COVERAGE MATTERS: INSURANCE TYPE AND ACCESS TO A USUAL SOURCE OF CARE IN MEDICAL EXPENDITURE PANEL SURVEY (2018-2023)
Author(s)
Mohammed Amaan Shaikh, DPharm1, MOHAMMAD IKRAM, PhD2, Nazneen Fatima Shaikh, PhD3.
1University of Mumbai, Mumbai, India, 2Penn State University, Harrisburg, PA, USA, 3Real World Solutions, IQVIA, Inc., Jersey City, NJ, USA.
1University of Mumbai, Mumbai, India, 2Penn State University, Harrisburg, PA, USA, 3Real World Solutions, IQVIA, Inc., Jersey City, NJ, USA.
OBJECTIVES: Access to a usual source of care (USC) is a key indicator of timely, continuous healthcare. Insurance coverage may influence access to care; this study evaluates the association between insurance type and having a USC among U.S. adults.
METHODS: Pooled data from the Medical Expenditure Panel Survey (MEPS) 2018-2023 were used to identify adults who responded to the question on having a USC. Insurance coverage was identified as private, public, or uninsured. In MEPS, a USC refers to the specific healthcare provider, clinic, or facility that an individual typically visits when seeking care for illness or health advice. Chi-square tests and multivariable logistic regression analyzed the unadjusted and adjusted associations between insurance coverage type and USC. All analyses accounted for the complex survey design of MEPS.
RESULTS: A total of 113,781 adults were included. The study population was predominantly female (51.4%) and White (62.1%), with a mean age of 50.6 years (SD ±18.5). Overall, 28.5% of adults lacked a USC, most commonly due to never being sick (56.7%), lack of insurance (9.7%), or recent relocation (6.7%), among other reasons. Among coverage types, 61.2% had private insurance, 30.5% public, and 8.3% were uninsured. The proportion without a USC was highest among the uninsured, followed by private and public coverage (66.5% vs 24.9% vs 20.4%; p<0.001). In the fully adjusted model, compared with private coverage, public coverage was associated with slightly higher odds of USC (AOR [95% confidence interval]: 1.15 [1.06-1.24]; p<0.001), whereas being uninsured was associated with substantially lower odds (AOR [95% CI]: 0.26 [0.23-0.29]; p<0.001). Older adults, females, and Asians were less likely to have USC.
CONCLUSIONS: Insurance coverage type is strongly associated with having a USC. Uninsured adults experience substantial access gaps even after adjusting for sociodemographic factors, underscoring the role of coverage in enabling stable entry points to healthcare.
METHODS: Pooled data from the Medical Expenditure Panel Survey (MEPS) 2018-2023 were used to identify adults who responded to the question on having a USC. Insurance coverage was identified as private, public, or uninsured. In MEPS, a USC refers to the specific healthcare provider, clinic, or facility that an individual typically visits when seeking care for illness or health advice. Chi-square tests and multivariable logistic regression analyzed the unadjusted and adjusted associations between insurance coverage type and USC. All analyses accounted for the complex survey design of MEPS.
RESULTS: A total of 113,781 adults were included. The study population was predominantly female (51.4%) and White (62.1%), with a mean age of 50.6 years (SD ±18.5). Overall, 28.5% of adults lacked a USC, most commonly due to never being sick (56.7%), lack of insurance (9.7%), or recent relocation (6.7%), among other reasons. Among coverage types, 61.2% had private insurance, 30.5% public, and 8.3% were uninsured. The proportion without a USC was highest among the uninsured, followed by private and public coverage (66.5% vs 24.9% vs 20.4%; p<0.001). In the fully adjusted model, compared with private coverage, public coverage was associated with slightly higher odds of USC (AOR [95% confidence interval]: 1.15 [1.06-1.24]; p<0.001), whereas being uninsured was associated with substantially lower odds (AOR [95% CI]: 0.26 [0.23-0.29]; p<0.001). Older adults, females, and Asians were less likely to have USC.
CONCLUSIONS: Insurance coverage type is strongly associated with having a USC. Uninsured adults experience substantial access gaps even after adjusting for sociodemographic factors, underscoring the role of coverage in enabling stable entry points to healthcare.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH45
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas