Examining the impact of weather-related barriers on primary care utilization in older adults with chronic conditions

The National Institute of Environmental Health Sciences, part of the Department of Health and Human Services National Institutes of Health, awarded $471,196 to Aurora Health Care, Inc. on September 1, 2026, under the Environmental Health program (CFDA 93.113) to examine how weather-related barriers affect primary care utilization in older adults with chronic conditions.

The recipient will quantify the impact of inclement weather—including extreme temperatures, high heat index, and heavy precipitation—on missed primary care visits among elderly adults with chronic conditions and evaluate whether telemedicine can mitigate these effects. The research responds to a documented gap: while no-show rates for primary care visits range from 4 to 55 percent nationally and cost the healthcare system over $150 billion annually, the relationship between specific weather events and missed visits remains understudied in elderly populations and those with chronic disease. The study will identify which patients face the greatest risk and the magnitude of primary care disruption caused by weather, with particular attention to common chronic conditions including diabetes, hypertension, chronic obstructive pulmonary disease, congestive heart failure, and Alzheimer's disease and other neurocognitive disorders.

The award is structured as a Project Grant, a form of assistance funding. Aurora Health Care, Inc., a nonprofit healthcare entity based in Milwaukee, Wisconsin, serves as the recipient organization. Performance of work will occur in Milwaukee, Wisconsin. The period of performance runs from September 1, 2026, through August 31, 2028.

Abstract

Nationally, missed visits are a widespread and costly issue, with no-show rates ranging from 4% to 55% and costing the healthcare system over $150 billion annually. Missed primary care visits also pose a significant threat to the health of elderly patients and the efficiency of the healthcare system. With 80% of older adults in the U.S. Having at least one chronic condition, consistent primary care is vital for disease monitoring and treat- ment-especially for common conditions such as diabetes, hypertension, chronic obstructive pulmonary DIS- ease, congestive heart failure, and alzheimer's disease and other neurocognitive disorders. However, missed visits disrupt this continuity of care, contributing to poor health outcomes, including increased mortality risk, delayed follow-up, and greater patient attrition. These disruptions are especially problematic for older adults with chronic conditions who are more likely to miss visits. One understudied barrier to primary care access is inclement weather, such as extreme temperatures, high heat index, and heavy precipitation. While some RE- search shows a link between specific weather events and missed visits, findings vary by region, and most stud- IES have not focused on elderly patients or those with chronic conditions. There remains a critical GAP in under- standing who is most at risk and how much primary care is affected. Telemedicine offers a promising solution, having proven effective in reducing missed visits during the covid-19 pandemic. Both patients and clinicians reported satisfaction with telemedicine, particularly when in-person visits were not feasible due to weather. This study aims to quantify how inclement weather contributes to missed primary care visits among elderly adults with chronic conditions and evaluate whether telemedicine can mitigate these effects by providing an accessible alternative during inclement weather. Using electronic health record data from 2022-2025 linked with detailed weather information, we will assess the impacts of inclement weather on patterns of missed visits, time intervals between appointments, and subsequent emergency or hospital use within a large, diverse popu- lation of elderly patients across illinois and wisconsin. Ultimately, this research will provide critical insights to guide future interventions, such as proactively scheduling telemedicine visits ahead of forecasted inclement weather, that healthcare systems can adopt to maintain access, continuity, and health for all patients.