Patient–Provider Communication for Lonely, Socially Isolated Adults in Medicare

초록

Introduction: Older adults experiencing loneliness or social isolation may experience poor patient–provider communication, potentially contributing to suboptimal healthcare utilization, particularly in mental healthcare. However, empirical evidence is limited. Thus, this study examined whether there were differences in patient–provider communication and healthcare utilization between Medicare beneficiaries with and without loneliness and social isolation. Methods: This study conducted a cross-sectional study using data from the 2021 Medical Expenditure Panel Survey. Outcomes were patient–provider communication and healthcare utilization. The primary independent variables were loneliness and social isolation. Regression analysis was conducted to estimate adjusted differences in outcomes between Medicare beneficiaries with and without loneliness and social isolation. The analysis was conducted in September 2024. Results: The sample included 4,433 Medicare beneficiaries. Medicare beneficiaries experiencing loneliness were 4.0 percentage points (95% CI=1.0, 7.1) more likely to report poor patient–provider communication compared to those without loneliness. Similarly, those with social isolation were 2.0 percentage points (1.1, 2.9) more likely to report poor communication than those without social isolation. The rates of mental healthcare utilization were higher among those with loneliness (1.8 [1.0, 2.6], 1.5 [0.8, 2.2], and 3.1 [1.1, 5.1] for social workers, psychologists, and psychiatrists) or social isolation (2.3 [0.6, 4.0] for psychiatrists), but the overall level of mental healthcare utilization remained relatively low. Conclusions: These findings highlight significant disparities in patient–provider communication among Medicare beneficiaries experiencing loneliness and social isolation. These disparities may partly result from limited engagement with mental health services, which could help address their specific healthcare needs. © 2025 Elsevier Inc.

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