National Hospital Ambulatory Medical Care Survey: 2003 outpatient department summary

OBJECTIVES: This report describes ambulatory care visits to hospital outpatient departments (OPDs) in the United States. Statistics are shown on selected hospital, clinic, patient, and visit characteristics, as well as selected trends in OPD visits since 1993. The report highlights variation in use across the major types of OPD clinics surveyed. METHODS: The data shown in this report were collected from the 2003 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 2003, an estimated 94.6 million visits were made to hospital OPDs in the United States, about 33.1 visits per 100 persons. This rate represents a 35-percent increase since 1993, although rates have been stable since 1999. Infants under 12 months of age had a visit rate of 88.7 visits per 100 persons, a rate that increased by 23 percent since 1993. Increasing trends in OPD visit rates were found for persons 50-64 years of age (up by 30 percent), 13-21 years of age (up by 32 percent), 22-49 years of age (up by 34 percent), and 1-12 years of age (up by 71 percent). Females had higher OPD visit rates than males (39.6 compared with 26.4 visits per 100 persons), and black or African American persons had higher OPD visit rates than white persons (59.7 compared with 29.9 visits per 100 persons). Medicaid and State Children's Health Insurance Program patients used OPDs for preventive care services more frequently than private pay patients. The preventive care visit rate by Hispanic and Latino patients was twice the rate by non-Hispanic patients. Diphtheria, tetanus, and acellular pertussis (DTaP) was the most frequently provided vaccine to children under age 18 years. Between 1993-94 and 2003, the proportion of visits involving only mid-level providers increased from 5.9 to 12.6 percent of visits.     

National Hospital Ambulatory Medical Care Survey: 2004 outpatient department summary

OBJECTIVES: This report describes ambulatory care visits to hospital OPDs in the United States. Statistics are presented on selected hospital, patient, and visit characteristics. Selected trends in OPD utilization from 1994 through 2004 are also presented. METHODS: The data presented in this report were collected in the 2004 NHAMCS, a national probability sample survey of visits to emergency and outpatient departments of nonfederal, short-stay, and general hospitals in the United States. Selected comparisons are also made with data from the 2004 National Ambulatory Medical Care Survey (NAMCS), a national probability sample survey of visits to office-based physicians in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 2004, an estimated 85.0 million visits were made to hospital OPDs in the United States, about 29.5 visits per 100 persons. Females (35.1 per 100 persons) had higher OPD visit rates than males (23.6 per 100 persons), and black or African American persons (50.3 per 100 persons) had higher OPD visit rates than white persons (27.0 visits per 100 persons). The overwhelming majority of visits to hospital OPDs were made by established patients (85.4 percent). Females made 75.5 percent of preventive care visits. The preventive care visit rate by Hispanic or Latino patients was twice the rate of non-Hispanic patients. Diagnostic and screening services were ordered at 90.3 percent of visits, therapeutic and preventive services were ordered at 50.0 percent of visits, and medications were ordered at 67.4 percent of visits. The proportion of visits involving only midlevel providers increased from 5.9 in 1993-94 to 11.4 percent of visits in 2003-04.     

National Hospital Ambulatory Medical Care Survey: 2000 outpatient department summary

OBJECTIVES: This report describes ambulatory care visits to hospital outpatient departments (OPDs) in the United States. Statistics are presented on selected hospital, clinic, patient, and visit characteristics. Highlights of trends in OPD utilization from 1997 through 2000 are also presented. METHODS: The data presented in this report were collected from the 2000 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. Trends are based on NHAMCS data from 1997 through 2000. RESULTS: During 2000, an estimated 83.3 million visits were made to hospital OPDs in the United States, about 30.4 visits per 100 persons. Females had higher OPD visit rates than males (35.3 versus 25.2 visits per 100 persons). The OPD utilization rate for black persons was higher than for white persons (48.3 versus 28.0 visits per 100 persons). Of all visits made to hospital OPDs in 2000, private insurance (38.5 percent), Medicaid (22.1 percent), and Medicare (16.9 percent) were listed as the leading primary expected source of payment. Approximately 21 percent of OPD visits reported that patients belonged to an HMO. There were an estimated 9.5 million injury-related OPD visits in 2000. Since 1997, the percent of OPD visits that were for injuries increased by 24% (from 9.2 percent to 1.4 percent). Most of these visits were for unintentional injuries (57.6 percent), including those caused by falls (12.9 percent). Medications were prescribed at 64.0 percent of visits. On average, 1.6 medications were ordered at each OPD visit. In 2000, patients saw one or more physicians (i.e., staff physician, resident/intern, or other physician) at approximately 79 percent of visits. Most patients were given an appointment to return to the clinic (57.2 percent).     

