1 in 3 Older Adults Reported Using an Alternate Health Care Site

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Visiting urgent care and retail health clinics has grown in recent years, and more than half of adults reported in a survey using these alternative sites.

The popularity of alternative sites grew during the COVID-19 pandemic for people to obtain rapid testing and treatment. Even now, alternate sites of care remain in high demand.

The University of Michigan National Poll on Healthy Aging surveyed a national sample of adults aged 50 – 80 years about their use and thoughts on alternative health care sites. The poll sought to see how many older adults used alternate sites in the past 2 years.

An alternate site of care was defined as an urgent care clinic (but not a hospital emergency department), retail health clinic (often found in retail locations like pharmacies, grocery stores, or department stores), worksite clinic, or mobile clinic (in a bus or a van).

In the survey, 1 in 3 adults (60%) reported using an alternative site of care in the past 2 years. Nearly half of older adults (47%) reported visiting an urgent care clinic in the past 2 years. Of those who did go to an urgent care clinic, 23% went more than twice in the past 2 years.

The poll also found more than 1 in 4 older adults (28%) visited a retail health clinic in the past years, followed by a worksite clinic (9%) and a mobile clinic (5%).

People aged 50 – 64 (64%) were more likely to use alternative sites for health care than people aged 65 – 80 years (55%). Women (63%) were also more likely to use alternative sites than men (57%).

Older adults of greater annual household incomes (≥ $60,000) used alternative sites more than older adults with incomes < $60,000 (65% vs 53%, respectively). Additionally, those living in urban or suburban areas (population ≥ 50,000; 62%) were more likely to visit alternative care sites rather than people living in less populated areas (52%).

Of the older adults who had an alternative site visit, 34% had follow-up care afterward, with 21% seeking follow-up care from their usual health care provider, 7% receiving care from the same alternative site, and 6% going somewhere else. However, 58% reported not needing follow-up care and 9% chose not to get follow-up care.

Most older adults (91%) who went to an alternative site of care had a primary care provider, with 71% informing their primary care provider about their alternative site for health care. More than 1 in 5 (22%) had a follow-up appointment with their usual health provider. For adults who did not have a follow-up appointment with their primary care provider, 43% informed their doctor they had visited an alternative health care site and 29% had their visit records sent to their primary care provider.

Older adults reported visiting alternate health care sites to avoid the hospital emergency department (44%); to get a vaccine, specific test, or health exam (35%); to get an appointment sooner or a more convenient time (31%); their regular provider’s office was closed (26%); the alternative site’s location was closer (15%); their regular provided told them to go (10%); cost (9%); travel or being out of town (6%); usually going to an alternative health care site (4%); and wanting care aligned with their culture or language (1%).

When specifically asked what type of care they received at an alternative site, people reported having symptoms of an illness (41%), wanting a vaccine (38%), having an injury (21%), a COVID-19 infection/possible infection (14%), specific screening or exam (11%), prescription renewals (8%), physical exams for work or travel (3%), and mental health concerns (3%).

People were 75% more likely to use an alternative site if they already used one opposed to people who did not (43%). Moreover, 38% of older adults who said they were not likely to use an alternative site said the reasons were because they preferred seeing their usual health care provider, insurance not covering costs, not trusting them, having concerns about the privacy of their health data, or the alternative site being too far away.

“…it is vital for clinicians, researchers, and policymakers to monitor older adults’ experiences with quality and cost of care at alternative sites of care, as well as take meaningful steps to ensure that care received at these sites is well-coordinated with care received from one’s usual health care provider,” wrote the authors of the poll.

References

^{Dean O, Komisar H, Singer D, Solway E, Box N, Roberts S, Hutchens L, Smith E, Kirch M, Kullgren J. Alternative Sites for Health Care. University of Michigan National Poll on Healthy Aging. April 2024. Available at https://dx.doi.org/10.7302/22501.}