• Sungchul Park, Ann M Nguyen, Zoe Lindenfeld, and Ji Eun Chang.
• Department of Health Policy and Management, College of Health Science, BK21 FOUR R&E Center for Learning Health Systems, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Republic of Korea, 02841. Ele... more ctronic address: sungchul_park@korea.ac.kr. less
• Am J Prev Med. 2025 Jan 30.

IntroductionOlder adults experiencing loneliness or social isolation may experience poor patient-provider communication, potentially contributing to suboptimal health care utilization, particularly in mental health care. However, empirical evidence is limited. Thus, this study examined whether there were differences in patient-provider communication and health care utilization between Medicare beneficiaries with and without loneliness and social isolation.MethodsThis study conducted a cross-sectional study using data from the 2021 Medical Expenditure Panel Survey. Outcomes were patient-provider communication and health care utilization. The primary independent variables were loneliness and social isolation. Regression analysis was conducted to estimate adjusted differences in outcomes between Medicare beneficiaries with and without loneliness and social isolation. The analysis was conducted in September 2024.ResultsThe sample included 4,433 Medicare beneficiaries. Medicare beneficiaries experiencing loneliness were 4.0 percentage points (95% CI: 1.0-7.1) more likely to report poor patient-provider communication compared to those without loneliness. Similarly, those with social isolation were 2.0 percentage points (1.1-2.9) more likely to report poor communication than those without social isolation. The rates of mental health care utilization were higher among those with loneliness (1.8 [1.0-2.6], 1.5 [0.8-2.2], and 3.1 [1.1-5.1] for social workers, psychologists, and psychiatrists) or social isolation (2.3 [0.6, 4.0] for psychiatrists), but the overall level of mental health care utilization remained relatively low.ConclusionsThese findings highlight significant disparities in patient-provider communication among Medicare beneficiaries experiencing loneliness and social isolation. These disparities may partly result from limited engagement with mental health services, which could help address their specific health care needs.Copyright © 2025. Published by Elsevier Inc.

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