N C H S - Publications and Information Products - U.S. Medical Care Visits Exceed 1 Billion

Series 13, No. 159. Ambulatory Care Visits to Physician Offices, Hospital Outpatient Departments, and Emergency Departments: United States, 2001-02. 73 pp. (PHS) 2005-1730.
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Americans made more than 1 billion visits a year to doctors' offices, emergency rooms and hospital outpatient departments, according to a detailed report on ambulatory medical care. "Ambulatory Care Visits to Physicians’ Offices, Hospital Outpatient Departments, and Emergency Departments, 2001-02" provides a comprehensive analysis of visits for ambulatory health care in all three settings and builds upon and expands the data in earlier reports that examined visits in each separate setting. Summary reports have been published through 2003 and data for 2004 are expected in a few months.

The report from the Centers for Disease Control and Prevention shows that the annual number of medical care visits reached 1.1 billion in 2001-02, up 10 percent from the visit rate in 1999-2000. Fueling the increase was a 17-percent jump in visits to primary care physicians.

Half of the 1.1 billion visits were to primary care doctors. The rest were to medical specialists (16 percent), surgical specialists (15 percent), hospital emergency departments (10 percent), and hospital outpatient departments (8 percent). Since 1993-94, visits to all types of settings increased with the exception of visits to medical care specialists. Patients are seeking care more frequently from primary care physicians in lieu of specialists, perhaps as a result of managed care.

Those living in the Northeast went to the doctor and other medical care-givers more often than those living in the rest of the country. The elderly, who are largely covered by Medicare, saw doctors more than any other age group–about 7.4 visits a year for each person 65 and older.

The uninsured made the least use of medical care. They saw a doctor or specialist or visited an emergency department or outpatient clinic only 1.6 times over the year. This compares with 3.8 visits per person for the overall population.

Some patients went to emergency and outpatient departments for their care more frequently than average, including those under age 45, males, African Americans, those covered by Medicaid, and the uninsured. In contrast, those 45 and over, white persons, and those with private insurance were more likely to visit doctors’ offices for their care.

Visits for hypertension occurred most frequently followed by routine child health visits and visits for the common cold, arthropathies (joint diseases), diabetes, and spinal disorders. Normal pregnancy was the most frequent reason why women ages 15 to 24 sought medical care. The most frequent diagnosis for those 45 and older was hypertension. Visits for injuries increased from 139 million in 1999-2000 to more than 152 million in 2001-02.

Almost two-thirds of the time, drugs were provided or prescribed during the visits, amounting to 1.7 billion annual prescriptions (not including telephone prescriptions). Nonsteroidal anti-inflammatory drugs were the most frequently prescribed, followed by antihistamines and antidepressants.

The report also shows that since 1993-94, medical visits have grown for diabetes (from 58 to 104 visits per 1,000 persons) and attention deficit disorder (from 11 to 19 visits per 1,000 persons).

The report combines 2 years of data to provide detailed estimates of ambulatory medical care in the United States, including characteristics of the patients and information on conditions and treatments. CDC’s National Center for Health Statistics conducted surveys of a sample of visits occurring during 2001 and 2002 from a sample of nonfederal, short-stay and general hospitals, and office-based physicians representing the 50 states and the District of Columbia.