Unmet Needs for Care and Medications, Cost as a Reason for Unmet Needs, and Unmet Needs as a Big Problem, due to Health-Care Provider (Dis)Continuity

J Patient Exp. 2018 Dec;5(4):258-266. doi: 10.1177/2374373518755499. Epub 2018 Mar 8.

Abstract

Objective: Provider discontinuity is associated with poorer health-care outcomes compared to continuity in studies using retrospective reports of provider (dis)continuity. This study examined unmet needs for care and assessed cost as the reason for and the level of the problem resulting from unmet needs by provider (dis)continuity using longitudinal data.

Methods: Pooled data on 10 714 working-age adults (aged 18-64) from the Medical Expenditure Panel Survey (panels 16 [2011-2012] and 17 [2012-2013]) were analyzed. Provider (dis)continuity was defined by 2 reports of having a health-care provider during the period.

Results: Persons who lost providers were more likely to forego medical care and prescription medications, forego care due to cost, and report that delaying care was a big problem than their peers who experienced continuity. Persons who gained providers were more likely to delay dental care than those who always had, lost, or never had providers.

Conclusions: Persons who experience discontinuity have poorer access to care than their peers who experience continuity. Public health initiatives should promote longitudinal relationships between persons and health-care providers.

Keywords: cost as barrier to care; provider continuity; provider discontinuity; unmet needs for care; unmet needs for care problems.