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National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Page 1
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables The Ambulatory and Hospital Care Statistics Branch is pleased to release the most current nationally representative data on ambulatory care visits to physician offices in the United States. Statistics are presented on physician practices as well as patient and visit characteristics using data collected in the 2015 National Ambulatory Medical Care Survey (NAMCS). NAMCS is an annual nationally representative sample survey of visits to nonfederal office-based patient care physicians, excluding anesthesiologists, radiologists, and pathologists. Visit estimates for the following 16 states that were targeted for separate estimation are included in the summary tables: Arizona, California, Florida, Georgia, Illinois, Indiana, Massachusetts, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, Virginia, and Washington. The remaining 34 states and DC were grouped into four region remainders (North, South, East, and West) or groups of states that comprise Census regions excluding the 16 states for which state estimates were calculated. Four tables presenting state estimates are included, in addition to the tables presenting national estimates. The sampling frame for the 2015 NAMCS was composed of physicians listed in the master files maintained by the American Medical Association and the American Osteopathic Association. The 2015 NAMCS utilized a two-stage probability design that involved probability samples of physicians within targeted states and Census regions, and patient visits within practices. Although an additional sample of physicians and non-physician practitioners from community health center (CHC) delivery sites was also selected, CHC estimates are not included in the summary tables and will be presented in a separate report. The 2015 NAMCS sample included 8,091 physicians. A total of 3,181 physicians did not meet all of the criteria and were ruled out of scope (ineligible) for the study. Of the 4,910 in- scope (eligible) physicians, 1,410 completed Patient Record Forms (PRFs) in the study. PRFs were not completed by 327 physicians because they saw no patients during their sample week due to vacation, illness, or other reasons for being temporarily not in practice. Of the 1,410 physicians who completed PRFs, 1,088 participated fully or adequately (i.e. at least half of the PRFs expected, based on the total number of visits during the reporting week, were submitted), and 322 participated minimally (i.e. fewer than half of the expected number of PRFs were submitted). Within physician practices, data are abstracted from medical records for up to 30 sampled visits during a randomly assigned 1-week reporting period. In all, 28,332 PRFs were submitted. The participation rate—the percentage of in-scope physicians for whom at least one PRF was completed—was 36.5% percent. The response rate—the percentage of in-scope physicians for whom at least one-half of their expected number of PRFs was completed—was 29.6%. Among the 16 targeted states, response rates ranged from 14.3% to 55.6%. The 2015 NAMCS was conducted from December 22, 2014, through December 20, 2015. The U.S. Bureau of the Census was the data collection agent for the 2015 NAMCS. NAMCS was collected electronically, using a computerized instrument developed by the U.S. Census Bureau. For 2015, abstraction by Census field representatives using laptop computers to access the automated PRF instrument was the preferred mode of data collection. The PRF may be viewed at: https://www.cdc.gov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_Card.pdf. Data processing and medical coding were performed by SRA International, Inc., Durham, North Carolina. As part of the quality assurance procedure, a 10% quality control sample of NAMCS survey records were independently recoded and compared. Differences were adjudicated by a quality control supervisor with error rates reported to NCHS. Coding error rates for the 10% sample ranged between 0.5 and 1.4%. For further details, see the 2015 NAMCS
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Page 2
Public Use Data File Documentation at: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_ Documentation/NAMCS/doc2015.pdf. Web table estimates consist of visits to physicians at office-based practices. Visit estimates are based on sample data weighted to produce annual national estimates and include standard errors. Because of the complex multistage design of NAMCS, a sample weight is computed for each sample visit that takes all stages of design into account. The survey data are inflated or weighted to produce national annual estimates. The visit weight includes four basic components: inflation by reciprocals of selection probabilities, adjustment for nonresponse, population ratio adjustments, and weight smoothing. Estimates of the sampling variability were calculated using Taylor approximations in SUDAAN, which take into account the complex sample design of NAMCS. Detailed information on the design, conduct, and estimation procedures of the 2015 NAMCS are discussed in the NAMCS Public Use Data File Documentation. As in any survey, results are subject to sampling and nonsampling errors. Nonsampling errors include reporting and processing errors as well as biases due to nonresponse and incomplete response. In 2015, race data were missing for 28.6% of visits, and ethnicity data were missing for 23.4% of visits. Starting with 2009 data, NAMCS adopted the technique of model-based single imputation for NAMCS race and ethnicity data. Race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2015 NAMCS Public Use Data File Documentation (see above for link). Information on missing data for other variables is provided in table footnotes. In the following tables, estimates are not presented and replaced with an asterisk (*) if they are based on fewer than 30 cases in the sample data. Estimates based on 30 or more cases include an asterisk if the relative standard error (RSE) of the estimate exceeds 30 percent. Suggested citation: Rui P, Okeyode T. National Ambulatory Medical Care Survey: 2015 State and National Summary Tables. Available from: http://www.cdc.gov/nchs/ahcd/ahcd_ products.htm.
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 1. Physician office visits, by selected physician characteristics: United States, 2015
Physician characteristic
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Physician specialty
Percent distribution (standard error of percent) 1000
Number of visits per 100 persons per year1,2,3 (standard error of rate) 3133 (155)
4
General and family practice Internal medicine Pediatrics5 Obstetrics and gynecology6 Ophthalmology Orthopedic surgery Psychiatry Cardiovascular diseases Dermatology Otolaryngology Urology General surgery Neurology All other specialties
192,789 139,028 94,861 81,045 57,938 56,427 45,863 41,223 37,110 24,798 20,735 16,806 15,635 166,552
(31,485) (29,149) (12,045) (13,273) (8,095) (8,367) (9,509) (8,033) (5,515) (3,320) (2,677) (2,556) (3,521) (31,285)
195 140 96 82 58 57 46 42 37 25 21 17 16 168
(28) (27) (13) (14) (08) (09) (10) (08) (06) (04) (03) (03) (04) (28)
610 440 1226 610 183 178 145 130 117 78 66 53 49 527
(100) (92) (158) (100) (26) (26) (30) (25) (17) (10) (08) (08) (11) (99)
Professional identity Doctor of medicine Doctor of osteopathy
933,628 (49,194) 57,180 (12,491)
942 (13) 58 (13)
2952 (156) 181 (39)
505,522 (38,066) 281,430 (32,708) 203,856 (13,179)
510 (26) 284 (27) 206 (16)
1598 (120) 890 (103) 645 (42)
200,430 174,667 355,705 260,007
202 176 359 262
3608 2610 2992 3470
Specialty type4 Primary care Medical specialty Surgical specialty Geographic region Northeast Midwest South West
(17,743) (14,124) (30,239) (31,521)
(17) (14) (24) (26)
(319) (211) (254) (421)
Metropolitan status7 MSA Non-MSA
921,047 (48,815) 69,761 (13,263)
930 (13) 70 (13)
3331 (177) 1755 (334)
Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau Population estimates by metropolitan statistical area defnitions status are based on estimates of the civilian noninstitutional population of the United States as of July 1, 2015, from the 2015 National Health Interview Survey, National Center for Health Statistics, compiled according to November 2009 Office of Management and Budget defnitions of core-based statistical areas See https://wwwcensusgov/programs-surveys/metro-microhtml for more about metropolitan statistical defnitions 3 For geographic and metropolitan statistical area, population denominators are different for each category and thus do not add to total population rate For other variables,the denominator is the total population 4 Physician specialty and specialty type are defned in the 2015 National Ambulatory Medical Care Survey public use fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/ Dataset_Documentation/NAMCS/doc2015pdf 5 Number of visits (numerator) and population estimate (denominator) consist of children under 18 years of age 6 Number of visits (numerator) and population estimate (denominator) consist of females 15 years and over 7 MSA is metropolitan statistical area 1 2
NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 2. Office visits by selected states: United States, 2015 Selected states
Number of visits in thousands (standard error in thousands)
Number of visits per 100 persons per year1 (standard error of rate)
All visits
990,808 (49,038)
3133 (155)
19,902 (2,585) 161,353 (30,549) 56,104 (8,580) 19,527 (4,330) 29,704 (4,198) 24,596 (4,700) 17,551 (3,863) 21,874 (2,075) 47,479 (13,081) 72,661 (9,740) 20,732 (3,915) 30,720 (4,406) 38,520 (6,001) 93,724 (22,578) 30,413 (5,704) 19,578 (2,279)
2962 4178 2813 1951 2344 3772 2613 2230 5364 3716 2110 2685 3058 3475 3722 2774
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
(385) (791) (430) (433) (331) (721) (575) (211) (1478) (498) (398) (385) (476) (837) (698) (323)
Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau
1
NOTE: Numbers do not add to national total because estimates are only available for 16 states SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 3. Office visits, by selected physician practice characteristics: United States, 2015
Physician practice characteristics
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Percent distribution (standard error of percent) 1000
Employment status Full-owner Part-owner Employee Contractor Blank1
382,800 266,604 324,526 *12,993 *3,885
(39,442) (26,744) (31,169) (3,898) (2,944)
386 269 328 *13 *04
(31) (25) (28) (04) (03)
792,842 64,351 46,258 17,010 29,384 *8,372 32,592
(49,198) (12,881) (11,672) (4,645) (6,015) (2,949) (9,127)
800 65 47 17 30 *08 33
(21) (13) (12) (05) (06) (03) (09)
368,295 86,863 248,415 178,044 107,749 *1,442
(38,670) (13,924) (24,309) (22,645) (22,768) (730)
372 88 251 180 109 *01
(31) (14) (23) (22) (22) (01)
Ownership Physician or group Other health care corporation Other hospital HMO2 Medical or academic health center Other3 Blank1 Practice size Solo 2 3–5 6–10 11 or more Blank1 Type of practice Single-specialty group Multispecialty group Solo Blank1
354,447 (24,147) 267,939 (34,449) 368,295 (38,670) *
358 (26) 270 (30) 372 (31) *
922,208 (49,591) 24,904 (6,625) 43,697 (7,763)
931 (11) 25 (07) 44 (08)
750,882 (49,468) 114,191 (14,473) 124,382 (17,518) *1,355 (726)
758 115 126 *01
902,293 (49,350) 73,429 (12,426) *15,087 (7,146)
911 (14) 74 (13) *15 (07)
Office type Private practice Freestanding clinic or urgicenter Other4 Electronic medical records Yes—all electronic Yes—part paper and part electronic No Blank1
(23) (15) (18) (01)
Practice submits claims electronically Yes No Blank1
Category not applicable *Figure does not meet standards of reliability or precision 1 Blank may include missing, unknown, and/or “refused to answer the question” data 2 HMO is health maintenance organization 3 “Other” includes owners such as local government (state, county or city) and charitable organizations 4 “Other” includes the following office types: HMO, nonfederal government clinic, mental health center, family planning clinic, and faculty practice plan NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 4. Office visits, by patient age and sex: United States, 2015
Patient age and sex
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Percent distribution (standard error of percent) 1000
Number of visits per 100 persons per year1 (standard error of rate) 3133 (155)
Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
125,386 24,522 38,205 62,660 75,861 178,819 305,071 305,670 159,752 145,918
(11,829) (3,554) (4,271) (5,758) (7,688) (12,919) (20,537) (22,379) (10,511) (13,072)
127 (13) 25 (04) 39 (05) 63 (06) 77 (07) 180 (10) 308 (10) 309 (14) 161 (07) 147 (09)
2056 6167 2399 1526 1769 2163 3663 6578 5847 7623
(194) (894) (268) (140) (179) (156) (247) (482) (385) (683)
Female Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
585,795 58,858 49,976 127,017 179,058 88,254 82,633
(30,238) (6,082) (6,271) (10,926) (12,897) (6,162) (7,390)
591 (10) 59 (07) 50 (06) 128 (09) 181 (08) 89 (04) 83 (05)
3622 1972 2353 3027 4173 6067 7362
(187) (204) (295) (260) (301) (424) (658)
Male Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
405,013 66,529 25,886 51,802 126,014 71,499 63,284
(23,023) (6,461) (2,986) (4,217) (10,016) (5,358) (6,424)
409 (10) 67 (07) 26 (03) 52 (04) 127 (06) 72 (04) 64 (05)
2621 2137 1196 1273 3121 5595 7992
(149) (208) (138) (104) (248) (419) (811)
Sex and age
Category not applicable 1 Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 5. Number of office visits per 100 persons per year by patient age and sex, in selected states: United States, 2015 Patient age
Patient sex
Selected states
Under 18 years (standard error)
18-64 years (standard error)
65 years and over (standard error)
Female (standard error)
Male (standard error)
All visits
2035 (178)
2728 (167)
6578 (482)
3622 (187)
2621 (149)
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
*1990 *2342 *1127 *1230 *1766 *2736 *2001 1283 *3383 *2577 *1512 *2918 *1913 2558 *1851 1892
(759) (708) (654) (491) (736) (826) (1136) (337) (1430) (904) (717) (1121) (1045) (658) (555) (555)
2499 3185 2051 1776 1838 3295 *2125 2102 *5330 3387 1754 2196 2510 *3374 3297 2201
(353) (634) (352) (480) (329) (717) (675) (273) (1785) (650) (457) (361) (437) (1141) (784) (327)
6051 12220 6948 4225 5586 7588 5546 4094 8543 6811 4498 4283 6560 *6110 8614 6662
(1396) (3533) (1427) (1097) (1222) (1648) (1300) (536) (2134) (1043) (854) (721) (1257) (1872) (2075) (942)
3012 4511 3211 2253 2728 3963 3590 2436 5412 4616 2327 3237 3396 4421 4669 2840
(412) (814) (552) (510) (466) (703) (1062) (239) (1360) (853) (492) (471) (535) (1161) (999) (391)
2910 3836 2388 1625 1942 3574 1571 2014 *5314 2754 1875 2105 2702 2496 2717 2706
(428) (825) (431) (383) (323) (813) (275) (247) (1750) (383) (381) (362) (459) (561) (552) (323)
* Figure does not meet standards of reliability or precision NOTES: Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstritutionalized population of the United States as developed by the Population Division, USCensus Bureau Numbers may not add to totals because estimates are only available for 16 states SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 6. Office visits, by patient race and age, and ethnicity: United States, 2015
Patient characteristic All visits
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
Number of visits per 100 persons per year1 (standard error of rate)
990,808 (49,038)
100
White Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
769,517 94,485 57,933 139,940 234,250 125,867 117,043
(34,016) (8,944) (5,690) (9,707) (14,140) (7,166) (8,656)
777 95 58 141 236 127 118
(20) (10) (05) (08) (09) (06) (07)
3150 2138 1832 2246 3514 5476 7099
Black or African American Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over Other3
130,562 15,688 11,717 23,762 46,064 19,447 13,884 90,729
(13,454) (3,117) (2,329) (3,470) (6,481) (3,716) (2,616) (21,305)
132 16 12 24 46 20 14 92
(11) (03) (02) (03) (06) (03) (03) (19)
3164 (326) 1708 (339) 1783 (354) 2122 (310) 4558 (641) 7429 (1420) 8735 (1646) 2951 (693)
Hispanic or Latino Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
139,853 29,624 15,556 30,319 38,090 13,681 12,583
(14,011) (4,850) (3,558) (4,993) (6,534) (2,229) (3,455)
141 30 16 31 38 14 13
(12) (05) (03) (05) (06) (02) (03)
2500 (250) 1937 (317) 1662 (380) 1803 (297) 3546 (608) 6058 (987) 8607 (2364)
Not Hispanic or Latino White Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
850,956 640,625 68,674 42,803 110,903 199,466 114,158 104,621
(43,797) (29,476) (6,884) (4,034) (7,252) (11,976) (6,739) (7,067)
859 647 69 43 112 201 115 106
(12) (21) (07) (04) (06) (09) (06) (06)
3269 3285 2210 1826 2336 3500 5456 6913
Black or African American Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over Other3
126,527 14,779 11,667 23,332 43,744 19,226 13,779 83,804
(13,126) (3,023) (2,329) (3,450) (5,898) (3,713) (2,615) (21,075)
128 15 12 24 44 19 14 85
(11) (03) (02) (03) (05) (03) (03) (19)
3278 (340) 1767 (362) 1911 (382) 2242 (331) 4527 (610) 7600 (1468) 8962 (1701) 3137 (789)
Race and age
3133 (155)
2
(139) (202) (180) (156) (212) (312) (525)
Race, ethnicity, and age2
(168) (151) (222) (172) (153) (210) (322) (467)
Category not applicable 1 Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau 2 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data File documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 286% of visits, and ethnicity data were missing for 234% of visits 3 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 7. Expected sources of payment at office visits: United States, 2015 Expected source of payment
Number of visits in thousands1 (standard error in thousands)
Percent of visits (standard error of percent)
All visits
990,808 (49,038)
Private insurance Medicare Medicaid or CHIP or other state-based program2 Medicare and Medicaid3 No insurance4 Self-pay No charge or charity Workers’ compensation Other Unknown or blank
552,975 269,578 156,303 19,929 51,720 47,566 *4,175 6,721 16,717 58,801
(28,160) (21,510) (14,454) (3,053) (10,027) (9,516) (3,222) (1,422) (2,395) (14,368)
558 272 158 20 52 48 04 07 17 59
(17) (15) (14) (03) (09) (09) (03) (01) (02) (14)
Category not applicable 1 Combined total of expected sources of payment exceeds “all visits” and “percent of visits” exceeds 100% because more than one source of payment may be reported per visit 2 CHIP is Children’s Health Insurance Program 3 The visits in this category are also included in both the Medicare and Medicaid or CHIP or other state-based program categories 4 “No insurance” is defned as having only self-pay, no charge, or charity as payment sources The individual self-pay and no charge or charity categories are not mutually exclusive NOTE: Numbers may not add to totals because of rounding More than one category could be indicated SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 8. Primary care provider and referral status of office visits, by prior-visit status: United States, 2015 Prior-visit status, primary care provider, and referral status
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Visit to PCP Visit to non-PCP1,2 Referred for this visit Not referred for this visit Unknown if referred3 Unknown if PCP1 visit 2,3
422,327 550,151 164,024 322,490 63,638 18,330
1
Percent distribution (standard error of percent)
(37,718) (31,436) (13,237) (23,181) (6,712) (2,501)
1000 426 555 166 325 64 18
(26) (26) (12) (20) (07) (03)
Established patient All visits
829,576 (41,121)
837 (09)
Visit to PCP1 Visit to non-PCP1,2 Referred for this visit Not referred for this visit Unknown if referred 3 Unknown if PCP1 visit 2,3
387,543 428,378 91,541 291,416 45,422 13,655
467 516 110 351 55 16
(33,027) (25,550) (10,453) (20,861) (5,282) (1,985)
(26) (26) (12) (22) (06) (02)
New patient All visits
161,232 (12,224)
163 (09)
Visit to PCP Visit to non-PCP1,2 Referred for this visit Not referred for this visit Unknown if referred3 Unknown if PCP1 visit 2,3
34,785 121,773 72,483 31,074 18,216 4,674
216 755 450 193 113 29
1
(6,989) (9,839) (5,476) (6,898) (2,710) (1,008)
(36) (36) (33) (36) (16) (07)
Category not applicable 1 PCP is patients primary care provider as indicated by a positive response to the question “Are you the patient’s primary care physician/provider?” 2 Referral status was only asked for visits to non-PCPs and visits with unknown PCP status Among these visits, referral information was unknown for 132% of visits 3 The unknown category includes blanks NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 9. Primary care provider and referral status, according to physician specialty: United States, 2015 Visit to non-PCP1,2 Physician specialty
Total
Visit to PCP1
Referred by other physician
Not referred by other physician
Unknown if referred3
Unknown if PCP1 visit2,3
Percent distribution (Standard error of percent) All visits
1000
426 (26)
166 (12)
325 (20)
64 (07)
Pediatrics Internal medicine General and family practice Cardiovascular diseases Obstetrics and gynecology Psychiatry Otolaryngology Urology Neurology General surgery Ophthalmology Orthopedic surgery Dermatology All other specialties
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
894 (24) 866 (49) 909 (18) *184 (80) *134 (46) *63 (34) *19 (11) *13 (05) * *75 (41) *06 (04) * * *106 (40)
*25 (11) *50 (26) * 257 (49) 122 (26) *104 (32) 481 (51) 420 (47) 450 (69) 370 (46) 200 (37) 380 (46) 201 (37) 314 (49)
*47 (20) *43 (22) *46 (17) 417 (63) 662 (58) 715 (69) 368 (46) 466 (49) 462 (73) 428 (57) 686 (43) 423 (47) 551 (51) 495 (54)
*22 (10) *19 (16) 15 (04) *127 (56) 52 (15) *90 (33) 89 (21) *85 (32) *45 (16) *115 (35) 106 (30) 176 (49) 213 (43) 71 (15)
18 (03) *12 *23 *16 *15 *29 *29 *45 *16 *37 * * * *34 *13
(04) (08) (05) (06) (12) (20) (23) (09) (27) (19) (06)
Category not applicable * Figure does not meet standards of reliability or precision 1 PCP is patient’s primary care provider as indicated by a positive response to the question “Are you the patient’s primary care physician/provider?” 2 Referral status was asked only for visits to non-PCPs and visits with unknown PCP status Among these visits, referral information was unknown for 132% of visits 3 The unknown category includes blanks NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 10. Continuity-of-care office visit characteristics, by specialty type: United States, 2015 Specialty type 1 Continuity-of-care visit characteristic
All specialties
Primary care
Specialty type 1
Surgical specialties Medical specialties
All specialties
Surgical specialties Medical specialties
Percent distribution (standard error of percent)
Number of visits in thousands (standard error in thousands) All visits
Primary care
990,808 (49,038)
505,522 (38,066)
203,856 (13,179)
281,430 (32,708)
829,750 59,643 294,966 264,706 210,435 161,059
448,906 29,611 148,835 144,193 126,267 56,616
155,262 16,817 64,477 44,951 29,017 48,594
225,582 13,215 81,654 75,562 55,151 55,848
1000
1000
1000
1000
Prior-visit status and number of visits in last 12 months Established patient 2 None 1–2 visits 3–5 visits 6 or more visits New patient
(41,138) (3,758) (18,059) (17,551) (13,792) (12,223)
(32,534) (3,088) (15,603) (12,317) (11,792) (7,958)
(10,636) (1,601) (4,200) (3,553) (3,555) (4,070)
(26,677) (1,689) (9,230) (12,861) (7,233) (8,995)
837 60 298 267 212 163
(09) (04) (10) (09) (11) (09)
888 59 294 285 250 112
(11) (06) (17) (14) (19) (11)
762 82 316 221 142 238
Category not applicable 1 Specialty types are defned in the 2015 public use fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf 2 Number of previous visits by established patients to responding physician in the last 12 months NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
(14) (06) (11) (08) (13) (14)
802 (21) 47 (06) 290 (16) 268 (21) 196 (18) 198 (21)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 11. Twenty leading principal reasons for office visits, by patient’s sex: United States, 2015
Number of visits in thousands 1 (standard error in thousands)
Principal reason for visit and RVC code 1 All visits
990,808 (49,038)
Progress visit, not otherwise specifed General medical examination Medication, other and unspecifed kinds Counseling, not otherwise specifed Postoperative visit Cough Gynecological examination Prenatal examination, routine Knee symptoms Back symptoms Hypertension For other and unspecifed test results Stomach and abdominal pain, cramps and spasms Well baby examination Shoulder symptoms Diabetes mellitus Skin rash Preoperative visit for specifed and unspecifed types of surgery Symptoms referable to throat Other special examination
140,842 75,412 35,232 26,528 25,441 20,984 20,735 18,152 16,241 15,875 *15,762 15,159 15,026 13,217 *12,619 12,432 9,464 9,443 9,346 9,092
T800 X100 T115 T605 T205 S440 X225 X205 S925 S905 D510 R700 S545 X105 S940 D205 S860 T200 S455 X240
All other reasons
(12,765) (6,690) (7,003) (5,495) (2,679) (2,718) (4,607) (4,460) (2,629) (3,701) (4,820) (3,625) (2,796) (2,019) (4,604) (2,608) (1,373) (1,424) (2,021) (1,473)
473,807 (24,570)
Percent distribution (standard error of percent)
Female 2
Male 3
Percent distribution (standard error of percent)
Percent distribution (standard error of percent)
1000
1000
1000
142 76 36 27 26 21 21 18 16 16 16 15 15 13 *13 13 10 10 09 09
136 69 29 28 27 19 35 31 17 15 12 16 19 09 *11 11 07 09 10 09
151 86 45 25 24 24 16 17 *22 14 10 19 *16 15 13 11 08 09
(12) (06) (06) (05) (03) (03) (04) (05) (03) (04) (05) (03) (03) (02) (04) (03) (01) (01) (02) (02)
478 (12)
(12) (06) (05) (06) (03) (03) (07) (07) (03) (04) (02) (04) (04) (02) (04) (03) (01) (02) (02) (02)
480 (13)
Category not applicable *Figure does not meet standards of reliability or precision 1 Based on A Reason for Visit Classifcation for Ambulatory Care (RVC), defned in the 2015 public use fle documentation (ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf) 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
(14) (08) (09) (04) (03) (05) (03) (05) (11) (04) (02) (03) (05) (04) (03) (02) (02) (02)
475 (15)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 12. Provider-assessed major reason for office visit, by selected patient and visit characteristics: United States, 2015 Total number of visits in thousands (standard error in thousands)
Total percent
New problem
Chronic problem, routine
Chronic problem, fare-up
Pre-surgery
Post-surgery
Preventive care1
Unknown or blank
1000
309 (11)
333 (15)
70 (06)
15 (02)
46 (05)
204 (12)
23 (06)
(11,829) (3,554) (4,271) (5,758) (7,688) (12,919) (20,537) (22,379) (10,511) (13,072)
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
488 357 552 501 352 309 290 242 241 244
109 * 58 168 214 260 376 453 410 501