National Hospital Ambulatory Medical Care Survey: 2005 outpatient department summary

OBJECTIVES: This report describes ambulatory care visits to hospital outpatient departments (OPDs) in the United States. Statistics are presented on selected hospital, patient, and visit characteristics. Selected trends in OPD utilization from 1995 to 2005 are also presented. METHODS: The data presented in this report were collected in the 2005 National Hospital Ambulatory Medical Care Survey (NHAMCS), a national probability sample survey of visits to emergency and OPDs of nonfederal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 2005, an estimated 90.4 million visits were made to hospital OPDs in the United States, about 31.0 visits per 100 persons. Females (37.2 per 100 persons) had higher OPD visit rates than males (24.7 visits per 100 persons), and black or African-American persons (56.8 visits per 100 persons) had higher OPD visit rates than white persons (28.3 visits per 100 persons). Visit rates to OPD clinics for preventive care were highest for children under 1 year of age (43.1 per 100 persons). Almost one-half of OPD visits (46.1 percent) were made by patients with one or more chronic conditions. Hypertension was the most frequent chronic condition listed (19.7 percent). Visits with asthma declined with increasing age. From 1995 to 2005, the following visit characteristics changed: The visit rate for children under 15 years of age increased by 38%, the percentage of visits made by adults 18 years and over with depression indicated on the medical record increased by 48%; visits by adults with obesity, diabetes, and hypertension increased by 24%, 34%, and 43%, respectively; visits with counseling for tobacco use increased from 2.7 to 3.8 percent; visits with counseling for diet and nutrition increased from 9.4 to 15.7 percent; and visits with 6 or more medications prescribed or provided more than doubled, from 4.9 to 11.2 percent.     

National Hospital Ambulatory Medical Care Survey: 2001 outpatient department summary

OBJECTIVES: This report describes ambulatory care visits to hospital outpatient departments (OPDs) in the United States. Statistics are presented on selected hospital, clinic, patient, and visit characteristics. The report highlights new items on continuity of care of OPD visits, including: whether the visit was the first or a followup for a problem, number of visits to the clinic during the past 12 months for established patients, and whether other physicians shared care for the patient's problem. The report also highlights variation in utilization across the major types of OPD clinics surveyed. METHODS: The data presented in this report were collected from the 2001 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 2001, about 83.7 million visits were made to hospital OPDs in the United States. The 2001 rate (29.9 per 100 persons) represents a 33 percent increase since 1992. Females had higher OPD visit rates than males (35.2 versus 24.3 visits per 100 persons) and black or African-American persons had higher OPD visit rates than white persons (48.8 versus 27.9 visits per 100 persons). The majority of visits to hospital OPDs were made by patients with previous visits to the clinic (84.2 percent); 70.0 percent had visited the clinic one or more times during the past 12 months. Preventive care visits comprised 15.5 percent of all OPD visits; nearly three out of four preventive care visits were made by females (72.8 percent). Diagnostic and screening services were ordered or provided at 85.0 percent of visits, therapeutic and preventive services were ordered or provided at 45.6 percent of visits, and medications were prescribed at 64.6 percent of visits. Most patients were given an appointment to return to the clinic (60.1 percent).     

National Hospital Ambulatory Medical Care Survey: 1998 emergency department summary

OBJECTIVES: This report describes ambulatory care visits to hospital emergency departments in the United States. Statistics are presented on selected patient and visit characteristics. METHODS: The data presented in this report were collected from the 1998 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability survey of visits to hospital emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 1998, an estimated 100.4 million visits were made to hospital emergency departments (ED's) in the United States, about 37.3 visits per 100 persons. Persons 75 years and over had the highest rate of ED visits. There were an estimated 37.1 million injury-related ED visits during 1998, or 13.8 visits per 100 persons. Seventy-four percent of injury-related ED visits were made by persons under 45 years of age. Injury visit rates were higher for males than females in each age group under 45 years. According to ICD-9-CM classification, 77.2 percent of injury visits were unintentional. About 71 percent of the ED visits involved medication therapy, with pain relief drugs accounting for 31.5 percent of the medications mentioned. Acute upper respiratory infection was the leading illness-related diagnosis at ED visits.     

National Hospital Ambulatory Medical Care Survey: 2002 emergency department summary

OBJECTIVES: This report describes ambulatory care visits to hospital emergency departments (EDs) in the United States. Statistics are presented on selected hospital, patient, and visit characteristics. Selected trends in ED utilization from 1992 through 2002 are also presented. METHODS: The data presented in this report were collected from the 2002 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 2002, an estimated 110.2 million visits were made to hospital EDs, about 38.9 visits per 100 persons. From 1992 through 2002, an increasing trend in the ED utilization rate was observed for persons over 44 years of age. In 2002, abdominal pain, chest pain, fever, and cough were the leading patient complaints accounting for nearly one-fifth of all visits. Acute upper respiratory infection was the leading illness-related diagnosis at ED visits. From 1992 through 2002, decreases in ED visit rates were observed for intracranial injuries in children, and increases were found for depression in young adults and arthropathies among middle-aged and elderly patients. There were an estimated 39.2 million injury-related visits during 2002, or 13.8 visits per 100 persons. Diagnostic/screening services, procedures, and medications were provided at 86.8 percent, 43.2 percent, and 75.8 percent of visits, respectively. In 2002, approximately 12 percent of ED visits resulted in hospital admission. On average, patients spent 3.2 hours in the ED.     

