National
Center for Health Statistics (NCHS)
Monitoring Health Care in America Quarterly Fact
Sheet
December 1995
Spotlight
on: Office Visits to Neurologists
An average of 7.3
million visits are made annually to neurologists in the U.S. according to
1991-92 data. This is up from just under 5 million visits per year in 1985
and 3 million visits annually in 1980. In 1991-92, the visitation rate to
neurology specialists was 3 visits per 100 people. Females are more likely
to visit neurologists (3.3 visits per 100 population) than males (2.5
visits per 100 population). Six percent of patients who visit neurologists
are referred by another physician. Fifteen percent are new patients, while
three out of five are old patients visiting for old reasons.
Visit
characteristics
The biggest reason for patient visits to neurologists is the headache (23
percent). The most frequent diagnoses at these visits are convulsions
(10.6 percent of all visits) and migraines (10.3 percent of visits).
Convulsions are reported more frequently among men (13 percent of all
visits vs. 9 percent of all visits for women), while migraines are
reported more frequently among women (14 percent vs. 6 percent for men).
Migraine was the most frequently reported principal diagnosis for adults
aged 25-44 years (421,000 visits, 16.4 percent of all visits). For
children under 15 years of age, hyperkinetic syndrome of childhood was the
most frequent principal diagnosis (13.3 percent of all visits).
There were 331,000
diagnoses of Parkinson's disease in 1991-92, or 4.6 percent of all visits.
Parkinson's disease was also the most frequently reported diagnosis for
patients 65 years of age and over, and it was the seventh leading
diagnosis for people aged 45-64 years. Multiple Sclerosis (MS) was the
fourth leading diagnosis among adults 25-44 years of age and the fifth
leading diagnosis for people aged 45-64 years. There were 244,000
diagnoses of MS in 1991-92, accounting for 3 percent of all visits.
Epilepsy was diagnosed on 150,000 occasions, or 2 percent of all visits,
and was the 10th leading diagnosis for adults 25-44 years of age.
Drug mentions
Neurologic drugs were mentioned at over a quarter of all visits, the
greatest proportion being anticonvulsants (1.3 million mentions or 16
percent of the total). Drugs used for pain relief, including general
analgesics and antiarthritics, were mentioned at 22 percent of all visits.
Psychopharmacologic drugs such as antidepressants, antianxiety drugs, and
sedatives and hypnotics were mentioned in about one out of five visits.
The most frequently prescribed drugs were anticonvulsants Tegretol and
Dilantin, followed by Sinemet, used for extrapyramidal movement disorders.
Source of payment Private or commercial insurance was the expected source of payment at
44 percent of all visits. Medicare accounted for 22 percent, followed by
patient-paid (13.5 percent), and HMOs or other prepaid plans (11.4
percent). Medicaid was the expected source of payment for 7 percent of all
visits.
More on neurologic disorders and health care utilization In 1993 Americans made 717.2 million office visits to physicians, and
nearly 8.4 million of these visits were to physicians specializing in
neurology. There were 909,000 procedures on the nervous system performed
on hospital inpatients in 1993. Over one-third of those were spinal tap
procedures. In addition, there were 629,000 computerized axial tomography
scans performed on the head. In 1993 over 5.2 million visits to hospital
emergency departments were for symptoms relating to the nervous system,
resulting in more than 6.1 million principal diagnoses of diseases
relating to the nervous system or sense organs. There were an additional
1.6 million visits to hospital outpatient departments due to neurological
reasons, resulting in nearly 3.8 million diagnoses of neurological
disease.
For more information
or to arrange an interview with the author, please contact NCHS, Office of
Public Affairs (301) 458-4800, or via e-mail at paoquery@nch10a.em.cdc.gov.
Data Sources Advance Data From Vital and Health Statistics
No. 264.
1993 Summary: National Hospital Discharge Survey. 12 pp. (PHS) 95-1250 View/download PDF108 KB
No. 267.
Office Visits to Neurologists: United States, 1991-92. 20 pp. (PHS)
95-1250 View/download PDF234 KB
No. 270.
National Ambulatory Medical Care Survey: 1993 Summary. 20 pp. (PHS)
96-1250 View/download PDF262 KB
No. 271.
National Hospital Ambulatory Medical Care Survey: 1993 Emergency
Department Summary. 16 pp. (PHS) 96-1250. View/download PDF199 KB