* * * * * 14 16 22 24 18
12 * 13 13 35 48 60 47 54 40
338 537 342 258 322 275 140 142 170 111
Female 585,795 (30,238) Male 405,013 (23,023)
1000 1000
Patient and visit characteristic
All visits 990,808 (49,038) Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
125,386 24,522 38,205 62,660 75,861 178,819 305,071 305,670 159,752 145,918
(21) (32) (25) (28) (29) (18) (17) (14) (14) (22)
(17) (14) (24) (32) (18) (19) (23) (23) (29)
28 (05) * *19 (07) 40 (07) 49 (11) 69 (08) 93 (11) 70 (08) 79 (11) 60 (08)
(03) (03) (04) (05) (05)
(02) (03) (03) (10) (06) (09) (05) (06) (05)
(20) (33) (24) (23) (43) (25) (14) (14) (19) (14)
*22 * *15 * *16 25 *24 *24 *21 *27
(08) (05) (06) (07) (09) (08) (07) (10)
312 (12) 304 (14)
301 (17) 379 (18)
74 (08) 64 (05)
14 (02) 17 (03)
44 (05) 48 (06)
231 (17) 166 (10)
23 (07) 23 (07)
1000 1000 1000
303 (11) 298 (23) 367 (25)
334 (15) 319 (29) 342 (56)
71 (05) 75 (18) 53 (15)
16 (02) 16 (05) *
51 (05) 32 (07) *17 (06)
200 (11) 229 (29) 200 (43)
24 (07) *30 (10) *
(14,011) (43,797) (29,476) (13,126) (21,075)
1000 1000 1000 1000 1000
356 301 295 294 356
177 358 364 326 362
58 44 50 32 *15
262 195 187 231 199
*62 17 16 *30 *
Private insurance 552,975 (28,160) Medicare 269,578 (21,510) Medicare and Medicaid5 19,929 (3,053) Medicaid or CHIP or other 6 state-based program 156,303 (14,454) No insurance7 51,720 (10,027) Other8 47,959 (4,740)
1000 1000 1000
323 (12) 243 (14) 257 (46)
311 (14) 456 (26) 408 (59)
75 (08) 73 (09) *91 (29)
17 (03) 22 (04) *
52 (06) 44 (05) 29 (07)
207 (11) 135 (17) 80 (21)
15 (03) *27 (10) *
1000 1000 1000
360 (26) 330 (45) 260 (24)
203 (22) 436 (49) 370 (35)
64 (11) 65 (15) 86 (16)
09 (02) * *
32 (06) *35 (11) 71 (10)
287 (37) 101 (24) 176 (28)
*46 (24) * *
Sex
Race2 White 769,517 (34,016) Black or African American 130,562 (13,454) Other3 90,729 (21,305) Race and ethnicity2 Hispanic or Latino Not Hispanic or Latino White Black or African American Other3
139,853 850,956 640,625 126,527 83,804
(31) (12) (12) (23) (26)
(20) (16) (16) (29) (56)
69 70 72 72 *54
(13) (06) (06) (16) (17)
*16 15 16 15 *
(05) (02) (02) (04)
(17) (04) (04) (07) (05)
(35) (11) (10) (29) (46)
(34) (03) (03) (10)
Expected source(s) of payment4
* Figure does not meet standards of reliability or precision … Category not applicable 1 Preventive care includes routine prenatal, well-baby, screening and insurance, or general exams (see major reason for visit question on the Patient Record Sample Card at https://wwwcdcgov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_Cardpdf) 2 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of modelbased single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 286% of visits, and ethnicity data were missing for 234% of visits 3 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race 4 Combined total of individual sources exceeds “all visits” and percent of visits exceeds 100% because more than one source of payment may be reported per visit 5 The visits in this category are also included in both the Medicaid or CHIP or other state-based program and Medicare categories 6 CHIP is Children’s Health Insurance Program 7 No insurance is defned as having only self-pay, no charge, or charity as payment sources 8 Other includes workers’ compensation, unknown or blank, and sources not classifed elsewhere NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 13. Preventive care visits made to primary care specialists, by selected patient and visit characteristics: United States, 2015
Patient and visit characteristics
Number of visits in thousands Percent distribution (standard error in thousands) (standard error of percent)
All preventive care visits3
202,266 (14,826)
1000
Number of visits per 100 persons per year1 (standard error of rate)
Percent of preventive care visits made to primary care specialists2 (standard error of percent)
640 (47)
829 (22)
Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
42,358 13,157 13,048 16,153 24,445 49,247 42,743 43,473 27,209 16,264
(4,965) (1,992) (1,712) (2,072) (4,791) (6,592) (5,205) (5,738) (3,867) (2,234)
209 65 65 80 121 243 211 215 135 80
(28) (11) (09) (11) (19) (23) (19) (25) (17) (10)
695 3309 819 393 570 596 513 936 996 850
(81) (501) (108) (50) (112) (80) (62) (123) (142) (117)
936 963 942 909 911 919 774 633 667 577
(29) (19) (35) (35) (33) (19) (40) (56) (56) (64)
Female Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
135,131 19,809 20,945 43,256 25,502 15,177 10,442
(12,483) (2,470) (4,734) (6,499) (3,094) (2,717) (1,854)
668 98 104 214 126 75 52
(23) (14) (19) (24) (12) (12) (08)
836 664 986 1031 594 1043 930
(77) (83) (223) (155) (72) (187) (165)
871 934 955 946 805 706 673
(20) (26) (16) (15) (38) (66) (70)
Male Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
67,134 22,549 3,499 5,991 17,241 12,032 5,822
(5,205) (2,907) (967) (914) (2,844) (1,748) (906)
332 111 17 30 85 59 29
(23) (16) (05) (05) (11) (08) (05)
434 724 162 147 427 942 735
(34) (93) (45) (22) (70) (137) (114)
746 938 651 722 727 618 404
(32) (33) (148) (61) (56) (67) (80)
Sex and age
Race4 White Black or African American Other5
154,164 (10,191) 29,961 (5,362) 18,141 (3,064)
762 (24) 148 (20) 90 (13)
631 (42) 726 (130) 590 (100)
804 (23) 901 (34) 929 (33)
36,649 165,616 119,800 29,173 16,644
181 819 592 144 82
655 636 614 756 623
926 808 769 899 927
Ethnicity4 Hispanic or Latino Not Hispanic or Latino White Black or African American Other5
(6,589) (11,924) (7,601) (5,363) (3,035)
(26) (26) (33) (20) (13)
(118) (46) (39) (139) (114)
(22) (25) (26) (35) (35)
Expected source(s) of payment6 Private insurance Medicare Medicaid or CHIP or other state-based program7 Medicare and Medicaid No insurance8 Other9
114,208 (8,039) 36,292 (6,103) 44,878 (8,157) 1,595 (411) 5,208 (1,033) 8,441 (1,649)
565 (31) 179 (27)
580 (41) 722 (121)
816 (25) 661 (66)
222 08 26 42
807 182
943 * 671 824
(35) (02) (05) (08)
(147) (36)
(20) (103) (58)
* Figure does not meet standards of reliability or precision Category not applicable 1 Visit rates for age, sex, and race and ethnicity are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau Visit rates for expected source(s) of payment are based on the 2015 National Health Interview Survey estimates of health insurance 2 Primary care specialty as defned in the 2015 public use fle documentation (ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf) 3 Preventive care includes routine prenatal, well-baby, screening, insurance or general exams (see “Major reason for this visit” question on the Patient Record Sample card, available at: https://wwwcdcgov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_Cardpdf) 4 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 317% of preventive care visits, and ethnicity data were missing for 248% of preventive care visits 5 Other includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race 6 Combined total of individual sources exceeds all visits and percent of visits exceeds 100% because more than one source of payment may be reported per visit 7 CHIP is Children’s Health Insurance Program 8 No insurance is defned as having only self-pay, no charge or charity as payment sources The visit rate was calculated using uninsured as the denominator from the 2015 estimates of health insurance coverage from the National Health Interview Survey 9 Other includes workers’ compensation, unknown or blank, and sources not classifed elsewhere NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 14. Preventive care visits made to primary care specialists, by selected states: United States, 2015
Selected states
Number of visits in thousands (standard error in thousands)
Number of visits per 100 persons per year1 (standard error of rate)
Percent of preventive care visits made to primary care specialists2 (standard error of percent)
All preventive care visits3
202,266 (14,826)
640 (47)
829 (22)
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
3,059 29,139 7,882 3,027 7,515 4,678 *3,264 3,351 *4,326 7,941 *3,406 6,407 *5,475 *21,884 4,212 2,205
(833) (6,703) (2,096) (821) (2,140) (1,186) (1,654) (672) (2,002) (1,916) (1,287) (1,405) (1,676) (8,851) (1,066) (400)
455 755 395 302 593 717 *486 342 *489 406 *347 560 *435 *811 515 312
(124) (174) (105) (82) (169) (182) (246) (69) (226) (98) (131) (123) (133) (328) (130) (57)
627 886 753 *477 855 835 805 919 525 749 717 877 791 976 882 922
(128) (54) (87) (215) (51) (64) (141) (52) (155) (112) (141) (46) (70) (12) (44) (27)
* Figure does not meet standards of reliability or precision 1 Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutionalized population of the United States as developed by the Population Division, US Census Bureau 2 Primary care specialty as defned in the 2015 public use fle documentation (ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf) 3 Preventive care includes routine prenatal, well-baby, screening, insurance or general exams (see Major reason for this visit question on the Patient Record Sample Card, available from http://wwwcdcgov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_cardpdf) NOTE: Numbers do not add to total because estimates are only available for 16 states SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 15. Primary diagnosis at office visits, classifed by major disease category: United States, 2015 Major disease category and ICD-9-CM code range1
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Infectious and parasitic diseases 001–139 Neoplasms 140–239 Endocrine, nutritional, metabolic diseases, and immunity disorders 240–279 Mental disorders 290–319 Diseases of the nervous system and sense organs 320–389 Diseases of the circulatory system 390–459 Diseases of the respiratory system 460–519 Diseases of the digestive system 520–579 Diseases of the genitourinary system 580–629 Diseases of the skin and subcutanaous tissue 680–709 Diseases of the musculoskeletal and connective tissue 710–739 Symptoms, signs, and ill-defned conditions 780–799 Injury and poisoning 800–999 Supplementary classifcation2 V01–V90 All other diagnoses3 Blank
16,794 37,075 69,845 59,776 89,562 88,343 64,624 32,271 45,388 44,576 108,700 73,149 31,659 198,910 26,802 3,333
(2,027) (6,205) (10,227) (8,211) (6,596) (10,475) (6,269) (5,976) (4,399) (4,672) (17,702) (6,519) (3,848) (13,104) (3,919) (738)
Percent distribution (standard error of percent) 1000 17 37 70 60 90 89 65 33 46 45 110 74 32 201 27 03
(02) (06) (09) (08) (07) (09) (05) (06) (04) (05) (15) (05) (04) (11) (04) (01)
Category not applicable 1 Based on the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) 2 Supplementary classifcation is preventive and follow-up care and includes general medical examination, routine prenatal examination, and health supervision of an infant or child, and other diagnoses not classifable to injury or illness 3 Includes diseases of the blood and blood-forming organs (280–289); complications of pregnancy, childbirth, and the puerperium (630–677); congenital anomalies (740–759); certain conditions originating in perinatal period (760–779); and entries not codable to the ICD–9–CM (eg “illegible entries, left against medical advice, transferred, entries of none, or no diagnoses) NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 16. Twenty leading primary diagnosis groups for office visits: United States, 2015
Primary diagnosis group and ICD-9-CM code(s)
1
All visits Arthropathies and related disorders Essential hypertension Spinal disorders Routine infant or child health check Diabetes mellitus General medical examination Acute upper respiratory infections, excluding pharyngitis Malignant neoplasms Specifc procedures and aftercare Rheumatism, excluding back Gynecological examination Heart disease, excluding ischemic
710–719 401 720–724 V200–V202 249–250 V70 460–461,463–466 140–208,209–20936,2097–20979,230–234 V50–V599 725–729 V723 391–3920,393–398,402,404,415–416, 420–429 Disorders of lipoid metabolism 272 Normal pregnancy V22 Benign neoplasms 210–229,2094–20969,235–239 Ischemic heart disease 410–4149 Attention defcit disorder 314 Anxiety states 300 Psychoses, excluding major depressive disorder 290–295,2960-2961,2964–299 Follow up examination V67 All other diagnoses4
Number of visits in thousands (standard error in Percent distribution Female2 percent distribution Male3 percent distribution thousands) (standard error of percent) (standard error of percent) (standard error of percent) 990,808 (49,038) 46,997 42,749 37,833 37,473 34,593 32,078 25,162 24,601 23,591 20,864 18,171 15,486
1000
1000
1000
(9,732) (5,982) (7,164) (4,371) (4,971) (5,029) (3,204) (5,887) (4,681) (5,302) (4,469) (2,488)
47 (09) 43 (05) 38 (06) 38 (05) 35 (05) 32 (04) 25 (03) 25 (06) 24 (05) 21 (05) 18 (04) 16 (03)
47 (11) 36 (05) 34 (06) 31 (04) 27 (04) 30 (05) 28 (04) 23 (06) 22 (04) 23 (06) 31 (07) 13 (03)
48 (08) 54 (09) 44 (09) 47 (06) 47 (07) 36 (06) 22 (04) 28 (06) 26 (06) 19 (04) 19 (04)
14,474 (2,973) 14,324 (2,945) 12,474 (1,628) 11,594 (2,599) 11,457 (2,436) 10,943 (1,814) 10,710 (1,954) 9,941 (1,740) 535,293 (25,194)
15 (03) 14 (03) 13 (02) 12 (03) 12 (02) 11 (02) 11 (02) 10 (02) 540 (14)
13 (03) 24 (05) 11 (02) 07 (02) 09 (02) 11 (02) 11 (02) 09 (02) 561 (15)
17 (04) 14 (02) 19 (05) 16 (04) 12 (02) 11 (02) 11 (03) 510 (17)
