Factors associated with loss of usual source of care among older adults

Access to a usual source of medical care is particularly important for older adults as they manage chronic medical conditions. According to a new national study, odds of losing a usual source of care are higher among older adults who have unmet transportation needs, who move to a new residence, or who report symptoms of depression. Odds of losing a usual source of care are lower for older adults with four or more chronic conditions and with supplemental or Medicaid insurance coverage. The study followed 7,609 participants in the National Health and Aging Trends Study, a nationally representative sample of Medicare beneficiaries age 65 years and older, for up to six years (2011-2016). Of the 95 percent of older adults who reported having a usual source of care in 2011, five percent subsequently did not. Most participants (60 percent) who reported loss of a usual source of care regained it by the next round of the study, however, those who did not regain it were more likely to continue to report lack of a usual source of care. The study results suggest that clinical as well as social factors are important in an older adult's ability to maintain a stable relationship with a clinician over time. The authors call for future work to assess how changes in health insurance, transportation and residence affect older adults' ability to experience a continuous source of care and the impact of that continuity on functional decline and hospital admissions.

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Factors Associated With Loss of Usual Source of Care Among Older Adults
Stephanie K. Nothelle, MD, et al
Johns Hopkins University School of Medicine, Baltimore, Maryland