Access and Perceived Quality of Care in US Adults with Multiple Chronic Conditions: MEPS 2019-2021.

Abstract

Managing multiple chronic conditions (MCC) requires complex oversight. A usual source of care (USC) is pivotal in navigating complex care and coordination and enhancing self-management. However, the knowledge about access and quality of USC and associated disparities is limited in US adults with MCC. To examine access and perceived quality of USC and identify sociodemographic disparities in US adults with MCC. This is a cross-sectional study using US Medical Expenditure Panel Survey (MEPS) data. This study used 2019 and 2021 MEPS Household Component data to identify US adults reporting two or more chronic conditions. The outcomes included characteristics, accessibility, and perceived quality of USC. Quality of care was measured by asking respondents if their provider asked about treatments given by other providers and involved them in treatment decision-making. Logistic regression was used to identify sociodemographic disparities in access and perceived quality of USC. Person-level weights were applied to statistical analysis to obtain national estimates. The study sample included 9471 eligible US adults with MCC, of which 91.6% reported having a USC, representing 44.9 million US individuals. Respondents who were older (≥ 65 years), married, non-Hispanic White, insured, or Midwestern were more likely to have a USC. Family physicians accounted for 63.5% of reported USC providers. Nearly 43% of respondents indicated difficulty accessing providers after hours. Over 20% of the respondents reported that their providers did not ask about treatments from other doctors or consistently involve them in treatment decision-making. Younger (< 65 years), married, non-Hispanic White, or more educated respondents were more likely to be asked about treatments from other doctors or consistently involved in treatment decision-making. Most US adults with MCC reported having a USC. However, sociodemographic disparities exist in having access to a USC and the quality of care.