Category not applicable 1 Based on the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) However, certain codes have been combined in this table to form larger categories that better describe the utilization of ambulatory care services 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males 4 Includes all other diagnoses not listed above, as well as unknown and blank diagnoses NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 17. Injury visits to office-based physicians, by selected patient and visit characteristics: United States, 2015 Patient characteristics
Number of visits in thousands (standard error in thousands)
All injury visits2
82,358 (7,503)
Percent distribution (standard error of percent) 1000
Number of visits per 100 persons per year1 (standard error of rate) 260 (24)
Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
8,720 * 1,861 6,694 9,049 13,247 24,986 26,355 14,421 11,934
(1,738) (416) (1,639) (2,313) (1,601) (2,459) (2,640) (1,715) (1,449)
106 * 23 81 110 161 303 320 175 145
(17) (05) (16) (21) (16) (18) (25) (17) (16)
143 * 117 163 211 160 300 567 528 623
(28) (26) (40) (54) (19) (30) (57) (63) (76)
Female Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
42,267 4,446 *4,398 5,716 12,679 7,943 7,084
(4,598) (1,220) (1,434) (934) (1,490) (1,187) (1,179)
513 54 53 69 154 96 86
(18) (12) (15) (10) (13) (12) (13)
261 149 *207 136 295 546 631
(28) (41) (67) (22) (35) (82) (105)
Male Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
40,091 4,273 4,651 7,531 12,307 6,478 4,850
(3,396) (739) (1,102) (1,073) (1,274) (1,044) (684)
487 52 56 91 149 79 59
(18) (08) (10) (12) (11) (12) (08)
259 137 215 185 305 507 613
(22) (24) (51) (26) (32) (82) (86)
Sex and age
Race 3 White Black or African American Other 4
68,083 (6,456) 6,898 (954) *7,376 (2,932)
827 (32) 84 (12) *90 (33)
279 (26) 167 (23) *240 (95)
8,271 74,087 61,272 6,554 *6,261
100 900 744 80 *76
148 285 314 170 *234
Race and ethnicity3 Hispanic or Latino Not Hispanic or Latino White Black or African American Other 4
(1,370) (6,972) (5,899) (924) (2,843)
(15) (15) (31) (11) (32)
(24) (27) (30) (24) (106)
* Figure does not meet standards of reliability or precision Category not applicable 1 Visit rates for age, sex, race, and ethnicity are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau 2 The National Ambulatory Medical Care Survey defnition of injury visits, as shown in this table, changed in 2010 and includes only frst-, second-, third-, fourth-, and ffth-listed reason for visit and diagnosis codes that are injury or poisoning related Adverse effects and complications are excluded Reason for visit was coded using A Reason for Visit Classifcation for Ambulatory Care; diagnosis was coded using the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) Injury visits, using this defnition, accounted for 83% (SE = 07) of all office visits in 2015 For more information on why this defnition changed, see the 2015 National Ambulatory Medical Care Survey Public Use Data File Documentation, available at: http://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf 3 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data File documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 267% of injury visits, and ethnicity data were missing for 255% of injury visits 4 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 18. Office visits related to injury or trauma, overdose or poisoning, and adverse effects, by intent and mechanism: United States, 2015 Intent 1, mechanism 2, and cause-of-injury code 2 All visits related to injury, poisoning, and adverse effect 1 Unintentional injury or poisoning 1 Falls Exposure to radiation Natural and environmental factors Overexertion and strenuous movements Cutting or piercing instruments or objects Motor vehicle traffic Struck against or struck accidentally by objects or persons Poisoning Other mechanism 3
… … E8800–E8869,E888 E926 E900–E909,E9280–E9282 E927 E920 E810–E819
E916–E917 E850–E869 E800–E807(0–3,8–9),E820–E825, E826–E848,E890–E899,E910–E915, E918–E919,E921,E922,E923–E925, E9283–5,8,E9290–5,8 Mechanism unspecifed and blank E887,E9289,E9299 Intentional injury or poisoning 1 … Injury or poisoning—unknown intent 1 … Adverse effect of medical treatment, or surgical care or adverse effect of medicinal drug 1 … Medical or sugical complication E870–E879 Adverse drug effects E930–E949 Other and blank 4 …
Number of visits in thousands (standard error in thousands)
92,217 56,843 13,199 11,709 5,553 5,462 * 4,612
(7,842) (6,159) (2,126) (2,123) (1,439) (1,425) (916)
Percent distribution (standard error of percent)
1000 616 143 127 60 59 * 50
(32) (16) (23) (15) (13) (09)
3,557 (1,017) * 8,157 (1,227)
39 (09) * 88 (11)
3,243 (489) 1,477 (424) 23,180 (3,028)
35 (05) 16 (05) 251 (27)
10,717 (1,883) *4,075 (1,610) 2,416 (639) 4,226 (720)
116 *44 26 46
(20) (17) (07) (08)
Category not applicable * Figure does not meet standards of reliability or precision 1 The defnition of visits related to injury or trauma, overdose or poisoning, and adverse effect of medical or surgical treatment or adverse effect of medicinal drug used in this table is based on automated Patient Record form entries for patient’s reason for visit, diagnosis, and cause of injury Starting in 2014, up to fve reasons and diagnoses and up to three causes could be coded for each visit Categories shown refect the classifcations used Reason for visit was coded using “A Reason for Visit Classifcation for Ambulatory Care (RVC)” as defned in the 2015 public use fle documentation, available from ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf Diagnosis codes are based on the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) Visits related to injury or trauma, overdose or poisoning, and adverse effect of medical or surgical treatment or adverse effect of medicinal drug accounted for 93% (SE = 07) of all office visits in 2015 For more information, see the 2015 NAMCS Public Use Data File documentation 2 Mechanism of injury is based on the “Supplementary Classifcation of External Cause of Injury or Poisoning” in the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM), US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260 Data are based on frst-listed external cause of injury or poisoning Up to three external cause of injury or poisoning codes could be collected per visit 3 Includes injuries caused by drowning, frearms, fre and fames, pedal cycle (nontraffic), motor vehicle (nontraffic and other), suffocation, foreign bodies, other transportation, caught accidentally between objects, machinery, and other mechanism 4 Other includes visits that were classifed as adverse effects of medical or surgical care or adverse effect of medicinal drug based on the PRF in conjunction with frst-, second-, third-, fourth-, or ffthlisted reason for visit and diagnosis codes related to adverse effects but that could not be classifed as such based on frst-listed external cause of injury or poisoning NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 19. Presence of selected chronic conditions at office visits, by patient age and sex: United States, 2015 Chronic conditions1
Total
Under 45 years
45–64 years
65–74 years
75 years and over
Female
Male
Percent distribution (standard error of percent) All visits
1000
1000
1000
1000
1000
1000
1000
None One or more chronic conditions One Two Three or more Blank
373 610 246 146 218 17
(16) (17) (10) (08) (15) (03)
658 318 222 63 34 24
(22) (21) (16) (07) (04) (07)
246 738 301 190 248 16
(14) (15) (13) (11) (18) (03)
163 829 220 209 401 08
(13) (14) (15) (14) (23) (02)
125 864 223 204 437 11
(13) (14) (19) (18) (33) (03)
395 590 256 134 201 15
(17) (17) (11) (06) (14) (03)
341 639 232 164 243 20
(20) (20) (11) (14) (20) (05)
Hypertension Hyperlipidemia Arthritis Diabetes mellitus (DM) Diabetes mellitus (DM), Type 1 Diabetes mellitus (DM), Type 2 Diabetes mellitus (DM), Type unspecifed Depression Obesity Cancer Coronary artery disease (CAD), ischemic heart disease (IHD), or history of myocardial infarction (MI) Asthma Chronic kidney disease (CKD) Chronic Obstructive pulmonary disease (COPD) Obstructive sleep apnea (OSA) Osteoporosis Substance abuse or dependence Cerebrovascular disease, history of stroke (CVA), or transient ischemic attack (TIA) Congestive heart failure (CHF) Alzheimer’s disease and dementia Alcohol misuse, abuse or dependence History of pulmonary embolism (PE), deep vein thrombosis (DVT), or venous thromboembolism (VTE) Autism spectrum disorder HIV infection and AIDS End-stage renal disease (ESRD)
299 202 160 152 06 84 62 104 79 65 64
(16) (15) (15) (09) (01) (08) (06) (07) (06) (07) (06)
62 34 41 33 02 16 16 91 66 11 02
(07) (07) (05) (06) (00) (03) (04) (09) (08) (03) (01)
347 256 189 199 12 103 84 140 105 60 51
(17) (21) (20) (15) (03) (11) (10) (12) (10) (09) (09)
516 367 256 268 08 165 95 87 96 135 131
(25) (22) (23) (15) (02) (15) (10) (10) (11) (16) (13)
575 348 301 238 *06 132 101 80 37 139 176
(29) (29) (32) (15) (02) (16) (14) (14) (06) (17) (19)
270 175 169 136 05 77 54 119 84 59 42
(15) (13) (16) (10) (01) (07) (06) (08) (08) (08) (05)
341 241 146 176 08 94 73 83 71 74 95
(21) (20) (15) (12) (02) (11) (09) (08) (07) (08) (09)
62 45 32 26 25 23
(04) (12) (03) (03) (02) (03)
66 * 05 11 * 19
(06) * (01) (02) * (03)
69 36 28 37 18 37
(06) (08) (05) (04) (03) (06)
59 82 68 43 59 14
(08) (24) (10) (07) (09) (03)
40 *135 74 24 64 *12
(06) (41) (10) (04) (09) (05)
67 *38 30 20 37 18
(05) (12) (04) (03) (04) (03)
54 54 36 34 07 30
(05) (13) (05) (04) (02) (04)
18 16 09 06
(02) (03) (02) (01)
* * * * * * 06 (01)
10 (02) 12 (03) * * 08 (02)
31 36 11 06
(05) (08) (03) (02)
60 (10) 46 (07) 44 (10) * *
18 17 10 04
(03) (04) (02) (01)
17 16 09 10
(02) (02) (02) (02)
06 02 *02 *02
(01) (01) (01) (01)
* * 05 (01) * * * *
*08 (03) * * * * * *
*10 (04) * * * * * *
11 (03) * * * * * *
05 (01) * * * * * *
08 *04 *03 *02
(02) (01) (01) (01)
Category not applicable * Figure does not meet standards of reliability or precision 1 Presence of chronic conditions was based on the checklist of chronic conditions and reported diagnoses Combined total visits by patients with chronic condtions and percent of visits exceeds 100% because more than one chronic condition may be reported per visit NOTE: Numbers may not add to totals because more than one chronic condition may be reported per visit SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 20. Presence of selected chronic conditions at office visits, by selected states: United States, 2015 Selected states
Hypertension
Hyperlipidemia
Arthritis
Diabetes1
Depression
Obesity
Asthma
Cancer
COPD2
Osteoporosis
Percent of visits (standard error of percent) All visits
300 (21)
213 (18)
171 (20)
158 (11)
96 (08)
81 (08)
64 (05)
67 (09)
35 (04)
26 (03)
273 (45) 340 (73) 425 (64) 277 (40) 334 (52) 322 (42) 166 (41) 305 (35) 274 (53) 255 (36) 246 (46) 299 (53) 329 (42) 237 (37) 249 (63) 309 (41)
152 (32) 237 (53) 370 (67) *135 (42) 182 (42) 249 (41) *96 (44) 221 (33) 229 (66) 257 (59) 173 (43) 175 (38) 212 (45) *118 (36) *157 (48) 235 (36)
127 (27) 200 (55) 195 (30) 173 (29) 158 (31) 141 (24) 128 (34) 162 (25) 143 (39) 174 (44) 87 (23) *101 (34) 149 (37) *219 (91) *99 (31) 181 (31)
152 (26) 204 (36) 161 (27) 132 (21) 152 (34) 181 (32) 67 (18) 130 (17) 132 (32) 163 (24) 112 (29) 118 (29) 148 (26) 150 (26) 140 (42) 129 (21)
106 (21) 72 (19) 66 (16) *166 (51) 97 (24) 152 (20) 178 (52) 161 (42) *135 (61) *53 (16) 82 (17) 152 (38) *98 (35) 87 (14) *65 (20) 171 (29)
*56 (18) 79 (18) 103 (29) 49 (09) *71 (26) 103 (26) * 77 (15) 101 (25) 80 (19) 78 (17) *96 (39) 77 (18) *78 (38) 63 (19) 103 (25)
63 (14) 49 (11) 79 (21) 84 (18) 50 (10) 67 (18) *75 (27) 71 (09) 74 (17) 62 (10) 64 (18) 68 (11) 66 (13) 66 (14) *75 (30) 68 (11)
56 (15) *54 (28) 133 (31) 66 (17) 54 (12) *95 (48) 53 (15) 44 (08) * 73 (15) *66 (21) 63 (12) 75 (16) *49 (17) *144 (93) 52 (11)
* * 83 (22) * * 57 (15) * 44 (08) * * * * 31 (07) *22 (07) *87 (31) 37 (11)
* * *47 (17) * * 25 (07) * *23 (07) * *32 (13) * * * * * 28 (07)
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
* Figure does not meet standards of reliability or precision 1 Diabetes includes both Type I diabetes mellitus (insulin dependent or IDDM), Type II diabetes mellitus (non-insulin dependent or NIDDM), and diabetes with type unspecifed Excludes diabetes insipidus and gestational diabetes 2 COPD is chronic obstructive pulmonary disease NOTES: Presence of chronic conditions was based on the checklist of chronic conditions and reported diagnoses Combined total visits by patients with chronic condtions and percent of visits exceeds 100% because more than one chronic condition may be reported per visit Numbers may not add to totals because more than one chronic condition may be reported per visit SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 21. Selected services ordered or provided at office visits, by patient sex: United States, 2015
Services
Number of visits in thousands 1 (standard error in thousands)
Both sexes
Male3
Female2
Percent distribution (standard error of percent) All visits One or more services ordered or provided 4 None
990,808 (49,038) 967,598 (48,591) 23,211 (4,619)
1000 (00) 977 (05) 23 (05)
1000 (00) 979 (05) 21 (05)
1000 (00) 973 (05) 27 (05)
Examinations and screenings Skin Retinal or eye Neurologic Pelvic Foot Depression screening Breast Alcohol misuse screening (includes AUDIT, MAST, CAGE, T-ACE) Rectal Substance abuse screening (includes NIDA/NM ASSIST, CAGE-AID, DAST-10) Domestic violence screening
184,944 149,662 145,770 52,258 50,962 43,525 37,671
