Presentation (CTI)

OBJECTIVES: 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. This study aimed to examine access and quality of USC and to identify racial/ethnic disparities in US adults with MCC.
METHODS: This study used 2019 and 2021 Medical Expenditure Panel Survey (MEPS) data to identify US adults reporting two or more chronic conditions. The primary outcomes included access and quality of USC. Two quality indicators were examined by questioning whether USC providers asked about treatments from other doctors and involved respondents in treatment decision-making. Logistic regression was used to identify racial/ethnic disparities in access and quality of USC. Person-level weights were applied to statistical analysis to obtain national estimates.
RESULTS: The study sample included 9,471 eligible US adults with MCC, of which 91.6% reported having a USC, representing 44.9 million US individuals. Family physicians accounted for 63.5% of reported USC providers. Nearly 43% of respondents reported difficulty accessing providers after hours. Over 20% of the respondents reported that their providers did not ask about treatments from other doctors or consistently involved them in treatment decision-making. Compared to non-Hispanic White respondents with MCC, Hispanic and non-Hispanic Black respondents with MCC were less likely to have a USC (OR = 0.73, 95% CI: 0.59-0.91 for Hispanic; OR = 0.72, 95% CI: 0.53-0.97 for non-Hispanic Black) and be consistently involved in treatment decision-making (OR = 0.61, 95% CI: 0.47-0.78 for Hispanic; OR = 0.63, 95% CI: 0.53-0.76 for non-Hispanic Black).
CONCLUSIONS: Most US adults with MCC reported having a USC. However, racial/ethnic disparities between non-Hispanic Whites and non-Hispanic Blacks and Hispanics exist regarding having access to a USC and quality of care.