Objective

Although important for healthcare access and outcomes, Usual Source of Care (USC) disparities have not been assessed among cancer survivors. This study aimed to 1) describe USC types and their associated predictors, and 2) assess associations between USC type and healthcare outcomes.

Methods

This retrospective cross-sectional analysis using 2013-2018 Medical Expenditure Panel Survey included 2,287 adult cancer survivors reporting one of the five mutually exclusive USC types: a person in solo practice (PSP), a specific person in a non-hospital facility, a specific person in a hospital clinic/outpatient department (hospital-based facility), a non-hospital facility, and a hospital-based facility. We used multinomial logistic regression to identify predictors of USC and generalized linear regression models to determine associations of USC type with measures of health, and healthcare access and utilization outcomes, adjusting for patient demographic and clinical characteristics.

Results

Non-Hispanic black race, West region, and low income were associated with higher odds of having hospital-based USC types. Cancer survivors having a hospital-based facility (vs. PSP) type USC were more likely to report ‘Not good’ health (OR: 2.02, 95% CI: 1.37–2.98; p<0.001), having 37.4% (95% CI: 0.4% to 88.1%; p=0.047) more ED visits, and 30.7% (95% CI: 6.0 % to 61.3%; p=0.01) higher total expenses. Those having USC other than PSP reported higher odds of facing difficulty in contacting USC by telephone.

Conclusions

Compared to PSP, other USC types were associated with worse health care access and health, and higher expenses. Transitioning to PSP type USC may result in better healthcare outcomes.