(17,327) (16,076) (22,465) (7,747) (10,601) (7,964) (5,411)
187 151 147 53 51 44 38
(16) (15) (20) (08) (10) (08) (05)
177 145 138 89 51 47 60
(16) (14) (17) (12) (10) (07) (08)
200 160 160 * 52 40 *06
(19) (19) (29) (11) (10) (03)
*17,694 (7,665) 17,274 (3,529)
*18 (08) 17 (04)
*18 (08) 18 (04)
*18 (07) 17 (04)
10,782 (2,816) *5,436 (2,481)
11 (03) *05 (02)
12 (03) *06 (03)
*09 (03) *
Vital signs Weight Height Blood pressure Temperature
753,804 698,091 677,507 383,829
(45,727) (46,892) (47,416) (39,819)
761 705 684 387
(17) (20) (20) (29)
773 710 709 376
(17) (21) (20) (31)
743 696 647 403
(20) (22) (24) (31)
130,395 101,742 99,152 97,237 69,212 56,184 41,147 36,263 28,643 28,450 23,402 *21,410 15,859 *13,150 *12,093 *11,701 *9,981 9,764 8,498 *7,964
(18,298) (16,199) (13,957) (17,445) (12,547) (8,312) (6,860) (8,687) (7,493) (5,312) (5,455) (7,278) (2,572) (9,358) (3,976) (4,762) (4,369) (2,718) (2,252) (2,833)
132 103 100 98 70 57 42 37 29 29 24 *22 16 *13 *12 *12 *10 10 09 *08
(15) (14) (13) (15) (11) (07) (07) (09) (07) (05) (05) (07) (02) (09) (04) (05) (04) (03) (02) (03)
142 105 114 100 74 67 45 45 *31 49 26 *26 * *18 *14 *15 *12 14 15 *11
(20) (18) (18) (18) (16) (10) (10) (13) (10) (08) (05) (11) (11) (05) (05) (05) (04) (04) (05)
117 100 80 95 64 41 37 25 26 * 20 *15 39 * 10 *07 * * * *
(12) (11) (10) (13) (09) (05) (06) (06) (07) (05) (05) (06) (03) (04)
24,632 (6,779) *5,698 (2,000) 4,475 (1,302) 5,211 (884)
25 *06 05 05
(07) (02) (01) (01)
*31 *05 05 07
(10) (02) (02) (01)
*16 *07 *03 02
(05) (03) (02) (00)
41 19 18 12 11 *10 *08 08 *07 *07 06 06 *04 *03 01 *
(07) (05) (04) (01) (02) (03) (05) (01) (03) (03) (02) (02) (02) (01) (00)
35 19 *20 10 09 *10 *12 05 *10 *11 04 *06 *05 *04 *01 *
(06) (05) (06) (01) (02) (04) (08) (01) (05) (05) (01) (02) (03) (01) (00)
51 20 14 16 13 *10 *02 11 * * *10 05 *03 * 01 *
(09) (06) (03) (02) (03) (04) (01) (02) (03) (02) (01) (00)
Laboratory tests Complete blood count (CBC) Lipids or cholesterol Urinalysis (UA) Comprehensive metabolic panel (CMP) Glycohemoglobin (HgbA1C) TSH or thyroid panel Basic metabolic panel (BMP) Glucose Creatinine or renal function panel Pap test Vitamin D test Liver enzymes or hepatic function panel Prostate specifc antigen (PSA) HPV DNA test 5 Rapid strep test Hepatitis testing HIV test6 Chlamydia test Pregnancy or HCG test Gonorrhea test Culture Urine Throat Blood Other Procedures Electrocardiogram (EKG or ECG) Biopsy Colonoscopy Excision of tissue Audiometry Spirometry Sigmoidoscopy Cryosurgery (cryotherapy) Upper gastrointestinal endoscopy or EGD Fetal monitoring Cardiac stress test Tonometry Electromyogram (EMG) Tuberculosis skin testing or PPD Electroencephalogram (EEG) Peak fow See footnotes at end of table.
40,886 19,035 17,531 12,347 10,737 *10,000 *7,576 7,438 *6,977 *6,458 6,260 5,677 *4,221 *3,105 1,246 *
(7,408) (5,260) (4,381) (1,327) (2,188) (3,544) (4,829) (1,321) (2,934) (2,802) (1,740) (1,586) (1,892) (1,187) (299)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 21. Selected services ordered or provided at office visits, by patient sex: United States, 2015—Con.
Services
Number of visits in thousands 1 (standard error in thousands)
Both sexes
Male3
Female2
Percent distribution (standard error of percent) Imaging Any imaging X ray Ultrasound, excluding echocardiogram Mammography Magnetic resonance imaging (MRI) Computed tomography (CT) scan Echocardiogram Bone mineral density Other imaging
164,853 58,537 49,104 22,587 21,309 17,428 11,604 7,724 *4,443
(16,460) (6,531) (10,501) (4,080) (3,007) (3,054) (2,706) (2,040) (1,497)
166 59 50 23 22 18 12 08 *04
(12) (06) (09) (04) (03) (03) (03) (02) (01)
190 56 63 38 22 18 12 12 *03
(14) (06) (11) (06) (03) (04) (03) (03) (01)
132 63 31 * 21 17 12 * *06
(12) (07) (08) (03) (03) (03) (03)
21,330 14,949 14,325 11,347 *10,818 7,622 6,833 *2,507 *914 *
(3,224) (3,476) (1,814) (2,619) (3,494) (1,416) (1,844) (1,288) (299)
22 15 14 11 *11 08 07 *03 *01 *
(03) (04) (02) (03) (03) (01) (02) (01) (00)
24 15 13 11 *12 07 04 *02 * *
(04) (04) (02) (03) (04) (01) (01) (01)
18 16 17 13 *10 09 *11 * * *
(03) (04) (03) (03) (04) (02) (04)
146,889 101,678 47,237 28,068 27,280 25,735 19,481 8,297 *6,571 5,910 5,413 5,036 *4,032 *2,336 *2,239
(16,427) (15,386) (8,054) (5,844) (3,575) (7,098) (3,729) (1,765) (2,537) (1,486) (1,072) (1,361) (2,025) (1,335) (740)
148 103 48 28 28 26 20 08 *07 06 05 05 *04 *02 *02
(15) (13) (08) (06) (03) (07) (04) (02) (02) (01) (01) (01) (02) (01) (01)
153 102 42 28 26 22 19 12 *05 05 06 06 *03 *04 *
(17) (14) (08) (08) (04) (06) (04) (03) (02) (01) (01) (02) (01) (02)
142 104 55 29 30 31 21 * *08 *08 *05 *04 *06 * *
(15) (14) (10) (06) (04) (08) (04) (03) (03) (01) (01) (03)
Treatment Physical therapy Other mental health counseling Wound care Psychotherapy Home health care Cast, splint, or wrap Durable medical equipment Complementary and alternative medicine (CAM) Occupation therapy Radiation therapy Health education and counseling Diet or nutrition Exercise Injury prevention Growth or evelopment Weight reduction Tobacco use or exposure Diabetes education Family planning or contraception Substance abuse counseling Asthma Stress management STD Prevention Alcohol abuse counseling Genetic counseling Asthma action plan given to patient
Category not applicable 00 Quantity more than zero but less than 005 * Figure does not meet standards of reliability or precision -- Quantity zero 1 Combined total of all listed services exceeds “all visits” and percent of visits exceeds 100% because more than one service may be reported per visit 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males 4 Includes up to nine write-in procedures from the Services item on the Patient Record Form Procedures are coded to the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Volume 3, Procedure Classifcation Records with write-in procedures that overlap checkboxes (for example, procedure 9311, “Physical therapy exercises: Assisting exercise,” which could also be coded in the checkbox for physical therapy) are edited to ensure that the check box is marked; in this way the check box always provides a summary estimate, but should not be added to the corresponding ICD–9–CM procedure to avoid double counting Procedures that could not be included in one of the checkboxes are included in the estimated total number of visits with services, but are not shown separately 5 HPV is human papilloma virus; DNA is deoxyribonucleic acid 6 HIV is human immunodefciency virus SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 22. Initial blood pressure measurements recorded at office visits to primary care providers for adults aged 18 and over, by selected patient characteristics: United States, 2015 Initial blood pressure 1 Patient characteristic
Number of visits in thousands
Total
Not high
Mildly high
Moderately high
Severely high
Percent distribution (standard error of percent) All visits 2
371,911
1000
299 (17)
461 (16)
28,869 103,263 130,766 57,546 51,467
1000 1000 1000 1000 1000
549 436 194 229 229
323 436 503 477 463
245,420 126,491
1000 1000
356 (23) 188 (15)
273,033 69,867 29,011
1000 1000 1000
61,851 310,060 215,747 67,603 26,710
1000 1000 1000 1000 1000
185 (13)
56 (09)
Age 18–24 years 25–44 years 45–64 years 65–74 years 75 years and over
(40) (29) (16) (22) (20)
(37) (24) (24) (37) (39)
*104 103 229 240 220
(36) (17) (23) (22) (22)
* *26 (08) 74 (13) *53 (22) *89 (34)
458 (18) 466 (27)
138 (12) 275 (25)
48 (12) 71 (09)
317 (17) 202 (26) 363 (51)
464 (17) 466 (27) 418 (41)
172 (16) 253 (31) 147 (32)
48 (09) 79 (15) *
372 284 297 206 376
376 478 489 461 429
185 185 172 252 *
* 53 (08) 41 (07) 81 (15) *
Sex Female Male Race 3 White Black or African American Other 4 Ethnicity 3 Hispanic or Latino Not Hispanic or Latino White Black or African American Other 4
(51) (14) (15) (25) (47)
(49) (15) (17) (28) (49)
(43) (13) (15) (32)
Category not applicable * Figure does not meet standards of reliability or precision 1 Blood pressure (BP) levels were categorized using the following hierarchical defnitions: Severely high BP is defned as 160 mm Hg systolic or above, or 100 mm Hg diastolic or above Moderately high BP is defned as 140–159 mm Hg systolic or 90–99 mm Hg diastolic Mildly high BP is defned as 120–139 mm Hg systolic or 80–89 mm Hg diastolic Not high BP is defned as any BP less than 120 mm Hg systolic and less than 80 mm Hg diastolic High BP classifcation was based on the “Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC–7)” Mildly high BP corresponds to the (JNC–7) prehypertensive range Moderately high BP corresponds to the (JNC–7) stage 1 hypertensive range Severely high BP corresponds to the JNC–7 stage 2 hypertensive range 2 Visits where blood pressure was taken represent 943% (SE = 12) of all office visits made to primary care specialists by adults (aged 18 and over) 3 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of modelbased single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data File documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 276% of adult visits made to primary care specialists, and ethnicity data were missing for 165% of adult visits made to primary care specialists 4 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 23. Medication therapy and number of medications mentioned at office visits, by patient sex: United States, 2015 Medication therapy 1
Number of visits in thousands 1 (standard error in thousands)
Both sexes
Female2
Male3
Percent distribution (standard error of percent) All visits
990,808 (49,038)
Visits with mention of medication Visits without mention of medication
755,286 (43,578) 235,523 (14,437)
4
1000 762 (13) 238 (13)
1000 765 (15) 235 (15)
1000 759 (15) 241 (15)
Number of medications provided or prescribed All visits
990,808 (49,038)
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 or more
235,523 176,873 124,529 94,793 65,726 52,756 43,980 37,156 30,389 25,144 19,611 16,780 14,696 11,102 7,915 33,837
(14,437) (11,490) (10,390) (8,203) (5,153) (4,437) (4,463) (3,794) (2,990) (3,137) (2,578) (1,860) (3,237) (1,927) (1,287) (4,349)
1000 238 (13) 179 (09) 126 (07) 96 (05) 66 (04) 53 (04) 44 (04) 38 (03) 31 (03) 25 (03) 20 (02) 17 (02) 15 (03) 11 (02) 08 (01) 34 (04)
1000 235 (15) 187 (10) 127 (09) 91 (06) 61 (06) 54 (05) 44 (04) 41 (05) 32 (04) 26 (03) 20 (03) 17 (02) 12 (02) 12 (02) 08 (02) 33 (04)
1000 241 (15) 166 (11) 123 (07) 102 (08) 74 (06) 52 (04) 46 (05) 32 (04) 29 (03) 24 (03) 19 (03) 17 (02) 19 (06) 10 (02) 08 (02) 36 (05)
Category not applicable 1 Includes prescription drugs, over-the-counter preparations, immunizations, and desensitizing agents 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males 4 A drug mention is documentation in a patient’s record of a drug provided, prescribed, or continued at a visit (up to 30 per visit) Also defned as drug visits NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 24. Office drug visits and drug mentions, by physician specialty: United States, 2015 Drug visits 1
Drug mentions 2
Number in thousands Percent distribution Number in thousands Percent distribution (standard error in thousands) (standard error of percent) (standard error in thousands) (standard error of percent)
Physician speciality All specialties
755,286 (43,578)
General and family practice Internal medicine Pediatrics Obstetrics and gynecology Ophthalmology Psychiatry Orthopedic surgery Cardiovascular diseases Dermatology Otolaryngology Urology Neurology General surgery All other specialties
163,903 116,773 66,633 54,640 39,651 38,929 35,754 35,055 27,102 15,621 15,273 12,463 9,727 123,763
(28,434) (25,385) (8,816) (10,614) (5,201) (8,329) (5,859) (7,038) (4,334) (2,459) (2,066) (2,872) (1,877) (25,480)
1000 217 155 88 72 52 52 47 46 36 21 20 17 13 164
(33) (30) (13) (14) (07) (11) (08) (09) (06) (03) (03) (04) (03) (30)
3,657,642 (266,769) 869,427 733,527 167,576 168,049 176,307 113,183 139,084 258,006 104,961 71,267 76,974 67,903 52,129 659,249
(141,910) (190,288) (25,277) (36,698) (27,765) (24,041) (23,459) (59,119) (19,225) (14,393) (11,528) (19,495) (11,901) (134,813)
1000 238 201 46 46 48 31 38 71 29 19 21 19 14 180
(35) (44) (08) (10) (08) (07) (07) (16) (06) (04) (04) (05) (03) (33)
Percent of office visits with drug mentions 3 (standard error of percent)
Drug mention rates 4 (standard error of rate)
762 (13)
3692 (174)
850 840 702 674 684 849 634 850 730 630 737 797 579 743
4510 5276 1767 2074 3043 2468 2465 6259 2828 2874 3712 4343 3102 3958
(25) (44) (23) (49) (47) (41) (43) (54) (29) (37) (30) (52) (54) (38)
Category not applicable 1 Visits at which one or more drugs were provided or prescribed 2 A drug mention is documentation in a patient’s record of a drug provided, prescribed, or continued at a visit (up to 30 per visit) Also defned as drug visits 3 Percent of visits that included one or more drugs provided or prescribed (number of visits divided by number of office visits multiplied by 100) 4 Average number of drugs that were provided or prescribed per 100 visits (total number of drug mentions divided by total number of visits multiplied by 100) NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
(383) (629) (139) (246) (418) (252) (293) (699) (254) (352) (324) (765) (456) (548)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 25. Twenty most frequently mentioned drugs by therapeutic drug category at office visits: United States 2015
Therapeutic drug category
1
