Factors Associated With Loss of Usual Source of Care Among Older Adults

Stephanie K. Nothelle, MD; Cynthia Boyd, MD, MPH; Orla Sheehan, MD, PhD; Jennifer L. Wolff, PhD


Ann Fam Med. 2018;16(6):538-545. 

In This Article


Data from interviews (rounds 1–6, 2011–2016) of the National Health and Aging Trends Study[26] were used to construct a data set with individual person-period observations. The National Health and Aging Trends Study is a longitudinal nationally representative sample of Medicare beneficiaries aged 65 years and older living in the contiguous United States. The study uses a stratified 3-stage sample design with oversampling of older adults by age and Black non-Hispanic persons. In-person interviews are conducted annually with the participant or proxy if the participant is unable to respond. Detailed self-report data on chronic conditions, functional ability, health care utilization, and economic status are collected. The sample size of the original cohort in 2011 was 8,245 (70.9% response rate). Subsequent annual interviews resulted in a sample size of 7,075 (86.1% response rate) in 2012, 5,799 (88.3% response rate) in 2013, 4,737 (89.9% response rate) in 2014, 4,152 (76.8% response rate) in 2015, and 3,675 (90.6% response rate) in 2016.[27] These data are publicly available, do not contain individual identifiers, and are therefore exempt from human subjects review.

Persons living in a nursing home or residential care facility in round 1 were excluded as data were only collected about the facility and no interview was conducted with sample persons who were living in the facility (n = 636). Participants who completed a round 1 interview and subsequently transitioned to a facility were included if an interview was completed in subsequent rounds.