Background
Methods
Data and sample
Analysis
Results
Summary statistics
Variable | Received no primary care | Received some primary care | Received only primary care |
---|---|---|---|
N (person-years) | 1,707,535 | 7,230,068 | 1,523,524 |
Mean age | 76.5*** (8.1) | 78.2*** (8.6) | 76.8*** (8.1) |
% Male | 38.5*** | 30.0*** | 31.3*** |
Race/Ethnicity | |||
% White | 48.1*** | 55.1*** | 41.4*** |
% Black | 17.5*** | 14.9*** | 15.6*** |
% Asian/Pacific Islander | 10.3*** | 10.9*** | 19.6*** |
% AI/AN | 2.7*** | 0.9*** | 1.0*** |
% Hispanic | 20.2*** | 17.0*** | 21.2*** |
% Other | 1.2*** | 1.2*** | 1.2*** |
Disability Status | |||
% Older adult with disability | 23.4*** | 27.9*** | 21.4*** |
Residence | |||
% Urban | 79.4*** | 83.1*** | 79.1*** |
% Rural | 20.6*** | 16.9*** | 20.9*** |
Health Status | |||
Mean # of chronic conditions | 3.0*** (2.9) | 6.2*** (2.9) | 3.5*** (2.3) |
% with 0 chronic conditions | 28.2*** | 0.9*** | 7.4*** |
% with 1–3 chronic conditions | 32.6*** | 17.5*** | 46.9*** |
% with 4–6 chronic conditions | 25.6*** | 38.7*** | 34.9*** |
% with 7–9 chronic conditions | 10.9*** | 29.7*** | 9.2*** |
% with 10+ chronic conditions | 2.7*** | 13.2*** | 1.6*** |
Health Services Use | |||
Mean PCP visits | 0.0*** (0.0) | 9.6*** (9.0) | 5.2*** (4.6) |
Mean outpatient specialist visits | 4.5*** (6.6) | 10.5*** (11.2) | 0.0*** (0.0) |
ACSC Hospitalizations | |||
Mean # of ACSC hospitalizations | 0.05*** (0.3) | 0.1*** (0.5) | 0.04*** (0.3) |
% with 1+ ACSC hospitalization | 3.6*** | 9.0*** | 3.3*** |
Regression results
Variable | Urban | Rural |
---|---|---|
N (person-years) | 8,562,571 | 1,894,368 |
PCP visits | − 0.059*** (0.002) | − 0.026*** (0.005) |
Outpatient specialist visits | −0.067*** (0.002) | − 0.146*** (0.004) |
Age | 0.037*** (0.001) | 0.025*** (0.003) |
Male | −0.138*** (0.021) | 0.336*** (0.050) |
Race/Ethnicity | ||
Black | 1.599*** (0.034) | −0.827*** (0.088) |
Asian/Pacific Islander | −0.707*** (0.028) | −0.787*** (0.192) |
AI/AN | 1.215*** (0.147) | 0.864*** (0.173) |
Hispanic | 0.399*** (0.029) | −0.471*** (0.108) |
Other | −0.795*** (0.080) | −0.539 (0.333) |
Chronic Conditions | ||
1–3 conditions | 1.129*** (0.011) | 1.606*** (0.030) |
4–6 conditions | 4.149*** (0.017) | 5.815*** (0.044) |
7–9 conditions | 12.130*** (0.031) | 16.440*** (0.074) |
10+ conditions | 29.970*** (0.060) | 36.280*** (0.136) |
Disability Status | ||
With Disability | 1.106*** (0.026) | 0.371*** (0.053) |
Year | ||
2014 | −0.339*** (0.027) | −0.566*** (0.063) |
2015 | −0.646*** (0.028) | −1.242*** (0.065) |
2016 | −0.508*** (0.028) | −1.292*** (0.066) |
2017 | −0.689*** (0.028) | −1.459*** (0.066) |
2018 | −0.949*** (0.028) | −1.830*** (0.067) |
Constant | −2.564*** (0.101) | −0.739*** (0.230) |
Variable | Urban | Rural |
---|---|---|
N (person-years) | 6,438,381 | 1,354,892 |
PCP visits | −0.056*** (0.002) | − 0.002 (0.005) |
Outpatient specialist visits | −0.059*** (0.002) | − 0.089*** (0.006) |
Age | 0.066*** (0.001) | 0.067*** (0.003) |
