Usual source of care and access to care in the US: 2005 vs. 2015.

Abstract

IntroductionThe study examined the association of usual source of care (USC) and healthcare access using a series of access indicators including both positive and negative measures for the US population in 2005 and 2015 while controlling for individual sociodemographic and socioeconomic characteristics. Results of the study would help advance the knowledge of the relationship between USC and access to care and assist decisionmakers in targeted interventions to enhance USC as a strategy to enhance access.MethodsThe household component of the US Medical Expenditure Panel Survey (MEPS-HC) in 2005 and 2015 were used for the study. To estimate the relative risk of having USC on access to care, odds ratios (ORs) and their 95% confidence intervals (CIs) were used with unconditional logistic regression and adjusted for socioeconomic and demographic characteristics.ResultsThose with USC were significantly more likely to have better access to care compared to those without USC. The USC-access connection remains significant and strong even after controlling for socioeconomic and demographic characteristics. Regarding subpopulations likely to lack USC, two notable findings are that racial/ethnic minorities (Black, Asian, and Hispanic) are more likely than White to lack USC and that those uninsured are more likely to lack USC.ConclusionThe study contributes to the literature on USC and access to care and has significant policy and practical implications. For example, having a USC is critical to accessing the health system and is particularly important as a tool to addressing racial disparities in access.