Care quality scores drop for older adults who lack regular physician

Medicare recipients who do not have a personal physician score lower on healthcare quality measures, according to a study published in Medical Care.

"Beneficiaries without [a] personal physician report worse care experiences, rating their overall quality of care substantially lower than those with a personal physician," said study author Marc Elliott, PhD.

The study authors examined data from over 272,000 Medicare beneficiaries responding to the 2012 Consumer Assessment of Healthcare Providers and Systems survey. The survey included a question about whether respondents had a personal physician, which indicated a physician they would see for a checkup, if they wanted advice about a health problem, or if they were ill or injured.

Here are five findings from the study.

1. In all, nearly 5 percent of Medicare recipients said they did not have a personal physician. Although this is a small percentage, the study authors noted 5 percent of the Medicare population accounts for over two million patients.

2. The lack of a regular physician was linked to lower scores on patient care experience measures, including an eight-point reduction (out of 100 points) in overall healthcare rating. Respondents without a personal physician also scored lower on measures of receiving needed care, receiving care quickly and receiving needed medications.

3. The percentage of Medicare recipients without a regular physician increased to 9.3 percent for respondents with less than a high-school education, 10.5 percent for Hispanic beneficiaries, and 16.3 percent for American Indians/Alaska Natives.

4. Additionally, beneficiaries without a personal physician were more likely to be enrolled in fee-for-service Medicare without a prescription drug plan and were also less likely to be enrolled in Medicare Advantage plans. Although older adults without a regular physician had better overall health, the study found they had poorer mental health.

5. "Beneficiaries without a personal physician were more than three times as likely to have not seen any healthcare provider in the last six months," the researchers wrote. "Medicare would be well-served to better understand who does and does not have a personal physician and take actions to help connect beneficiaries to providers."

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