The Importance of Having a Usual Source of Health Care

One Pagers | Aug 01, 2000 Susan Dovey, MD, MPH; Larry Green, MD; Ed Fryer, PhD

Most people (82%) in the United States have and use for much of their health care a usual source of care, and a majority of them name a particular primary care physician as that source. Regardless of self-reported health status, people benefit from having a usual source of health care even if they are uninsured.

The Medical Expenditure Panel Survey (MEPS) is a national probability survey sponsored since 1996 by the Agency for Health Care Policy and Research. As part of this survey, trained interviewers determine whether or not each individual in respondents’ families has a usual source of health care. If so, the source is determined and characterized and other data can be analyzed accordingly. MEPS data when weighted for survey design complexities can be used for inference to the general U.S. population, as has been done here.

In 1996, 82% of Americans had a usual source for getting health care. These individuals would go to this usual source for new health problems (97%), preventive care (96%), and to seek referral for specialty services (96%). Approximately 56% regarded an individual professional, rather than a facility, as their usual source of care and of these: 62% identify a family physician, 16% a general internist, and 15% a pediatrician, leaving all other provider types as the usual source of care for only 8%.

Although there were virtually no differences in self-reported physical and mental health status comparing individuals with and without a usual source of care, profiles of utilization differed:

Profiles of Utilization
Have Usual SourceNo Usual Source
Profiles of Utilization: Had difficulty obtaining careHave Usual Source: 11%
No Usual Source: 17%
Profiles of Utilization: Did without needed servicesHave Usual Source: 6%
No Usual Source: 12%
Profiles of Utilization: Had a doctor’s office visitHave Usual Source: 75%
No Usual Source: 39%
Profiles of Utilization: Admitted to hospitalHave Usual Source: 8%
No Usual Source: 4%
Profiles of Utilization: Purchased any prescription medicineHave Usual Source: 70%
No Usual Source: 38%

Results from this survey indicate that 17% of Americans were uninsured. Of these, 62% could identify a usual source of health care. Most such inferences from MEPS data to the U.S. population can be made with substantial confidence. For example, the estimate of 17% of Americans without insurance, has a standard error of just 0.47%.

Comment: The 1996 MEPS suggests that most Americans are accustomed to having a usual source of care, and many can name a particular primary care physician as that source. They expect to go to their usual source for a wide range of services, and they use more health care services when they have one. Interestingly, being uninsured does not preclude having a usual source of care. From the viewpoint of patients, this is consistent with a usual source of care being a good thing.

The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP. 

Published in American Family Physician, Aug 1, 2000. Am Fam Physician. 2000;62:477. This series is coordinated by Sumi Sexton, MD, AFP Associate Medical Editor.