Geriatrician and Other Physician Disciplines as the Usual Source of Care for Rural and Urban Older Adults: 2004-2010 Medical Expenditure Panel Survey

Wei-Chen Lee,Ciro V Sumaya

doi:10.4148/1936-0487.1071

Abstract

The purpose of this study is to examine the trend of usual source care (USC) rates and the discipline of choice among rural and urban older adults. Data used in this study were obtained from 2004 to 2010 Medical Expenditure Panel Survey. The yearly percentages of having a specific discipline as the USC were demonstrated from 2004 to 2010. The association of residence with likelihoods of having any of these three physician categories as USCs was assessed holding other individual characteristics constant. The overall sample size is 24,834, of which 20.0% of older adults resided in rural areas. A similar percentage of older adults living in urban areas had USCs than that of rural areas (93.69% vs. 93.46%). Overall, family practitioners were the most common USC noted in this survey while geriatricians are the least. The urban older adults are more likely than the rural ones to have geriatricians as their USC. Geriatrician discipline receives the most intensive education and training to care for older adults. The growing aging population makes it imperative to address the crisis of geriatrician shortage.

Highlights

Like those in other developed countries, the US population is aging.[1]
Urban older adults with usual source of care (USC) were more likely than urban people without USCs to be younger than 80 years old (73.7% vs. 66.5%), be female (58.0% vs. 53.3%), be non-Hispanic White (78.5% vs. 71.1%), have degree higher than high school (22.4% vs. 16.2%), have private insurance plans (54.8% vs. 40.7%), perceive good physical health (44.9% vs. 40.7%) and perceive very good mental health conditions (61.1% vs. 50.9%)
While the reason(s) for the above findings from this study may not be clear, the demographics and characteristics provide potential correlates in this study. This sampling survey examined the prevalence of a usual source of care (USC) across the U.S Three physician disciplines were selected as a USC based on their being considered frequent providers of health care to the aging population

Summary

Introduction

Like those in other developed countries, the US population is aging.[1]. Data from the US Census Bureau indicate that 40 million people were more than 65 years old in 2010; this number is expected to reach 72 million (20.3% of the total population) by 2030.2 Because young adults have migrated disproportionately from rural to urban areas for education and employment, the percentage of older people in rural areas is even higher than that nationally.[3]. The rapidly growing aging population has been accompanied by an increase in the prevalence of chronic diseases, functional disabilities, and polypharmacy.[5] About 80 % of older adults have at least one chronic condition such as diabetes, and 50 % have at least two. Half of rural Americans report having at least one major chronic disease such as hypertension.[6] Due to isolation and traditional caregiver responsibilities, approximately 40% of rural older adults are depressed or anxious compared to only 13-20 % of urban women.[7] The percentage of people 65 years and older with a physical disability has increases from 38.2 % to 46.6 % in association with the increasing level of rurality (from the most urbanized to most rural area).[8]

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