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
. 2025 Jun 8;4(3):195-205.
doi: 10.1002/hcs2.70020. eCollection 2025 Jun.

Examining Reasons for Using Non-Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study

Abbey Gregg  1 , Hui Wang  2 , Brankeciara Ard  1 , Marcelo Takejame Galafassi  2 , Maryam Bidgoli  1
Affiliations

Examining Reasons for Using Non-Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study

Abbey Gregg et al. Health Care Sci. .

Abstract

Introduction: Having a primary care usual source of care (USC) is associated with better population health outcomes. However, the percent of adults in the United States (US) with a usual primary care provider is declining. We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.

Methods: We analyzed data from 57,152 participants in the All of Us study who reported having a USC. We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing, enabling, and need factors, according to the source of usual care.

Results: An urgent care clinic, minute clinic, or emergency department was the source of usual care for 6.3% of our sample. The odds of seeking care at this type of facility increased with younger age, lower educational attainment, and better health status. Black and Hispanic individuals, as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity, were also less likely to have a primary care USC. Financial concerns, being anxious about seeing a provider, and the inability to take time off from work also increased the likelihood of having a non-primary care USC.

Conclusions: Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient, affordable primary care. Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.

Keywords: All of Us; Andersen Behavioral Model of Health Service Use; primary care; usual source of care.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Conceptual framework for primary care as the usual source of care using Andersen's model.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. The Medicaid and CHIP Payment and Access Commission. Advising Congress on Medicaid and CHIP Policy Access in Brief: Adults' Experiences in Accessing Medical Care, 2021, https://www.macpac.gov/publication/access-in-brief-adults-experiences-in....
    1. Croke K., Moshabela M., Kapoor N. R., et al., “Primary Health Care in Practice: Usual Source of Care and Health System Performance Across 14 Countries,” Lancet Global Health 12, no. 1 (2024): e134–e144. - PMC - PubMed
    1. Pereira Gray D. J., Sidaway‐Lee K., White E., Thorne A., and Evans P. H., “Continuity of Care With Doctors—A Matter of Life and Death? A Systematic Review of Continuity of Care and Mortality,” BMJ Open 8, no. 6 (2018): e021161, 10.1136/bmjopen-2017-021161. - DOI - PMC - PubMed
    1. Calixte R., Chahal K., Besson A., and Kaplan M. S., “Access to Routine Health Care and Awareness of Hypertension Status Among Adults: Results From the National Health and Nutrition Examination Survey, 2011–2018,” Preventive Medicine 179 (2024): 107843, 10.1016/j.ypmed.2023.107843. - DOI - PubMed
    1. Levine D. M., Landon B. E., and Linder J. A., “Quality and Experience of Outpatient Care in the United States for Adults With or Without Primary Care (Vol 179, Pg 363, 2019),” JAMA Internal Medicine 179, no. 6 (2019): 854. - PMC - PubMed

LinkOut - more resources