This report reveals inequities in how aging adults’ care preferences are taken into account based on race/ethnicity, income, health insurance status, and other variables.
Person-centered care, which involves eliciting individuals’ values, needs, and preferences to guide their health care, is a key aspect of a high-quality health care system. This study is the first to determine the prevalence or trends of person-centered care for older adults in the overall health care system. It uses data from the Health Retirement Study — a nationally representative survey of adults age 50 and over — to understand how often older adults’ preferences for care were taken into account regarding their experiences with the health care system in the last year.
One-third of older adults said their care preferences were “never” or “sometimes” considered. Compared to Non-Hispanic white people, Hispanic and Black people were 1.9-2.4 times more likely to report that their care preferences were “never” considered, even when other variables such as age and income were held constant. Other predictors of lower levels of person-centered care include lower income level, eligibility for Medicaid or for both Medicare and Medicaid, and poorer self-reported health status. There are multiple consequences of this lack of person-centered care, including being less likely to access care in the future, and having lower patient satisfaction.
This study highlights inequities in how older adults’ care preferences are taken into account based on variables such as race/ethnicity, income, and health insurance status. Putting an emphasis on person-centered care can help health systems reduce these disparities. Provider training to ask patients these important questions, measurement of goal-directed care and patient-centered outcomes, and consumer engagement activities such as consumer advisory boards are all potential ways to improve the delivery of person-centered care.