenditure Panel Survey (MEPS), conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics (Agency for Healthcare Research and Quality 1999). The household survey component from 1996, which contained detailed data on demographic characteristics, health hospital conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance, and income and employment, was used. More than twenty thousand individuals representing the U.S. population were surveyed. More details on the information collected ratings by the MEPS 1996 can be found in other studies (Cohen 1997; Vistnes and Monheit 1997).
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