Poor self-rated mental health and Medicare beneficiaries' routine care-seeking.

Objectives: To assess the relationship between self-rated mental health (SRMH) and infrequent routine care among Medicare beneficiaries and to investigate the roles of managed care and having a personal doctor.

Study Design: Cross-sectional analysis of data from the 2018 Medicare Consumer Assessment of Healthcare Providers and Systems survey.

Methods: Logistic regression was used to predict infrequent routine care (having not made an appointment for routine care in the last 6 months) from SRMH, Medicare coverage type (fee-for-service [FFS] vs Medicare Advantage [MA], the managed care version of Medicare), and the interaction of these variables. Models that did and did not include having a personal doctor were compared. All models controlled for demographics and physical health.

Results: Overall, 14.9% of beneficiaries did not make a routine care appointment in the last 6 months, with rates adjusted for demographics and physical health ranging from 14.5% for those with "excellent" SRMH to 19.2% for those with "poor" SRMH. Beneficiaries with poor SRMH were less likely to make a routine care appointment in FFS than in MA (20.1% vs 16.4%, respectively, had not done so in the last 6 months; P < .05). Accounting for having a personal doctor reduced the association between SRMH and infrequent routine care by about a third.

Conclusions: Extra efforts are needed to ensure receipt of routine care by beneficiaries with poor mental health-particularly in FFS, where more should be done to ensure that beneficiaries have a personal doctor.