Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug;53(4):2346-2367.
doi: 10.1111/1475-6773.12753. Epub 2017 Aug 31.

Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All

Winston Liaw  1 , Anuradha Jetty  1 , Stephen Petterson  1 , Andrew Bazemore  1 , Larry Green  2
Affiliations

Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All

Winston Liaw et al. Health Serv Res. 2018 Aug.

Abstract

Objective: (1) To examine usual source of care (USC) trends across four categories (No USC, Person USC, Person, in Facility USC, and Facility USC), and (2) to determine whether USC types are associated with emergency department (ED) visits and hospital admissions.

Data source: 1996-2014 Medical Expenditure Panel Surveys.

Study design: We stratified each USC category, by age, region, gender, poverty, insurance, race/ethnicity, and education and used regression to determine the characteristics associated with USC types, ED visits, and hospital admissions.

Principal findings: Those with No USC and Facility USCs increased 10 and 18 percent, respectively, while those with Person USCs decreased by 43 percent. Compared to those in the lowest income bracket, those in the highest income bracket were less likely to have a Facility USC. Among those with low incomes, individuals with No USC, Person, in Facility, and Facility USCs were more likely to have ED visits than those with Person USCs.

Conclusions: A growing number are reporting facilities as their USCs or none at all. The impact of these trends is uncertain, although we found that some USC types are associated with ED visits and hospital admissions. Tracking USCs will be crucial to measuring progress toward enhanced care efficiency.

Keywords: Primary care; access/demand/utilization of services; health policy/politics/law/regulation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Adjusted Percentage of Usual Source of Care Type, 1996–2014 [Color figure can be viewed at http://wileyonlinelibrary.com]

  1. Source: Authors’ analysis of the 1996–2014 Medical Expenditure Panel Surveys.

See this image and copyright information in PMC

References

    1. Agency for Healthcare Research and Quality . 2015. “Medical Expenditure Panel Survey Medical Provider Component Medical Organizations Survey (MOS)” [accessed on June 9, 2017]. Available at https://meps.ahrq.gov/survey_comp/misc_survey/mpc/2015/MOS_15.htm
    1. Agency for Healthcare Research and Quality and Quality . 2008. Medical Expenditure Panel Survey Provider Roster Section, October 16.
    1. Alexander, G. C. , Kurlander J., and Wynia M. K.. 2005. “Physicians in Retainer (‘Concierge’) Practice. A National Survey of Physician, Patient, and Practice Characteristics.” Journal of General Internal Medicine 20 (12): 1079–83. - PMC - PubMed
    1. Association of American Medical Colleges . 2015. The Complexities of Physician Supply and Demand: Projections from 2013 to 2025, May 22.
    1. Bindman, A. B. , Grumbach K., Osmond D., Vranizan K., and Stewart A. L.. 1996. “Primary Care and Receipt of Preventive Services.” Journal of General Internal Medicine 11 (5): 269–76. - PubMed

Publication types

MeSH terms

LinkOut - more resources