More patients reporting health facility as medical home vs. individual

LEAWOOD, Kan. - One in five Americans reports no usual source of health care, and the number of Americans reporting that they have a personal relationship with a usual source of care has declined steadily over the past 15 years, according to a report published in the American Family Physician earlier this week.

 

Previous studies have shown that most Americans (82%) have a usual source of care. For 56% of these people, their usual source is an individual as opposed to a facility, mostly family physicians (62%), followed by internists (16%), pediatricians (15%) and other clinicians (8%).

 

Having a usual source of health care has been associated with improved health outcomes, fewer health disparities and lower health system costs, the report noted. Additionally, individuals with a usual source of care and health insurance are more likely to access care when needed and to seek preventive care services. 

 

Researchers used data from the nationally representative Medical Expenditure Panel Survey collected between 1996 to 2012 to identify trends in the types of usual sources of care reported by individuals and noted the percentage of people who reported having a usual source of care, and whether that source was a person or facility. To smooth the trends, a three-year moving average for each measure was calculated.

 

Declines in the percentage of people reporting an individual clinician as their usual source of care was countered by a nearly equivalent rise in those reporting a facility. These trends persisted even after controlling for age, race, insurance status and poverty status, researchers noted. 

 

It is unclear whether identifying a facility rather than a clinician as a usual source of care impacts the delivery of the primary care functions deemed essential to improving health system costs and quality—first contact, coordination, continuity and comprehensiveness. It is also unknown whether the favorable effects of having a usual source of care hold true for people who shift from an individual to a facility as their usual source of care. The advent of patient-centered medical homes, broader primary care teams and increased virtual contact may help to explain these findings and represent opportunities for improved outcomes, researchers concluded.