[영문]Background: The relationship of distance to care with total health care utilization and disease burden is not well understood among the managed care population.Purposes: The aim of this study was to examine the relationship between the distance from a patient's home to his or her primary care physician (PCP) and the patient's health characteristics.Methodology: This was a population-based study of commercial health maintenance organization (HMO) members enrolled in one medium-sized health plan in Michigan in 2001. This study measured health care utilization from all settings (per member per year [PMPY]). Disease burden measure was based on the Adjusted Clinical Group (ACG) system. Distance was defined as straight-line distance between a member's residency and his or her PCP. Both direct standardization and regression modeling were used to assess the effect of distance on utilization.Findings: Both utilization and disease burden increased as distance increased, especially among members selecting PCPs in an academic health system (AHS). The difference in observed utilization between local (0-10 miles) and distant (qqqgt;30 miles) members was