Analgesics 3 Antihyperlipidemic agents Antidepressants Vitamins Antidiabetic agents Dermatological agents Anxiolytics, sedatives, and hypnotics Antiplatelet agents Anticonvulsants Proton pump inhibitors Beta-adrenergic blocking agents Vitamin and mineral combinations Bronchodilators Immunostimulants Diuretics Angiotensin converting enzyme inhibitors Antihistamines Calcium channel blocking agents Ophthalmic preparations Minerals and electrolytes 1 2 3
Number of occurrences in thousands (standard error in thousands)
Percent of drug mentions 2 (standard error of percent)
402,939 173,523 166,198 150,302 142,685 139,609 127,757 124,670 122,286 115,079 106,098 99,127 97,887 97,297 92,510
(35,239) (14,480) (14,134) (13,587) (15,118) (12,218) (10,529) (13,177) (12,559) (13,579) (9,255) (10,605) (9,001) (14,985) (9,332)
110 47 45 41 39 38 35 34 33 31 29 27 27 27 25
(04) (02) (03) (02) (02) (03) (02) (02) (02) (03) (01) (02) (02) (04) (01)
83,966 75,194 73,840 73,150 71,653
(7,735) (6,194) (7,713) (7,867) (8,256)
23 21 20 20 20
(01) (01) (01) (02) (01)
Based on Multum Lexicon second level therapeutic drug category (see https://wwwcernercom/solutions/drug-database) Based on an estimated 3,657,642,000 drug mentions Includes narcotic and nonnarcotic analgesics and nonsteroidal anti-infammatory drugs
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 26. Twenty most frequently mentioned drug names at office visits, by new or continued status: United States, 2015 New
Drug name
Number of mentions in thousands Percent distribution (standard error in thousands) (standard error of percent)
1
All drug mentions
3,657,642 (266,769)
Aspirin Multivitamin Omeprazole
103,951 (10,194) 77,015 (8,404) 62,408 (6,919)
Lisinopril Albuterol Levothyroxine Atorvastatin Amlodipine Metoprolol Metformin Acetaminophen-hydrocodone Simvastatin Omega-3 polyunsaturated fatty acids Ibuprofen Hydrochlorothiazide Losartan Gabapentin Furosemide Acetaminophen Ergocalciferol Other
60,917 (6,014) 59,480 (6,041) 58,081 (6,143) 53,372 (4,709) 50,894 (4,958) 50,373 (4,544) 46,660 (4,508) 46,033 (8,990) 43,262 (4,347) 40,252 (4,667) 40,154 (4,063) 36,645 (4,529) 36,605 (4,497) 35,461 (4,421) 35,382 (4,217) 34,986 (4,367) 34,948 (3,424) 2,650,765 (193,899)
1000 28 (01) 21 (02) 17 (01) 17 16 16 15 14 14 13 13 12 11 11 10 10 10 10 10 10 725
(01) (01) (01) (01) (01) (01) (01) (02) (01) (01) (01) (01) (01) (01) (01) (01) (01) (06)
Total
Continued
Unknown2
Percent distribution (standard error of percent)
1000
200 (15)
791 (16)
09 (02)
1000 1000 1000
41 (08) 48 (09) 108 (20)
952 (10) 945 (09) 889 (20)
*07 (03) *07 (03) *03 (01)
925 824 948 927 903 934 931 789 941 951 744 849 875 865 915 750 873 752
*07 *09 *06 *09 *06 *11 *06 *05 *03 *05 *01 *05 *02 *31 *05 *08 *05 *10
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
68 166 46 65 91 55 63 206 56 *44 254 *146 *123 105 80 242 122 239
(15) (33) (11) (18) (25) (12) (15) (57) (15) (16) (28) (51) (39) (27) (19) (39) (21) (18)
(16) (33) (11) (18) (25) (13) (15) (58) (16) (16) (28) (51) (38) (28) (19) (39) (21) (18)
(03) (04) (02) (04) (02) (04) (03) (03) (02) (02) (01) (03) (01) (19) (02) (03) (02) (02)
Therapeutic drug category 3 Analgesics, Antiplatelet agents Vitamin and mineral combinations Proton pump inhibitors Angiotensin converting enzyme inhibitors Bronchodilators Thyroid hormones Antihyperlipidemic agents Calcium channel blocking agents Beta-adrenergic blocking agents Antidiabetic agents Analgesics Antihyperlipidemic agents Nutraceutical products Analgesics Diuretics Angiotensin II inhibitors Anticonvulsants Diuretics Analgesics Vitamins Other
Category not applicable * Figure does not meet standards of reliability or precision 1 Based on Multum Lexicon terminology, drug name refects the active ingredient(s) of a drug provided, prescribed, or continued 2 Unknown includes drugs provided or prescribed that did not have either the new drug or continued drug checkboxes marked 3 Based on Multum Lexicon second-level therapeutic drug category (see https://wwwcernercom/solutions/drug-database) SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 27. Providers seen at office visits: United States, 2015 Type of provider
Number of visits in thousands 1 (standard error in thousands)
Percent of visits (standard error of percent)
All visits
990,808 (49,038)
Physician RN2 or LPN3 Physician assistant Nurse practitioner or midwife Mental health provider Other provider Blank
980,750 175,988 74,786 *30,845 *4,234 340,604 2,169
(48,769) (27,226) (19,105) (10,413) (1,425) (36,922) (586)
990 178 75 *31 *04 344 02
(02) (25) (18) (10) (01) (29) (01)
Category not applicable * Figure does not meet standards of reliability or precision 1 Combined total of individual providers exceeds “all visits” and “percent of visits” exceeds 100%, because more than one provider may be reported per visit The sample of visits was drawn from all scheduled visits to a sampled physician during the 1-week reporting period However, at 1% of these visits, the physician was not seen; instead, the patient saw another provider 2 RN is registered nurse 3 LPN is licensed practical nurse NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 28. Disposition of office visits: United States, 2015 Disposition
Number of visits in thousands 1 (standard error in thousands)
All visits
990,808 (49,038)
Return to referring physician Refer to other physician Return in less than 1 week Return in 1 week to less than 2 months Return in 2 months or greater Return at unspecifed time Return as needed (prn) Refer to emergency room/ Admit to hospital Other disposition Blank
29,287 81,808 35,022 305,110 270,959 55,298 226,859
Percent of visits (standard error of percent)
(4,597) (10,749) (4,282) (19,999) (17,023) (6,573) (26,647)
30 (05) 83 (09) 35 (04) 308 (16) 273 (14) 56 (06) 229 (22)
6,798 (1,403) 86,435 (12,309) 16,027 (3,000)
07 (01) 87 (12) 16 (03)
Category not applicable 1 Combined total of individual dispositions exceeds “all visits,” and “percent of visits” exceeds 100% because more than one disposition may be reported per visit SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 29. Time spent with physician: United States, 2015 Time spent with physician
Number of visits in thousands (standard error in thousands)
All visits
990,808
Visits at which no physician was seen Visits at which a physician was seen
10,058 (1,663) 980,750 (48,769)
Total 1
980,750
1–5 minutes 6–10 minutes 11–15 minutes 16–30 minutes 31–60 minutes 61 minutes and over
9,452 85,784 326,626 411,324 138,070 9,494
(2,339) (13,024) (27,844) (24,603) (11,430) (2,193)
Percent distribution (standard error of percent) 1000 10 (02) 990 (02) 1000 10 87 333 419 141 10
(02) (13) (21) (16) (10) (02)
Category not applicable 1 Time spent with physician was reported only for visits where a physician was seen Time spent with physician was missing for 304% of visits where a physician was seen Estimates presented include imputed values for missing data NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 30. Time spent with physician, by physician specialty: United States, 2015
Physician specialty
Mean time in minutes spent with physician (standard error of mean) 1
25th percentile
Median
75th percentile
All visits
228 (04)
144
192
292
Psychiatry Neurology Ophthalmology General surgery Cardiovascular diseases Internal medicine Urology Orthopedic surgery Pediatrics Otolaryngology General and family practice Obstetrics and gynecology Dermatology All other specialities
343 289 288 228 226 222 221 217 217 211 203 201 179 240
199 150 145 144 145 145 143 143 144 143 141 142 115 145
297 250 201 190 191 191 164 158 191 164 158 150 147 197
448 392 342 292 291 292 292 290 279 246 247 238 197 292
(17) (26) (29) (12) (12) (14) (09) (14) (11) (07) (08) (08) (08) (14)
1 Only visits where a physician was seen are included Time spent with physician was missing for 304% of visits where physician was seen Estimates presented include imputed values for missing data
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 31. Physician characteristics, by response status: United States, 2015
Physician characteristic1 All office-based physicians
Total in-scope Number of sample percent sampled in-scope distribution3 (weighted) physicians2
Responding Nonresponding physician percent physician percent distribution4 distribution5 (weighted) (weighted)
Physician response rate (weighted)6
Participants 7
Particpation rate (weighted) 8
4,910
1000
1000
1000
0296
1,737
0365
1,896 3,014
393 607
402 598
389 611
0303 0291
654 1,083
0353 0373
3,591 1,319
676 324
677 323
676 324
0296 0295
1,259 478
0362 0371
4,550 360
918 82
927 73
914 86
0299 0263
1,617 120
0368 0328
4,707 203
947 53
951 49
946 54
0297 0277
1,671 66
0364 0388
358 275 274 263 383 396 342 406 396 278 302 418 411 408
184 131 89 30 72 47 39 22 20 58 20 38 19 232
189 96 130 32 69 40 44 22 18 47 16 37 19 240
182 146 72 30 73 50 37 22 20 62 22 38 19 228
0303 0217 0432 0314 0284 0251 0338 0291 0277 0240 0239 0294 0288 0307
147 90 128 97 141 129 107 146 139 90 86 159 135 143
0403 0309 0504 0360 0359 0313 0360 0349 0376 0358 0284 0377 0338 0337
1,248 2,032 1,630
465 207 328
470 200 329
463 209 327
0299 0287 0297
491 715 531
0389 0340 0347
1,018 219 2,935 109 168 461
214 47 576 20 33 110
224 40 567 18 36 115
210 50 581 20 31 108
0310 0254 0291 0272 0326 0309
371 80 1,030 33 64 159
0425 0343 0346 0325 0397 0354
1,228 1,228 1,227 1,227
225 230 322 223
351 221 187 241
171 234 379 215
0463 0284 0172 0320
559 376 298 504
0528 0353 0209 0440
Age Under 50 years 50 years and over Sex Male Female Metropolitan status 9 MSA Non-MSA Type of doctor Doctor of medicine Doctor of osteopathy Physician specialty 10,11 General or family practice Internal medicine Pediatrics General surgery Obstetrics and gynecology Orthopedic surgery Cardiovascular diseases Dermatology Urology Psychiatry Neurology Ophthalmology Otolaryngology All other specialties Specialty type11 Primary care Surgical Medical Practice type Solo Two physicians Group or HMO12 Medical school or government Other Unclassifed Annual visit volume10 0–25 percentile 26–50 percentile 51–75 percentile 76–100 percentile
Characteristic information is from a combination of sources: the master fles of the American Medical Association, the American Osteopathic Association, and the NAMCS physician induction form In-scope physicians are those who verifed that they were nonfederal and involved in direct patient care in an office-based practice, excluding the specialties of radiology, pathology, and anesthesiology 3 Total in-scope sample physicians are those who were selected from (a) the master fles of the American Medical Association, and (b) the American Osteopathic Association In-scope determination was also used for inclusion in NAMCS 4 Responding physicians are those who were in-scope and participated fully in completion of PRFs or were unavailable to complete PRFs 5 Nonresponding physicians are those who were in-scope and participated minimally or refused to participate in the NAMCS 6 Values represent a response rate among physicians selected from the core office-based sample Numerator is the number of in-scope physicians from the physician sample who participated fully in NAMCS or who did not see any patients during their sampled reporting week Denominator is all in-scope physicians selected from the physician sample 7 Participants are physicians for whom at least one Patient Record form was completed (full and minimal responders) and also include physicians who saw no patients during their sample week 8 Participation rate is the number of participants divided by the number of in-scope physicians 9 MSA is metropolitan statistical area 10 Chi-square test of association is statistically signifcant (p<005) between physician response and indicated physician characteristic 11 Physician specialty type defned in the 2015 National Ambulatory Medical Care Survey Public Use Data File Documentation (see ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/ NAMCS/doc2015pdf) 12 HMO is health maintenance organization 1 2
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 32. State location of physician office, by response status: United States, 2015 Total in-scope sample Percent percent Percent distribution distribution distribution of of non(weighted) respondents 4 respondents 5
Region and state 1
Number of sampled in-scope physicians 2,3
Total
4,910
553
164
389
0296
1,737
0365
178 258 286 239 262
23 40 78 39 30
16 20 59 42 28
26 48 86 37 30
0204 0150 0225 0326 0278
52 59 90 79 97
0278 0234 0347 0382 0362
224 305 244 231 289
37 24 30 34 84
31 21 57 24 86
39 26 19 38 83
0248 0258 0558 0206 0305
67 107 129 70 96
0295 0297 0577 0264 0330
206 178 161 279 239 272
54 19 18 81 28 127
44 28 09 64 24 169
58 15 22 89 29 110
0243 0441 0152 0232 0261 0393
93 98 61 72 85 130
0436 0580 0324 0252 0352 0515
251 288 232 288
19 148 24 65
20 152 27 79
19 146 23 59
0302 0304 0329 0360
79 82 82 109
0359 0319 0330 0418
Response rate 6 (weighted)
Participants 7
Participation rate 8 (weighted)
Northeast Massachusetts New Jersey New York Pennsylvania Remainder states (CT, ME, NH, RI, VT) Midwest Illinois Indiana Michigan Ohio Remainder States (IA, KS, NE, ND, SD, MN, MO, WI) South Florida Georgia North Carolina Texas Virginia Remainder states (AR,AL,DE,DC,KY,MD,MS,LA,OK,SC,TN,WV) West Arizona California Washington Remainder states (CO, ID, MT, NV, NM, OR, UT, WY, AK, HI). . . . .
