Family Medicine

Having a usual primary care source extends survival for older US adults

In this nationally representative cohort of 10,873 US adults aged 65–84, lacking a usual primary care source was uncommon but consequential. Older adults with a usual primary care source had a 16% lower 15-year mortality risk (adjusted HR 0.84; 95% CI 0.72–0.98). Median survival was over 2 years longer for those engaged with primary care (>15 vs 12.9 years). These findings support policies and practice models that secure continuous primary care access for aging patients. 1

Self-measured BP is rarely and inequitably documented in primary care EHRs

Among 156,444 adults with uncontrolled hypertension and ≥2 primary care visits, only 5% had any structured SMBP reading in the EHR. Most SMBP values were entered during office visits rather than via remote workflows, limiting continuous out-of-clinic monitoring. Black, Hispanic, Medicaid-insured, and non-English–preferring patients had significantly lower odds of documented SMBP than comparison groups. Results highlight the need to redesign SMBP workflows, EHR tools, and support to avoid widening hypertension control disparities. 2

Polypharmacy in older adults adds >$4,000 annually in health care costs

Using 2018–2021 MEPS data, investigators propensity-matched 4,925 older adults with polypharmacy (≥5 meds) to 4,925 without. Polypharmacy was associated with $4,304 higher annual total expenditures, largely from medications, office visits, inpatient, and outpatient care. Older adults with polypharmacy also had higher odds of finding prescription medications unaffordable (adjusted OR 1.70; 95% CI 1.30–2.23). These data strengthen the case for systematic deprescribing, medication review, and cost discussions in routine geriatric primary care. 3

Housing and transportation needs drive higher ED and inpatient utilization

This cohort of 166,682 Medicare and Medicaid patients screened under Accountable Health Communities linked health-related social needs with utilization. Housing instability and transportation needs were most strongly associated with higher ED use (OR 1.25 and 1.31, respectively). These two needs also independently predicted more inpatient admissions after adjustment for demographics, comorbidities, and other social needs. Findings suggest primary care teams should prioritize screening and referral pathways for housing and transportation support when targeting avoidable utilization. 4