National Hospital Ambulatory Medical Care Survey: 2001 emergency department summary

OBJECTIVES: This report describes ambulatory care visits to hospital emergency departments (EDs) in the United States. Statistics are presented on selected hospital, patient, and visit characteristics. Selected trends in ED utilization from 1992 through 2001 are also presented. The report highlights new items on the continuity of care provided at ED visits, initial vital sign measurements, whether the patient's residence was a nursing home or institution, and duration of the ED visit. METHODS: The data presented in this report were collected from the 2001 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 2001, an estimated 107.5 million visits were made to hospital EDs, about 38.4 visits per 100 persons. From 1992 through 2001, an increasing trend in the ED utilization rate was observed. Between 2 and 3 percent of ED visits were made by patients living in a nursing home or other institution. At approximately 3 percent of visits, the patient had been seen in the ED within the last 72 hours. In 2001, abdominal pain, chest pain, fever, and headache were the leading patient complaints accounting for nearly one-fifth of all visits. Acute upper respiratory infection was the leading illness-related diagnosis at ED visits. There were an estimated 39.4 million injury-related visits during 2001, or 14.1 visits per 100 persons. Diagnostic/screening services and procedures were provided at 85.4 percent and 40.9 percent of visits, respectively. Medications were provided at 74.2 percent of visits, and pain relief drugs accounted for 34.2 percent of the medications mentioned. In 2001, approximately 12 percent of ED visits resulted in hospital admission. On average, patients spent 3.0 hours in the ED.     

National Hospital Ambulatory Medical Care Survey: 1999 emergency department summary

OBJECTIVES: This report describes ambulatory care visits to hospital emergency departments (ED's) in the United States. Statistics are presented on selected hospital, patient, and visit characteristics. Highlights of trends in ED utilization from 1992 through 1999 are also presented. METHODS: The data presented in this report were collected from the 1999 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability survey of visits to hospital emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. Trends are based on NHAMCS data for 1992, 1993-94, 1995-96, 1997-98, and 1999. RESULTS: During 1999, an estimated 102.8 million visits were made to hospital ED's in the United States, about 37.8 visits per 100 persons. The volume of ED visits increased by 14 percent from 1992 through 1999, though no trend was observed in the overall population-based visit rates. There was a significant increase in the visit rate for black persons 75 years of age and over. In 1999, persons 75 years of age and over had the highest ED visit rate and 41.5 percent of these patients arrived by ambulance. There were an estimated 37.6 million injury-related ED visits during 1999, or 13.8 visits per 100 persons. Seventy-four percent of injury-related ED visits were made by persons under 45 years of age. Injury visit rates were higher for males than females in each age group under 45 years. The case mix of visits at ED's changed since 1992, with a greater percent of visits presenting with illness rather than injury conditions. Abdominal pain, chest pain, fever, and headache were the leading patient complaints accounting for one-fifth of all visits. Acute upper respiratory infection was the leading illness-related diagnosis at ED visits. Increases were observed in visits where no complete diagnosis could be made (16.2 percent of visits in 1999). Diagnostic and/or screening services were provided at 89.0 percent of visits, procedures were performed at 42.5 percent of visits, and medications were provided at 72.5 percent of visits. Pain relief drugs accounted for 31.1 percent of the medications mentioned. Trend data from 1992 indicated that the use of medications at ED visits increased. In 1999, approximately 13 percent of ED visits ended in hospital admission. Facility-level data indicated that there is variation among hospital ED's with respect to case mix, number of services provided, and case disposition distributions, especially the percent admitted to the hospital.     

National Hospital Ambulatory Medical Care Survey: 2004 emergency department summary

OBJECTIVES: This report describes ambulatory care visits to hospital emergency departments (EDs) in the United States in 2004. Statistics are presented on selected hospital, patient, and visit characteristics. Selected trends in ED utilization from 1994 through 2004 are also presented. METHODS: The data presented in this report were collected in the 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS), a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates. RESULTS: During 2004, an estimated 110.2 million visits were made to hospital EDs, about 38.2 visits per 100 persons. Visit rates have shown an increasing trend since 1994 for persons aged 22-49 years, 50-64 years, and 65 years and over. In 2004, more than 16 million patients arrived by ambulance (15.1 percent). At approximately 3 percent of visits, the patient had been seen in the ED within the last 72 hours. Abdominal pain, chest pain, fever, and back symptoms were the leading patient complaints, accounting for nearly one-fifth of all visits. Abdominal pain was the leading illness-related diagnosis at ED visits. There were an estimated 41.4 million injury-related visits or 14.4 visits per 100 persons. Diagnostic and screening services were provided at 89.9 percent of ED visits. Procedures were performed at 47.7 percent, and medications were prescribed at 78.4 percent of ED visits. Approximately 13 percent of ED visits resulted in hospital admission. On average, patients spent 3.3 hours in the ED, of which 47.4 minutes were spent waiting to see a physician.