Chi-square test of association is statistically signifcant (p<005) between physician response and state location of office where most visits were seen In-scope sample physicians are those confrmed during the survey to be nonfederal and involved in direct patient care in an office-based practice, excluding the specialities of radiology, pathology, and anesthesiology 3 Total in-scope sample physicians are those who were selected from (a) the master fles of the American Medical Association, and (b) the American Osteopathic Association In-scope determination was also used for inclusion in NAMCS 4 Responding physicians are those who were in-scope and participated fully in completion of PRFs or who saw no patients during their sample week 5 Non-responding physicians are those physicians who were in-scope and participated minimally or refused to participate in the NAMCS 6 Values represent a response rate among physicians selected from the office-based sample Numerator is the number of in-scope physicians from the physician sample who participated fully in NAMCS or who did not see any patients during their sampled reporting week Denominator is all in-scope physicians selected from the physician sample 7 Participants are physicians for whom at least one Patient Record form was completed (full and minimal responders) and also include physicians who saw no patients during their sample week 8 Participation rate is the number of participants divided by the number of in-scope physicians 1 2
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables The Ambulatory and Hospital Care Statistics Branch is pleased to release the most current nationally representative data on ambulatory care visits to physician offices in the United States. Statistics are presented on physician practices as well as patient and visit characteristics using data collected in the 2015 National Ambulatory Medical Care Survey (NAMCS). NAMCS is an annual nationally representative sample survey of visits to nonfederal office-based patient care physicians, excluding anesthesiologists, radiologists, and pathologists. Visit estimates for the following 16 states that were targeted for separate estimation are included in the summary tables: Arizona, California, Florida, Georgia, Illinois, Indiana, Massachusetts, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, Virginia, and Washington. The remaining 34 states and DC were grouped into four region remainders (North, South, East, and West) or groups of states that comprise Census regions excluding the 16 states for which state estimates were calculated. Four tables presenting state estimates are included, in addition to the tables presenting national estimates. The sampling frame for the 2015 NAMCS was composed of physicians listed in the master files maintained by the American Medical Association and the American Osteopathic Association. The 2015 NAMCS utilized a two-stage probability design that involved probability samples of physicians within targeted states and Census regions, and patient visits within practices. Although an additional sample of physicians and non-physician practitioners from community health center (CHC) delivery sites was also selected, CHC estimates are not included in the summary tables and will be presented in a separate report. The 2015 NAMCS sample included 8,091 physicians. A total of 3,181 physicians did not meet all of the criteria and were ruled out of scope (ineligible) for the study. Of the 4,910 in- scope (eligible) physicians, 1,410 completed Patient Record Forms (PRFs) in the study. PRFs were not completed by 327 physicians because they saw no patients during their sample week due to vacation, illness, or other reasons for being temporarily not in practice. Of the 1,410 physicians who completed PRFs, 1,088 participated fully or adequately (i.e. at least half of the PRFs expected, based on the total number of visits during the reporting week, were submitted), and 322 participated minimally (i.e. fewer than half of the expected number of PRFs were submitted). Within physician practices, data are abstracted from medical records for up to 30 sampled visits during a randomly assigned 1-week reporting period. In all, 28,332 PRFs were submitted. The participation rate—the percentage of in-scope physicians for whom at least one PRF was completed—was 36.5% percent. The response rate—the percentage of in-scope physicians for whom at least one-half of their expected number of PRFs was completed—was 29.6%. Among the 16 targeted states, response rates ranged from 14.3% to 55.6%. The 2015 NAMCS was conducted from December 22, 2014, through December 20, 2015. The U.S. Bureau of the Census was the data collection agent for the 2015 NAMCS. NAMCS was collected electronically, using a computerized instrument developed by the U.S. Census Bureau. For 2015, abstraction by Census field representatives using laptop computers to access the automated PRF instrument was the preferred mode of data collection. The PRF may be viewed at: https://www.cdc.gov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_Card.pdf. Data processing and medical coding were performed by SRA International, Inc., Durham, North Carolina. As part of the quality assurance procedure, a 10% quality control sample of NAMCS survey records were independently recoded and compared. Differences were adjudicated by a quality control supervisor with error rates reported to NCHS. Coding error rates for the 10% sample ranged between 0.5 and 1.4%. For further details, see the 2015 NAMCS
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Page 2
Public Use Data File Documentation at: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_ Documentation/NAMCS/doc2015.pdf. Web table estimates consist of visits to physicians at office-based practices. Visit estimates are based on sample data weighted to produce annual national estimates and include standard errors. Because of the complex multistage design of NAMCS, a sample weight is computed for each sample visit that takes all stages of design into account. The survey data are inflated or weighted to produce national annual estimates. The visit weight includes four basic components: inflation by reciprocals of selection probabilities, adjustment for nonresponse, population ratio adjustments, and weight smoothing. Estimates of the sampling variability were calculated using Taylor approximations in SUDAAN, which take into account the complex sample design of NAMCS. Detailed information on the design, conduct, and estimation procedures of the 2015 NAMCS are discussed in the NAMCS Public Use Data File Documentation. As in any survey, results are subject to sampling and nonsampling errors. Nonsampling errors include reporting and processing errors as well as biases due to nonresponse and incomplete response. In 2015, race data were missing for 28.6% of visits, and ethnicity data were missing for 23.4% of visits. Starting with 2009 data, NAMCS adopted the technique of model-based single imputation for NAMCS race and ethnicity data. Race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2015 NAMCS Public Use Data File Documentation (see above for link). Information on missing data for other variables is provided in table footnotes. In the following tables, estimates are not presented and replaced with an asterisk (*) if they are based on fewer than 30 cases in the sample data. Estimates based on 30 or more cases include an asterisk if the relative standard error (RSE) of the estimate exceeds 30 percent. Suggested citation: Rui P, Okeyode T. National Ambulatory Medical Care Survey: 2015 State and National Summary Tables. Available from: http://www.cdc.gov/nchs/ahcd/ahcd_ products.htm.
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 1. Physician office visits, by selected physician characteristics: United States, 2015
Physician characteristic
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Physician specialty
Percent distribution (standard error of percent) 1000
Number of visits per 100 persons per year1,2,3 (standard error of rate) 3133 (155)
4
General and family practice Internal medicine Pediatrics5 Obstetrics and gynecology6 Ophthalmology Orthopedic surgery Psychiatry Cardiovascular diseases Dermatology Otolaryngology Urology General surgery Neurology All other specialties
192,789 139,028 94,861 81,045 57,938 56,427 45,863 41,223 37,110 24,798 20,735 16,806 15,635 166,552
(31,485) (29,149) (12,045) (13,273) (8,095) (8,367) (9,509) (8,033) (5,515) (3,320) (2,677) (2,556) (3,521) (31,285)
195 140 96 82 58 57 46 42 37 25 21 17 16 168
(28) (27) (13) (14) (08) (09) (10) (08) (06) (04) (03) (03) (04) (28)
610 440 1226 610 183 178 145 130 117 78 66 53 49 527
(100) (92) (158) (100) (26) (26) (30) (25) (17) (10) (08) (08) (11) (99)
Professional identity Doctor of medicine Doctor of osteopathy
933,628 (49,194) 57,180 (12,491)
942 (13) 58 (13)
2952 (156) 181 (39)
505,522 (38,066) 281,430 (32,708) 203,856 (13,179)
510 (26) 284 (27) 206 (16)
1598 (120) 890 (103) 645 (42)
200,430 174,667 355,705 260,007
202 176 359 262
3608 2610 2992 3470
Specialty type4 Primary care Medical specialty Surgical specialty Geographic region Northeast Midwest South West
(17,743) (14,124) (30,239) (31,521)
(17) (14) (24) (26)
(319) (211) (254) (421)
Metropolitan status7 MSA Non-MSA
921,047 (48,815) 69,761 (13,263)
930 (13) 70 (13)
3331 (177) 1755 (334)
Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau Population estimates by metropolitan statistical area defnitions status are based on estimates of the civilian noninstitutional population of the United States as of July 1, 2015, from the 2015 National Health Interview Survey, National Center for Health Statistics, compiled according to November 2009 Office of Management and Budget defnitions of core-based statistical areas See https://wwwcensusgov/programs-surveys/metro-microhtml for more about metropolitan statistical defnitions 3 For geographic and metropolitan statistical area, population denominators are different for each category and thus do not add to total population rate For other variables,the denominator is the total population 4 Physician specialty and specialty type are defned in the 2015 National Ambulatory Medical Care Survey public use fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/ Dataset_Documentation/NAMCS/doc2015pdf 5 Number of visits (numerator) and population estimate (denominator) consist of children under 18 years of age 6 Number of visits (numerator) and population estimate (denominator) consist of females 15 years and over 7 MSA is metropolitan statistical area 1 2
NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 2. Office visits by selected states: United States, 2015 Selected states
Number of visits in thousands (standard error in thousands)
Number of visits per 100 persons per year1 (standard error of rate)
All visits
990,808 (49,038)
3133 (155)
19,902 (2,585) 161,353 (30,549) 56,104 (8,580) 19,527 (4,330) 29,704 (4,198) 24,596 (4,700) 17,551 (3,863) 21,874 (2,075) 47,479 (13,081) 72,661 (9,740) 20,732 (3,915) 30,720 (4,406) 38,520 (6,001) 93,724 (22,578) 30,413 (5,704) 19,578 (2,279)
2962 4178 2813 1951 2344 3772 2613 2230 5364 3716 2110 2685 3058 3475 3722 2774
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
(385) (791) (430) (433) (331) (721) (575) (211) (1478) (498) (398) (385) (476) (837) (698) (323)
Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau
1
NOTE: Numbers do not add to national total because estimates are only available for 16 states SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 3. Office visits, by selected physician practice characteristics: United States, 2015
Physician practice characteristics
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Percent distribution (standard error of percent) 1000
Employment status Full-owner Part-owner Employee Contractor Blank1
382,800 266,604 324,526 *12,993 *3,885
(39,442) (26,744) (31,169) (3,898) (2,944)
386 269 328 *13 *04
(31) (25) (28) (04) (03)
792,842 64,351 46,258 17,010 29,384 *8,372 32,592
(49,198) (12,881) (11,672) (4,645) (6,015) (2,949) (9,127)
800 65 47 17 30 *08 33
(21) (13) (12) (05) (06) (03) (09)
368,295 86,863 248,415 178,044 107,749 *1,442
(38,670) (13,924) (24,309) (22,645) (22,768) (730)
372 88 251 180 109 *01
(31) (14) (23) (22) (22) (01)
