Utilization of Health Services in Physician Offices and Outpatient Clinics by Adolescents and Young Women in the United States: Implications for Improving Access to Reproductive Health Services |
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| Authors: | Karen W. Hoover Guoyu Tao Stuart Berman Charlotte K. Kent |
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| Affiliation: | 1. Pediatric Rheumatology, University of Utah, 81 Mario Capecchi Way, 4th Floor, Salt Lake City, UT 84113, USA;2. Division of Developmental Medicine, Boston Children’s Hospital, 300 Longwood Avenue BCH3185, Boston, MA 02115, USA;3. Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Avenue BCH3187, Boston, MA 02115, USA;4. Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue BCH3187, Boston, MA 02115, USA;5. Computational Health Informatics Program, Boston Children’s Hospital, 300 Longwood Avenue BCH3187, Boston, MA 02115, USA;1. Department of Urology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland;2. Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland;3. Department of Nephrology, Endocrinology and Metabolic Diseases, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland;4. International Institute of Molecular and Cell Biology, Warsaw, Poland;5. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland;6. Department of Epidemiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland;1. Department of Pharmacogenomics, Medical University of Warsaw, ?wirki i Wigury 61, PL 02-091 Warszawa, Poland;2. Department of Psychiatry, Medical University of Warsaw, ?wirki i Wigury 61, PL 02-091 Warszawa, Poland;3. Department of Internal Medicine and Diabetology, Medical University of Warsaw, ?wirki i Wigury 61, PL 02-091 Warszawa, Poland;4. Department of Biochemistry and Clinical Chemistry, Medical University of Warsaw, ?wirki i Wigury 61, PL 02-091 Warszawa, Poland;5. Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA;1. Department of Pediatrics, Mount Sinai Hospital, Icahn School of Medicine, New York, New York;2. Private Medical Practice, New York, New York;3. Division of Adolescent Medicine, Children''s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York;4. Division of Academic General Pediatrics, Children''s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York;1. Milken Institute School of Public Health, The George Washington University, Washington, DC;2. Department of Obstetrics and Gynecology, School of Medicine, The George Washington University, Washington, DC |
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| Abstract: | PurposeWe examined utilization patterns of adolescents and young women as they seek general and reproductive health services in physician offices and hospital outpatient clinics.MethodsWe analyzed physician office visits in the 2003–2006 National Ambulatory Medical Care Surveys, and hospital outpatient clinic visits in the National Hospital Ambulatory Medical Care Surveys, to examine utilization patterns of females aged 9–26 years by 2-year age intervals and other characteristics such as physician specialty or clinic type.ResultsThe number of visits to primary care physician offices increased with age, from 4.9 million for ages 9–10 years to 9.0 million for ages 25–26 years. The proportion of visits made to obstetrician-gynecologists and family practitioners increased with age, and by ages 15–16 years fewer than half of all visits to primary care providers were made to pediatricians. The proportion of visits to family practitioners increased from 25% at ages 9–10 years to 30% at ages 25–26 years. By ages 17–18 years, a larger proportion of visits were made to obstetrician-gynecologists (33% of 7.0 million visits) and to family practitioners (34%) than to pediatricians (23%). The proportion of visits for reproductive health services peaked at 53% of 7.5 million physician visits at ages 20–21 years. Similar utilization patterns were observed for the 11.0 million hospital outpatient visits to primary care providers.ConclusionsBecause adolescents and young women most commonly utilize healthcare services provided by obstetrician-gynecologists and family practitioners, these specialties should be priority targets for interventions to improve the quality and availability of reproductive health services. |
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