Where Seniors Interact Most With Health Care Providers

Seniors across the country are interacting with the health care system in very different ways—and with very different regularity.

Whereas those living in Manhattan have had contact with the health care system nearly 25 days in a year, Medicare beneficiaries in Lebanon, New Hampshire made far less contact, at roughly 10 days, according to a report recently released by the Dartmouth Institute for Health Policy and Clinical Practice. That’s one week less than the national average of about 17 days.

“The number of contact days is a more patient-centered measure of the frequency of interactions with the health care system,” the report states. “By measuring how many different days in a year older adults seek or receive some type of medical contact, we can begin to appreciate how much of the older adult’s daily life is being occupied by health care.”


The Dartmouth report takes into account 2012 Medicare enrollment and claims data. It focuses on how the U.S. provides health care to seniors by region, comparing different areas based on where seniors spend the most time with doctors, where they’re most likely to be hospitalized or where they might be subjected to unnecessary tests or risky medications, Reuters reported.

Typically, a primary care physician served as 56.9% of Medicare beneficiaries’ predominant health care provider in 2012, but that percentage varied significantly across the country. In York, Pennsylvania, 73.4% of seniors turned to primary care doctors, but just 42.6% did the same in Metairie, Louisiana. In 2008, the Dartmouth Atlas noted that regions where a greater proportion of health care was provided by primary care physicians typically had lower costs, higher quality and lower rates of avoidable hospitalizations, according to the report.

Additionally, effective January 2011, annual wellness visits are provided to Medicare beneficiaries under the Affordable Care Act. However, just 10.7% of seniors nationally had such a visit in 2012. More than one out of every four beneficiaries in Clearwater, Florida; Worcester, Massachusetts; and Providence, Rhode Island took advantage of the annual wellness visit, but less than 2% visited the doctor preventatively in areas like Meridian, Mississippi; Minot, North Dakota; Terre Haute, Indiana; and Hattiesburg, Mississippi.


Other noteworthy information revealed in the report includes:

  • Number of Different Clinicians: The national average for the number of different clinicians seen by Medicare beneficiaries during 2012 was 3.4. In four Florida regions, that number topped four, while patients saw fewer than three different clinicians in regions like Bangor, Maine and Marquette, Michigan.
  • Number of Days in Inpatient Care: The number of days spent in inpatient care in 2012 was another factor tracked in the report, which indicated that Medicare beneficiaries spent an average of 4.6 days in inpatient settings, such as hospitals and skilled nursing facilities. However, this number was substantially different across the country, with patients in three Louisiana regions spending more than seven days as inpatients, and those on the West Coast averaging around 2 days.
  • 30-Day Readmission Rates: The average percentage of Medicare beneficiaries readmitted to the hospital within 30 days of discharge declined only slightly between 2008 and 2012, from 16.2% to 15.5%. Readmission rates hit 12% in 2012 in Bend, Oregon; Petoskey, Michigan; Muskegon, Michigan; and Grand Junction, Colorado, but almost 18% in areas such as Johnstown, Pennsylvania; Royal Oak, Michigan; Slidell, Louisiana; and Dearborn, Michigan.

Written by Kourtney Liepelt

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