Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study

ABSTRACT Introduction Having a primary care usual source of care (USC) is associated with better population health outcomes. However, the percent of adults in the United States (US) with a usual primary care provider is declining. We sought to identify factors associated with establishing a USC at a...

Full description

Saved in:
Bibliographic Details
Main Authors: Abbey Gregg, Hui Wang, Brankeciara Ard, Marcelo Takejame Galafassi, Maryam Bidgoli
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Health Care Science
Subjects:
Online Access:https://doi.org/10.1002/hcs2.70020
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849426291167592448
author Abbey Gregg
Hui Wang
Brankeciara Ard
Marcelo Takejame Galafassi
Maryam Bidgoli
author_facet Abbey Gregg
Hui Wang
Brankeciara Ard
Marcelo Takejame Galafassi
Maryam Bidgoli
author_sort Abbey Gregg
collection DOAJ
description ABSTRACT Introduction Having a primary care usual source of care (USC) is associated with better population health outcomes. However, the percent of adults in the United States (US) with a usual primary care provider is declining. We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care. Methods We analyzed data from 57,152 participants in the All of Us study who reported having a USC. We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing, enabling, and need factors, according to the source of usual care. Results An urgent care clinic, minute clinic, or emergency department was the source of usual care for 6.3% of our sample. The odds of seeking care at this type of facility increased with younger age, lower educational attainment, and better health status. Black and Hispanic individuals, as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity, were also less likely to have a primary care USC. Financial concerns, being anxious about seeing a provider, and the inability to take time off from work also increased the likelihood of having a non‐primary care USC. Conclusions Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient, affordable primary care. Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.
format Article
id doaj-art-16b8b9de4beb4a62896b84c21712d7dc
institution Kabale University
issn 2771-1757
language English
publishDate 2025-06-01
publisher Wiley
record_format Article
series Health Care Science
spelling doaj-art-16b8b9de4beb4a62896b84c21712d7dc2025-08-20T03:29:28ZengWileyHealth Care Science2771-17572025-06-014319520510.1002/hcs2.70020Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us StudyAbbey Gregg0Hui Wang1Brankeciara Ard2Marcelo Takejame Galafassi3Maryam Bidgoli4Department of Community Medicine and Population Health, College of Community Health Sciences The University of Alabama Tuscaloosa Alabama USAInstitute for Rural Health Research, College of Community Health Sciences The University of Alabama Tuscaloosa Alabama USADepartment of Community Medicine and Population Health, College of Community Health Sciences The University of Alabama Tuscaloosa Alabama USAInstitute for Rural Health Research, College of Community Health Sciences The University of Alabama Tuscaloosa Alabama USADepartment of Community Medicine and Population Health, College of Community Health Sciences The University of Alabama Tuscaloosa Alabama USAABSTRACT Introduction Having a primary care usual source of care (USC) is associated with better population health outcomes. However, the percent of adults in the United States (US) with a usual primary care provider is declining. We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care. Methods We analyzed data from 57,152 participants in the All of Us study who reported having a USC. We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing, enabling, and need factors, according to the source of usual care. Results An urgent care clinic, minute clinic, or emergency department was the source of usual care for 6.3% of our sample. The odds of seeking care at this type of facility increased with younger age, lower educational attainment, and better health status. Black and Hispanic individuals, as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity, were also less likely to have a primary care USC. Financial concerns, being anxious about seeing a provider, and the inability to take time off from work also increased the likelihood of having a non‐primary care USC. Conclusions Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient, affordable primary care. Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.https://doi.org/10.1002/hcs2.70020All of UsAndersen Behavioral Model of Health Service Useprimary careusual source of care
spellingShingle Abbey Gregg
Hui Wang
Brankeciara Ard
Marcelo Takejame Galafassi
Maryam Bidgoli
Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study
Health Care Science
All of Us
Andersen Behavioral Model of Health Service Use
primary care
usual source of care
title Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study
title_full Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study
title_fullStr Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study
title_full_unstemmed Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study
title_short Examining Reasons for Using Non‐Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study
title_sort examining reasons for using non primary care providers as usual source of health care insights from the all of us study
topic All of Us
Andersen Behavioral Model of Health Service Use
primary care
usual source of care
url https://doi.org/10.1002/hcs2.70020
work_keys_str_mv AT abbeygregg examiningreasonsforusingnonprimarycareprovidersasusualsourceofhealthcareinsightsfromtheallofusstudy
AT huiwang examiningreasonsforusingnonprimarycareprovidersasusualsourceofhealthcareinsightsfromtheallofusstudy
AT brankeciaraard examiningreasonsforusingnonprimarycareprovidersasusualsourceofhealthcareinsightsfromtheallofusstudy
AT marcelotakejamegalafassi examiningreasonsforusingnonprimarycareprovidersasusualsourceofhealthcareinsightsfromtheallofusstudy
AT maryambidgoli examiningreasonsforusingnonprimarycareprovidersasusualsourceofhealthcareinsightsfromtheallofusstudy