• Stephanie K Nothelle, Cynthia Boyd, Orla Sheehan, and Jennifer L Wolff.
• Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, Maryland snothel1@jhmi.edu.
• Ann Fam Med. 2018 Nov 1; 16 (6): 538-545.

PurposeAccess to a usual source of care (USC) is associated with better preventive health and chronic disease treatment. Although most older adults have a USC, loss of USC, and factors associated with loss of USC, have not previously been examined.MethodsWe followed 7,609 participants of the National Health and Aging Trends Study annually for up to 6 years (2011-2016). Discrete time-to-event techniques and pooled logistic regression were used to identify demographic, clinical, and social factors associated with loss of USC.ResultsNinety-five percent of older adults reported having a USC in 2011, of whom 5% subsequently did not. Odds of losing a USC were higher among older adults with unmet transportation needs (adjusted odds ratio [aOR] 1.67), who moved to a new residence (aOR 2.08), and who reported depressive symptoms (aOR 1.40). Odds of losing a USC were lower for those who had ≥4 chronic conditions (vs 0-1; aOR 0.42) and with supplemental (aOR 0.52) or Medicaid (aOR 0.67) insurance coverage.ConclusionsWe identified factors associated with older adults' loss of a USC. Potentially modifiable factors, such as access to transportation and supplemental insurance, deserve further investigation to potentially assist older adults with continuous access to care.© 2018 Annals of Family Medicine, Inc.

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