Characteristics of the elderly who do not visit primary care physicians

Background: Health care quality indicators encourage outreach programs for screening the elderly who do not voluntarily visit their primary care physician (PCP). The characteristics of this population, however, have never been rigorously studied. The aim of this study was therefore to characterize the demography and health status of the elderly who do not visit PCPs. Methods: A retrospective database study was carried out in the central district of Maccabi Healthcare Services (MHS) in Israel. People aged 65-100 years were included, excluding those who were registered for home-care treatment. The elderly who did not initiate a PCP visit during October 2007-October 2009 were compared to those who visited a PCP during this period, in terms of demographic characteristics, health services utilization, and major chronic diseases, using the computerized MHS database. Results: The study population consisted of 32,523 elderly, 1663 (5.1%) of whom had not visited PCP for at least two years (October 2007 - October 2009). The non-consulters were, on average, older, included more women and tended to have lower socio-economic class. They had fewer hospitalizations, used less prescribed medications, consulted secondary physicians less frequently and had less laboratory tests and imaging. In line with these findings, only 29% of the non-consulters were diagnosed with a chronic condition, compared with 91% of consulters. Conclusion: Our findings suggest that as a group, the older Israelis who do not initiate PCP visits are healthier than those who do. Given the high workload of PCPs in Israel, these findings do not support investing considerable efforts in reaching out to the elderly who do not voluntarily initiate PCP visits.