Objective: To examine prospectively, using the behavioral model of health service utilization, patient-initiated physician visits, physician-requested visits, and visits for disease flares by 270 patients with rheumatoid arthritis (RA).

Methods: Four waves of telephone interviews were conducted over 2 years. Hierarchical regression analyses were used to assess the relative contributions to variance explained by blocks of variables indicating need for care and predisposing and enabling factors.

Results: Predisposing and enabling factors accounted for 50-67% of the explained variance in the 3 types of visits, while need accounted only for 33-50%.

Conclusions: Studies seeking to identify factors other than need for care that facilitate or inhibit physician visits among RA patients are essential to analyzing the costs of care.