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National profile of the growing population of older adults who access community health centers

J Am Geriatr Soc. 2021 Mar 5. doi: 10.1111/jgs.17088. Online ahead of print.

ABSTRACT

BACKGROUND: Community health centers (CHCs) are federally funded safety-net clinics that provide care to low income and medically underserved persons. The proportion of CHC patients aged ≥65 doubled in the last ten years, yet little is known about this population. We aim to describe the demographic and clinical characteristics of the older adult CHC population.

DESIGN: Cross sectional analysis.

SETTING: The nationally representative 2014 Health Center Patient Survey.

PARTICIPANTS: CHC patients ≥55 years.

MEASURES: We used descriptive statistics to characterize older adults across demographic and clinical variables. To determine differences by age, we stratified into three groups (55-64, 65-74, 75+ years). We used t-tests and chi-squared to calculate p values and survey weights to make national estimates.

RESULTS: We included 1875 older adults ≥55 years, representing over 4.2 million people. Older adults were mostly aged 55-64 (60%), female (51%), and white (60%). The majority (73%) had Medicare or Medicaid and 47% reported fair or poor health. Regardless of age, older adults had an average of three chronic conditions and 0.6 impairments in activities of daily living (ADL). Healthcare utilization was not significantly different across age groups with most taking ≥5 prescription medications (54%) and one in five reporting ≥2 emergency department visits or ≥1 hospitalization in the last year.

CONCLUSIONS: Adults 55-64 who attend CHCs have similar disease burden as adults ≥65. As the population of older adults who access CHCs grow, our findings highlight the opportunity to enhance focus on key principles of geriatric medicine, such as measurement of functional impairment for those who are <65 while also addressing underlying health disparities.

PMID:33675077 | DOI:10.1111/jgs.17088

By Nevin Manimala

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