When a Usual Source of Care and Usual Provider Matter: Adult Prevention and Screening Services
Open accessAbstract
Objective To examine whether the usual source of preventive care, (having a usual place for care only or the combination of a usual place and provider compared with no usual source of preventive care) is associated with adults receiving recommended screening and prevention services.Design Using cross-sectional survey data for 24,138 adults (ages 18-64) from the 1999 National Health Interview Survey (NHIS), we estimated adjusted odds ratios using separate logistic regression models for receipt of five preventive services: influenza vaccine, Pap smear, mammogram, clinical breast exam, and prostate specific antigen.Results Having both a usual place and a usual provider was consistently associated with increased odds for receiving preventive care/screening services compared to having a place only or neither. Adults ages 50-64 with a usual place/provider had 2.8 times greater odds of receiving a past year flu shot compared with those who had neither. Men ages 50-64 with a usual place/provider had nearly 10 times higher odds of receiving a PSA test compared with men who had neither. Having a usual place/provider compared with having neither was associated with 3.9 times higher odds of clinical breast exam among women ages 20-64, 4.1 times higher odds of Pap testing among women ages 21-64, and 4.8 times higher odds of mammogram among women ages 40-64.Conclusions Having both a usual place and usual provider is a key variable in determining whether adults receive recommended screening and prevention services and should be considered a fundamental component of any medical home model for adults.
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Having a regular primary care provider, as opposed to only having a usual source of care or regular practice, is associated with more preventive care, better chronic disease and medication management, and improved access to care.
“previous studies have found that having a regular primary care provider, as opposed to only having a usual source of care or regular practice, is associated with more preventive care [75, 76], better chronic disease and medication management [77], and improved access to care [3].”
From Improved access to and continuity of primary care after attachment to a family physician: longitudinal cohort study on centralized waiting lists for unattached patients in Quebec, Canada (2022) · cites this paper as [75]
For the preventive-care portion attributed to this paper, the Discussion (page not available) says adults with both a usual place and usual provider were more likely to receive recommended services than those with a usual place alone. The Introduction (page not available) cautions that the data could not establish whether the usual provider met primary-care characteristics, so the specifically ‘primary care provider’ wording is not fully supported. The other outcomes in the citing sentence have separate citations. (LLM, conf=0.82)
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“While continuity is desirable at both physician and practice level, previous studies have found that having a regular primary care provider, as opposed to only having a usual source of care or regular practice, is associated with more preventive care [75, 76], better chronic disease and medication management [77], and…”
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Ganguli, I., McGlave, C., & Rosenthal, M. B. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.34798 · Cited by 12 · see citing works
Mahmood, A., Mosalpuria, K., Wyant, D. K., & Bhuyan, S. S. (2018) · Hospital Topics · doi:10.1080/00185868.2018.1551102 · Cited by 12 · see citing works
Cervical cancer screening and predictors of screening by diabetes status
Miller, E. A., & Pinsky, P. F. (2022) · Cancer Causes & Control · doi:10.1007/s10552-022-01615-5 · Cited by 12 · see citing works
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Affordable Care Act and cancer stage at diagnosis in an underserved population
Lu, Y., Jackson, B. E., Gehr, A. W., Cross, D. S., Neerukonda, L. S., Tanna, B., Ghabach, B., & Ojha, R. P. (2019) · Preventive Medicine · doi:10.1016/j.ypmed.2019.06.006 · Cited by 11 · see citing works
The Impact of Team-Based Primary Care on Guideline-Recommended Disease Screening
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Pandhi, N., DeVoe, J. E., Schumacher, J. R. M., Bartels, C. M., Thorpe, C. T., Thorpe, J. M., & Smith, M. A. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1955-7 · Cited by 10 · see citing works
- Authors
- Blewett, L. A., Johnson, P. J., Lee, B., & Scal, P. B.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Blewett, Lynn A.
- Venue
- Journal of General Internal Medicine
- Published
- 2008-05-28
- Volume
- 23
- Issue
- 9
- Pages
- 1354-1360
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2518015
- OpenAlex
- W2002456609
- Cited by
- 195
- References
- 11
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 14 · 2023: 14 · 2022: 20 · 2021: 15 · 2020: 8 · 2019: 10 · 2018: 13 · 2017: 12 · 2016: 7 · 2015: 6 · 2014: 13 · 2013: 11 · 2012: 15
- FWCI
- 5.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Minnesota
- National Institutes of Health
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (1-R01-HD046697-01, R01HD046697)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- usual source of care, preventive medicine, cancer screening, influenza vaccination, Pap smear, mammography, clinical breast examination, prostate-specific antigen testing, patient-centered medical home, adult primary care, health care access
- MeSH terms
- Adolescent, Adult, Continuity of Patient Care, Cross-Sectional Studies, Female, Humans, Insurance, Health, Male, Mass Screening, Middle Aged, Preventive Health Services, United States, Odds Ratio, Health Care Surveys
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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