Ambulatory Care Visits to Physician Offices, Hospital Outpatient
Departments, and Emergency Departments: United States, 1999-2000
For Immediate Release:
Thursday, September 23, 2004
Contact: NCHS/CDC Public
Affairs
(301) 458-4800
E-mail: nchsquery@cdc.gov
Ambulatory Care
Visits to Physician Offices, Hospital Outpatient Departments, and
Emergency Departments: United States , 1999-2000.Series Report 13, No. 157. 78 pp. (PHS)
2004-1728. View/download
PDF 4.3 MB
This new report by CDC
showcases the use of ambulatory medical care services across a broad range
of health care settings and paints a picture of variation in medical
services obtained by safety-net populations, including African Americans,
poor, uninsured, and persons living in sparsely-populated areas of the
country. The report also documents how use of emergency departments varies
from less-critical health care settings among differing populations. Some
of the findings include:
Emergency
departments provide one-quarter of care received by uninsured patients
compared with one-tenth by privately-insured patients. For every visit to
the emergency department by an uninsured patient, there are 1.3 visits to a
primary care specialist compared with 6.6 primary care visits for every
emergency department visit by a privately-insured patient.
Uninsured
patients are much less likely than privately-insured patients to have
medication prescribed during their visits. Meanwhile, more medications are
prescribed at visits in sparsely-populated areas compared with
densely-populated areas.
Compared
with densely-populated areas, patients seeking care in sparsely-populated
areas are more likely to visit primary care specialists such as family
practice or internal medicine specialists but less likely to visit medical
specialists such as dermatologists, psychiatrists, and allergy specialists.
In addition, use of ambulance transports to emergency departments is more
than twice the rate in sparsely-populated areas compared with
densely-populated areas (118 vs. 53 transports per 1,000 persons).
Age-adjusted
visit rates showed that between 1993-94 and 1999-2000, use of primary care
specialists and surgical care specialists increased while use of medical
care specialists decreased. Use of hospital settings did not change. This
coincides with an increase in use of HMOs and managed care plans during the
study period.
Out
of the nearly one billion annual ambulatory medical care visits across all
settings, nearly one-half were to primary care specialty offices, 16-17 percent
each to surgical and medical specialty offices, 11 percent to hospital
emergency departments, and 9 percent to hospital outpatient departments with
physician-supervised evaluation and management clinics.
There
were 375,000 medical visits for injuries, poisonings, and adverse effects of
medical treatment, representing 14 percent of all ambulatory care visits. The
leading illness-related diagnoses included high blood pressure, common cold,
arthropathies, and diabetes. Drugs were prescribed at 67 percent of visits
with the top therapeutic classes including antiarthritics, antidepressants,
and vaccines.
The report is based on
combined data from the 1999 and 2000 National Ambulatory Medical Care
Survey and National Hospital Ambulatory Medical
Care Survey, which are
annual probability-based surveys of ambulatory care utilization in the
United States conducted by CDC’s National Center for Health Statistics.
The five health care settings studied include primary care offices,
surgical specialty offices, medical specialty offices, hospital outpatient
departments, and emergency departments.