Male | 0.011 (0.012) | 0.596*** (0.051) |
Race/Ethnicity | ||
Black | 1.408*** (0.035) | −1.039*** (0.094) |
Asian/Pacific Islander | −0.522*** (0.027) | −0.762*** (0.183) |
AI/AN | 1.187*** (0.140) | 0.934*** (0.171) |
Hispanic | 0.473*** (0.028) | −0.635*** (0.107) |
Other | −0.815*** (0.075) | −0.708** (0.330) |
Chronic Conditions | ||
1–3 conditions | 1.019*** (0.012) | 1.277*** (0.031) |
4–6 conditions | 3.715*** (0.019) | 5.024*** (0.050) |
7–9 conditions | 10.990*** (0.037) | 15.320*** (0.093) |
10+ conditions | 26.010*** (0.083) | 34.320*** (0.198) |
Disability Status | ||
With Disability | 0.930*** (0.026) | 0.227*** (0.055) |
Year | ||
2014 | −0.281*** (0.026) | − 0.493*** (0.067) |
2015 | −0.495*** (0.027) | −1.042*** (0.068) |
2016 | −0.469*** (0.027) | −1.077*** (0.069) |
2017 | −0.671*** (0.027) | −1.247*** (0.070) |
2018 | −0.890*** (0.028) | −1.608*** (0.071) |
Constant | −5.049*** (0.107) | −4.162*** (0.262) |
Variable | Diabetes | CHF | ||
---|---|---|---|---|
Urban | Rural | Urban | Rural | |
N (person-years) | 3,819,765 | 782,184 | 2,131,443 | 530,800 |
PCP visits | −0.061*** (0.003) | − 0.034*** (0.007) | −0.112*** (0.004) | − 0.0462*** (0.001) |
Outpatient specialist visits | −0.061*** (0.002) | − 0.137*** (0.007) | −0.122*** (0.003) | − 0.275*** (0.009) |
Age | 0.035*** (0.002) | 0.008 (0.005) | −0.049*** (0.004) | −0.073*** (0.007) |
Male | −0.360*** (0.036) | 0.297*** (0.089) | −0.888*** (0.063) | 0.022 (0.138) |
Race/Ethnicity | ||||
Black | 2.496*** (0.057) | −0.436*** (0.148) | 3.487*** (0.092) | −0.583** (0.227) |
Asian/Pacific Islander | −0.335*** (0.050) | −0.942*** (0.350) | 0.696*** (0.111) | −0.185 (0.886) |
AI/AN | 1.700*** (0.248) | 1.364*** (0.291) | 2.883*** (0.473) | 2.685*** (0.512) |
Hispanic | 1.155*** (0.051) | −0.079 (0.192) | 2.407*** (0.098) | 0.813** (0.375) |
Other | −0.632*** (0.128) | −0.307 (0.608) | − 0.464* (0.237) | −1.115 (1.062) |
Chronic Conditions | ||||
2–3 conditions | 0.685*** (0.022) | 1.182*** (0.069) | 2.102*** (0.125) | 2.463*** (0.359) |
4–6 conditions | 3.311*** (0.027) | 4.894*** (0.080) | 6.982*** (0.121) | 8.516*** (0.350) |
7–9 conditions | 11.490*** (0.042) | 15.990*** (0.112) | 16.860*** (0.125) | 20.310*** (0.356) |
10+ conditions | 30.280*** (0.073) | 37.270*** (0.173) | 35.170*** (0.136) | 39.550*** (0.376) |
Disability Status | ||||
With Disability | 1.136*** (0.044) | 0.171 (0.091) | 1.187*** (0.076) | −0.081 (0.143) |
Year | ||||
2014 | −0.514*** (0.045) | − 0.713*** (0.112) | −0.688*** (0.078) | − 0.801*** (0.169) |
2015 | −1.227*** (0.048) | −1.664*** (0.115) | −1.539*** (0.082) | −2.283*** -(0.175) |
2016 | −1.294*** (0.048) | −2.035*** (0.117) | −1.415*** (0.083) | − 2.255*** (0.178) |
2017 | −1.346*** (0.048) | −2.288*** (0.118) | − 1.200*** (0.085) | − 2.490*** (0.181) |
2018 | − 1.648*** (0.049) | − 2.738*** (0.121) | − 1.661*** (0.085) | −3.272*** (0.184) |
Constant | − 2.499*** (0.181) | 0.702 (0.431) | 4.181*** (0.317) | 9.079*** (0.709) |