In a groundbreaking study published recently in JAMA Network Open, researchers from Case Western Reserve University have unveiled surprising insights into the priorities of older adults who seek care at walk-in ambulatory clinics across the United States. Contrary to widespread expectations, these senior patients place social engagement and inclusiveness above their own health status when asked the simple yet profound question: “What matters most to you?” This finding challenges traditional perceptions about geriatric healthcare demands and underscores the complexity of aging populations’ needs.
The study analyzed responses from nearly 388,000 adults aged 65 and older who attended approximately 900 walk-in clinics across 35 states from January 2021 through March 2024. These clinics, which primarily serve patients without appointments for minor acute conditions, provided a unique vantage point to gather authentic, real-time patient preferences. Through electronic health records, patients were asked an open-ended question designed to capture their most deeply held values and priorities concerning their well-being and quality of life.
Responses to the question “What matters most to you?” revealed that nearly 50% of older adults emphasized the importance of maintaining social activities and feeling included in their communities. This aspect overshadowed even health-related concerns, which accounted for only about 21% of responses. Independence and family togetherness followed, representing 17% and 10.5% of priorities respectively. This distribution indicates a holistic perception of well-being among seniors, where social and relational dimensions are integral components of health.
Nicholas Schiltz, assistant professor at the Frances Payne Bolton School of Nursing and a co-lead on the research, expressed surprise at the findings. Given that walk-in clinics primarily address acute medical issues, it was expected that physical health concerns would be paramount. However, Schiltz suggests that these results reflect the multifaceted needs of older adults, emphasizing that like all humans, seniors value community and connection just as urgently as their physical health.
From a clinical standpoint, these findings have substantial implications for how healthcare providers develop treatment plans for older adults. Schiltz elaborates that understanding patient priorities allows clinicians to tailor medical regimens in ways that preserve or promote independence and social engagement. For instance, medications may be chosen or adjusted to minimize side effects such as dizziness or cognitive impairment that could compromise mobility or participation in social activities. Similarly, prescribing mobility aids or arranging support services could be prioritized to align with a patient’s expressed values.
This patient-centered approach is part of a broader movement led by The John A. Hartford Foundation Age-Friendly Health Systems initiative, which aims to ensure that healthcare for older adults is informed by evidence-based practices attentive to what truly matters to this demographic. Mary Dolansky, Sarah C. Hirsh Professor at Case Western Reserve’s nursing school and co-leader of the study, highlights that optimal care for aging populations integrates multiple domains, including safe medication management, mental health evaluations, brain health assessments, and mobility support.
The demographic breakdown of survey respondents lends further depth to the study’s insights. Approximately two-thirds of participants were women, with about three-quarters identifying as White. Minority representation included 2.7% Asian, 5% Black, and 4.7% Hispanic. Interestingly, the dataset showed little variation in priorities across sex, race, or ethnicity, suggesting that social connectedness and inclusiveness transcend demographic boundaries among older adults attending ambulatory care clinics.
Beyond the clinical implications, these findings raise important questions about societal structures and public health policies aimed at aging populations. The prominence of social engagement as a priority underscores the need for community-based programs and social frameworks that promote inclusion and connectivity for seniors. Local governments, healthcare organizations, and social service providers might consider expanding resources such as senior centers, transportation services, and outreach programs designed to reduce isolation and facilitate active participation.
The methodology employed in this investigation, a large-scale survey embedded within electronic health records, exemplifies the power of leveraging health informatics to capture patient-reported outcomes in real-world settings. By integrating qualitative patient feedback into routine clinical data collection, researchers can gather rich, actionable insights while minimizing respondent bias and logistical barriers often encountered in traditional surveys.
Furthermore, the timing of this research, conducted during and following the COVID-19 pandemic, adds a compelling layer of context. The pandemic exacerbated social isolation and highlighted vulnerabilities in older adults’ access to community and healthcare resources. Understanding that social activity remains paramount to this population suggests that mitigating isolation through innovative healthcare delivery models—including telehealth and community partnerships—may be crucial in future system designs.
Overall, the study paves the way for a paradigm shift in how ambulatory care for older adults is conceptualized and delivered. Recognizing the primacy of social connection alongside traditional health metrics offers a more nuanced understanding of what it means to support seniors effectively. Future research might explore how these priorities evolve over time and in different care settings, as well as how interventions tailored to social and psychological well-being impact clinical outcomes.
Case Western Reserve University, known for its pioneering research and commitment to translational science, continues to lead advancements that intersect healthcare, social science, and technology. This study exemplifies how comprehensive, patient-centered research can influence not only medical treatment but also the broader social determinants of health, potentially enhancing quality of life for a rapidly growing segment of the population.
As the nation grapples with an aging demographic, such insights provide a critical foundation for policies and practices oriented toward holistic, respectful, and effective care. Ensuring that walk-in clinics and other ambulatory services address what matters most—not only in terms of pathology but in sustaining vibrant social engagement and independence—may ultimately improve health outcomes, reduce hospitalizations, and foster dignity in aging.
Subject of Research: People
Article Title: Patient-Centered Priorities for Older Adults in Ambulatory Care
News Publication Date: 6-Oct-2025
Web References: JAMA Network Open Article
References:
Schiltz, N.K., Dolansky, M., et al. (2025). Patient-Centered Priorities for Older Adults in Ambulatory Care. JAMA Network Open, DOI: 10.1001/jamanetworkopen.2025.35769
Keywords: Human health, Clinical medicine, Health care
Tags: aging populations needsCase Western Reserve University studygeriatric healthcare insightshealth status vs social activitiesimportance of community inclusivenessJAMA Network Open researchpatient preferences in healthcaresenior citizens prioritiessocial engagement in elderly caresurprising findings in senior healthcareunderstanding older adults valueswalk-in ambulatory clinics for seniors
