Declining Use of Primary Care Among Commercially Insured Adults in the United States, 2008–2016

Ganguli, Ishani; Shi, Zhuo; Orav, E. John; Rao, Aarti; Ray, Kristin N.; Mehrotra, Ateev

doi:10.7326/m19-1834

Cited by 66 publications

(55 citation statements)

References 44 publications

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“…Consistent with prior research, 1,3 the proportion of individuals in contact with a primary care physician over 2 years decreased a few percentage points, which was evident primarily among individuals aged between 18-64 years. The number of contacts with a primary care physician over 2 years declined across all age groups at varying rates.…”

Section: Discussionsupporting

confidence: 86%

“…revious reports suggest there has been a decrease in primary care visits and number of patients per month in contact with a primary care physician over the past 15 years. [1][2][3][4] It is unclear if this phenomenon is secondary to a decrease in number of visits per patient or absolute number of patients in contact with a primary care physician over time. In this regard, we sought to describe the proportion of patients in contact with a primary care physician, as well as the total number of primary care visits over multiple 2-year periods.…”

mentioning

confidence: 99%

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Decreasing Use of Primary Care: A Repeated Cross-Sectional Study of MEPS 2007-2017

Johansen

Niforatos

2021

Ann Fam Med

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Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

Decreasing Use of Primary Care: A Repeated Cross-Sectional Study of MEPS 2007-2017

Johansen

Niforatos

2021

Ann Fam Med

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“…These findings are consistent with those of a prior study identifying that primary care visits are becoming less common, and nearly one-half of commercially insured adults have no primary care visits in any given year. 11 Since each interaction with the health care system is an opportunity to improve the overall health of the patient, these results have important implications on the role of dermatologists in the care of patients with chronic inflammatory and autoimmune skin disease. If dermatologists are the main point of contact with the health care system for a patient, there is an opportunity for dermatologists to not only treat the patients' skin disease but also play a role in the identification of relevant comorbidities and screening or referral for common health issues.…”

Section: Discussionmentioning

confidence: 99%

Use of primary care services among patients with chronic skin disease seen by dermatologists

et al. 2021

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Background: Skin diseases, such as psoriasis, hidradenitis suppurativa, acne, and alopecia areata, have increasingly been linked to systemic and mental health comorbidities, such as depression. Although identification and management of these comorbidities is typically a part of primary care, some patients might not have an established relationship with a primary care provider and may only be seeing their dermatologist. Objective: To examine the frequency with which dermatologists are the main contact within a health care system for patients with these chronic skin conditions. Methods: We performed a retrospective cohort study using Optum's deidentified Clinformatics Data Mart Database. The primary outcome was the proportion of patients who established care with a dermatologist and had no encounters with a primary care provider during the subsequent year after this dermatology encounter. Results: Across each of the skin diseases evaluated, 21.6%-31.2% of men and 16.9%-26.2% of women had no primary care visits in the subsequent year after establishing care with their dermatologist. Conclusion and Relevance: For many patients with chronic skin diseases, their dermatologist might be their only source of contact with the health care system. There may be an opportunity for dermatologists to improve the quality of care for our patients by screening for associated comorbidities.

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“…Findings among Medicare beneficiaries aged 65 years and older may not be generalizable to younger, healthier individuals with lower risk for mortality or readmission. 42 However, Medicare beneficiaries account for growing share of ED visits, and lessons may be generalizable given that 60% of US residents have at least 1 chronic condition. 2 , 43 , 44 Our study is observational, and therefore, the associations suggest, but do not prove, the benefit of ambulatory follow-up after ED discharge.…”

Section: Discussionmentioning

confidence: 99%

Ambulatory Follow-up and Outcomes Among Medicare Beneficiaries After Emergency Department Discharge

et al. 2020

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Key Points Question How often do Medicare beneficiaries have an ambulatory follow-up visit after discharge from the emergency department, and is ambulatory follow-up associated with postdischarge outcomes? Findings In this cohort study of 9 470 626 emergency department discharges from 2011 to 2016, most patients had ambulatory follow-up within 30 days, with lower rates among Medicaid-eligible beneficiaries, Black beneficiaries, and those treated at rural emergency departments. Ambulatory follow-up was associated with a higher risk of subsequent hospitalization but a lower risk of 30-day mortality. Meaning The findings of this study suggest that access to ambulatory care may be a key driver of outcomes among Medicare beneficiaries discharged from the emergency department.

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Declining Use of Primary Care Among Commercially Insured Adults in the United States, 2008–2016

Cited by 66 publications

References 44 publications

Decreasing Use of Primary Care: A Repeated Cross-Sectional Study of MEPS 2007-2017

Decreasing Use of Primary Care: A Repeated Cross-Sectional Study of MEPS 2007-2017

Use of primary care services among patients with chronic skin disease seen by dermatologists

Ambulatory Follow-up and Outcomes Among Medicare Beneficiaries After Emergency Department Discharge

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