Health Care Use Among Recently Enrolled Young Adults in an Integrated Health Plan

Abstract

INTRODUCTION: Early establishment of a primary care practitioner (PCP) may enhance young adults' ability to navigate the health care system, particularly those new to integrated care. METHODS: The study population included 18- to 26-year-old individuals newly enrolled in 2023 at Kaiser Permanente Northern California (N = 30,099). This cross-sectional study examined associations between early establishment of a PCP (indicated in the electronic health record) and several outcomes: creation of secure messaging accounts, secure messaging use, appointment and advice call center use, e-visit use, emergency department (ED) utilization, and screening for mental health, alcohol, exercise, and tobacco use. Adjusted incidence rate ratios were estimated using a modified Poisson model controlling for sex, age, race and ethnicity, need for an interpreter, insurance type, neighborhood deprivation, and chronic health problem. RESULTS: Young members with early establishment of a PCP were more likely to utilize modalities of care that were outside of traditional office visits and had higher rates of preventive screening. They also demonstrated a 10% reduction in the likelihood of a low-acuity ED visit compared to those without early PCP connection. DISCUSSION: Improved navigation of health care resources and uptake of preventive screening with reduced reliance on ED visits were seen among some groups with early establishment of a PCP. CONCLUSION: Promoting PCP visits and targeted PCP outreach to those living in lower socioeconomic neighborhoods may foster beneficial health care relationships during this transitional life stage.