Ownership Physician or group Other health care corporation Other hospital HMO2 Medical or academic health center Other3 Blank1 Practice size Solo 2 3–5 6–10 11 or more Blank1 Type of practice Single-specialty group Multispecialty group Solo Blank1
354,447 (24,147) 267,939 (34,449) 368,295 (38,670) *
358 (26) 270 (30) 372 (31) *
922,208 (49,591) 24,904 (6,625) 43,697 (7,763)
931 (11) 25 (07) 44 (08)
750,882 (49,468) 114,191 (14,473) 124,382 (17,518) *1,355 (726)
758 115 126 *01
902,293 (49,350) 73,429 (12,426) *15,087 (7,146)
911 (14) 74 (13) *15 (07)
Office type Private practice Freestanding clinic or urgicenter Other4 Electronic medical records Yes—all electronic Yes—part paper and part electronic No Blank1
(23) (15) (18) (01)
Practice submits claims electronically Yes No Blank1
Category not applicable *Figure does not meet standards of reliability or precision 1 Blank may include missing, unknown, and/or “refused to answer the question” data 2 HMO is health maintenance organization 3 “Other” includes owners such as local government (state, county or city) and charitable organizations 4 “Other” includes the following office types: HMO, nonfederal government clinic, mental health center, family planning clinic, and faculty practice plan NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 4. Office visits, by patient age and sex: United States, 2015
Patient age and sex
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Percent distribution (standard error of percent) 1000
Number of visits per 100 persons per year1 (standard error of rate) 3133 (155)
Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
125,386 24,522 38,205 62,660 75,861 178,819 305,071 305,670 159,752 145,918
(11,829) (3,554) (4,271) (5,758) (7,688) (12,919) (20,537) (22,379) (10,511) (13,072)
127 (13) 25 (04) 39 (05) 63 (06) 77 (07) 180 (10) 308 (10) 309 (14) 161 (07) 147 (09)
2056 6167 2399 1526 1769 2163 3663 6578 5847 7623
(194) (894) (268) (140) (179) (156) (247) (482) (385) (683)
Female Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
585,795 58,858 49,976 127,017 179,058 88,254 82,633
(30,238) (6,082) (6,271) (10,926) (12,897) (6,162) (7,390)
591 (10) 59 (07) 50 (06) 128 (09) 181 (08) 89 (04) 83 (05)
3622 1972 2353 3027 4173 6067 7362
(187) (204) (295) (260) (301) (424) (658)
Male Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
405,013 66,529 25,886 51,802 126,014 71,499 63,284
(23,023) (6,461) (2,986) (4,217) (10,016) (5,358) (6,424)
409 (10) 67 (07) 26 (03) 52 (04) 127 (06) 72 (04) 64 (05)
2621 2137 1196 1273 3121 5595 7992
(149) (208) (138) (104) (248) (419) (811)
Sex and age
Category not applicable 1 Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 5. Number of office visits per 100 persons per year by patient age and sex, in selected states: United States, 2015 Patient age
Patient sex
Selected states
Under 18 years (standard error)
18-64 years (standard error)
65 years and over (standard error)
Female (standard error)
Male (standard error)
All visits
2035 (178)
2728 (167)
6578 (482)
3622 (187)
2621 (149)
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
*1990 *2342 *1127 *1230 *1766 *2736 *2001 1283 *3383 *2577 *1512 *2918 *1913 2558 *1851 1892
(759) (708) (654) (491) (736) (826) (1136) (337) (1430) (904) (717) (1121) (1045) (658) (555) (555)
2499 3185 2051 1776 1838 3295 *2125 2102 *5330 3387 1754 2196 2510 *3374 3297 2201
(353) (634) (352) (480) (329) (717) (675) (273) (1785) (650) (457) (361) (437) (1141) (784) (327)
6051 12220 6948 4225 5586 7588 5546 4094 8543 6811 4498 4283 6560 *6110 8614 6662
(1396) (3533) (1427) (1097) (1222) (1648) (1300) (536) (2134) (1043) (854) (721) (1257) (1872) (2075) (942)
3012 4511 3211 2253 2728 3963 3590 2436 5412 4616 2327 3237 3396 4421 4669 2840
(412) (814) (552) (510) (466) (703) (1062) (239) (1360) (853) (492) (471) (535) (1161) (999) (391)
2910 3836 2388 1625 1942 3574 1571 2014 *5314 2754 1875 2105 2702 2496 2717 2706
(428) (825) (431) (383) (323) (813) (275) (247) (1750) (383) (381) (362) (459) (561) (552) (323)
* Figure does not meet standards of reliability or precision NOTES: Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstritutionalized population of the United States as developed by the Population Division, USCensus Bureau Numbers may not add to totals because estimates are only available for 16 states SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 6. Office visits, by patient race and age, and ethnicity: United States, 2015
Patient characteristic All visits
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
Number of visits per 100 persons per year1 (standard error of rate)
990,808 (49,038)
100
White Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
769,517 94,485 57,933 139,940 234,250 125,867 117,043
(34,016) (8,944) (5,690) (9,707) (14,140) (7,166) (8,656)
777 95 58 141 236 127 118
(20) (10) (05) (08) (09) (06) (07)
3150 2138 1832 2246 3514 5476 7099
Black or African American Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over Other3
130,562 15,688 11,717 23,762 46,064 19,447 13,884 90,729
(13,454) (3,117) (2,329) (3,470) (6,481) (3,716) (2,616) (21,305)
132 16 12 24 46 20 14 92
(11) (03) (02) (03) (06) (03) (03) (19)
3164 (326) 1708 (339) 1783 (354) 2122 (310) 4558 (641) 7429 (1420) 8735 (1646) 2951 (693)
Hispanic or Latino Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
139,853 29,624 15,556 30,319 38,090 13,681 12,583
(14,011) (4,850) (3,558) (4,993) (6,534) (2,229) (3,455)
141 30 16 31 38 14 13
(12) (05) (03) (05) (06) (02) (03)
2500 (250) 1937 (317) 1662 (380) 1803 (297) 3546 (608) 6058 (987) 8607 (2364)
Not Hispanic or Latino White Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
850,956 640,625 68,674 42,803 110,903 199,466 114,158 104,621
(43,797) (29,476) (6,884) (4,034) (7,252) (11,976) (6,739) (7,067)
859 647 69 43 112 201 115 106
(12) (21) (07) (04) (06) (09) (06) (06)
3269 3285 2210 1826 2336 3500 5456 6913
Black or African American Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over Other3
126,527 14,779 11,667 23,332 43,744 19,226 13,779 83,804
(13,126) (3,023) (2,329) (3,450) (5,898) (3,713) (2,615) (21,075)
128 15 12 24 44 19 14 85
(11) (03) (02) (03) (05) (03) (03) (19)
3278 (340) 1767 (362) 1911 (382) 2242 (331) 4527 (610) 7600 (1468) 8962 (1701) 3137 (789)
Race and age
3133 (155)
2
(139) (202) (180) (156) (212) (312) (525)
Race, ethnicity, and age2
(168) (151) (222) (172) (153) (210) (322) (467)
Category not applicable 1 Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau 2 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data File documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 286% of visits, and ethnicity data were missing for 234% of visits 3 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 7. Expected sources of payment at office visits: United States, 2015 Expected source of payment
Number of visits in thousands1 (standard error in thousands)
Percent of visits (standard error of percent)
All visits
990,808 (49,038)
Private insurance Medicare Medicaid or CHIP or other state-based program2 Medicare and Medicaid3 No insurance4 Self-pay No charge or charity Workers’ compensation Other Unknown or blank
552,975 269,578 156,303 19,929 51,720 47,566 *4,175 6,721 16,717 58,801
(28,160) (21,510) (14,454) (3,053) (10,027) (9,516) (3,222) (1,422) (2,395) (14,368)
558 272 158 20 52 48 04 07 17 59
(17) (15) (14) (03) (09) (09) (03) (01) (02) (14)
Category not applicable 1 Combined total of expected sources of payment exceeds “all visits” and “percent of visits” exceeds 100% because more than one source of payment may be reported per visit 2 CHIP is Children’s Health Insurance Program 3 The visits in this category are also included in both the Medicare and Medicaid or CHIP or other state-based program categories 4 “No insurance” is defned as having only self-pay, no charge, or charity as payment sources The individual self-pay and no charge or charity categories are not mutually exclusive NOTE: Numbers may not add to totals because of rounding More than one category could be indicated SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 8. Primary care provider and referral status of office visits, by prior-visit status: United States, 2015 Prior-visit status, primary care provider, and referral status
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Visit to PCP Visit to non-PCP1,2 Referred for this visit Not referred for this visit Unknown if referred3 Unknown if PCP1 visit 2,3
422,327 550,151 164,024 322,490 63,638 18,330
1
Percent distribution (standard error of percent)
(37,718) (31,436) (13,237) (23,181) (6,712) (2,501)
1000 426 555 166 325 64 18
(26) (26) (12) (20) (07) (03)
Established patient All visits
829,576 (41,121)
837 (09)
Visit to PCP1 Visit to non-PCP1,2 Referred for this visit Not referred for this visit Unknown if referred 3 Unknown if PCP1 visit 2,3
387,543 428,378 91,541 291,416 45,422 13,655
467 516 110 351 55 16
(33,027) (25,550) (10,453) (20,861) (5,282) (1,985)
(26) (26) (12) (22) (06) (02)
New patient All visits
161,232 (12,224)
163 (09)
Visit to PCP Visit to non-PCP1,2 Referred for this visit Not referred for this visit Unknown if referred3 Unknown if PCP1 visit 2,3
34,785 121,773 72,483 31,074 18,216 4,674
216 755 450 193 113 29
1
(6,989) (9,839) (5,476) (6,898) (2,710) (1,008)
(36) (36) (33) (36) (16) (07)
Category not applicable 1 PCP is patients primary care provider as indicated by a positive response to the question “Are you the patient’s primary care physician/provider?” 2 Referral status was only asked for visits to non-PCPs and visits with unknown PCP status Among these visits, referral information was unknown for 132% of visits 3 The unknown category includes blanks NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 9. Primary care provider and referral status, according to physician specialty: United States, 2015 Visit to non-PCP1,2 Physician specialty
Total
Visit to PCP1
Referred by other physician
Not referred by other physician
Unknown if referred3
Unknown if PCP1 visit2,3
Percent distribution (Standard error of percent) All visits
1000
426 (26)
166 (12)
325 (20)
64 (07)
Pediatrics Internal medicine General and family practice Cardiovascular diseases Obstetrics and gynecology Psychiatry Otolaryngology Urology Neurology General surgery Ophthalmology Orthopedic surgery Dermatology All other specialties
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
894 (24) 866 (49) 909 (18) *184 (80) *134 (46) *63 (34) *19 (11) *13 (05) * *75 (41) *06 (04) * * *106 (40)
*25 (11) *50 (26) * 257 (49) 122 (26) *104 (32) 481 (51) 420 (47) 450 (69) 370 (46) 200 (37) 380 (46) 201 (37) 314 (49)
*47 (20) *43 (22) *46 (17) 417 (63) 662 (58) 715 (69) 368 (46) 466 (49) 462 (73) 428 (57) 686 (43) 423 (47) 551 (51) 495 (54)
*22 (10) *19 (16) 15 (04) *127 (56) 52 (15) *90 (33) 89 (21) *85 (32) *45 (16) *115 (35) 106 (30) 176 (49) 213 (43) 71 (15)
18 (03) *12 *23 *16 *15 *29 *29 *45 *16 *37 * * * *34 *13
(04) (08) (05) (06) (12) (20) (23) (09) (27) (19) (06)
Category not applicable * Figure does not meet standards of reliability or precision 1 PCP is patient’s primary care provider as indicated by a positive response to the question “Are you the patient’s primary care physician/provider?” 2 Referral status was asked only for visits to non-PCPs and visits with unknown PCP status Among these visits, referral information was unknown for 132% of visits 3 The unknown category includes blanks NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 10. Continuity-of-care office visit characteristics, by specialty type: United States, 2015 Specialty type 1 Continuity-of-care visit characteristic
All specialties
Primary care
Specialty type 1
Surgical specialties Medical specialties
All specialties
Surgical specialties Medical specialties
Percent distribution (standard error of percent)
Number of visits in thousands (standard error in thousands) All visits
Primary care
990,808 (49,038)
505,522 (38,066)
203,856 (13,179)
281,430 (32,708)
829,750 59,643 294,966 264,706 210,435 161,059
448,906 29,611 148,835 144,193 126,267 56,616
155,262 16,817 64,477 44,951 29,017 48,594
225,582 13,215 81,654 75,562 55,151 55,848
1000
1000
1000
1000
Prior-visit status and number of visits in last 12 months Established patient 2 None 1–2 visits 3–5 visits 6 or more visits New patient
(41,138) (3,758) (18,059) (17,551) (13,792) (12,223)
(32,534) (3,088) (15,603) (12,317) (11,792) (7,958)
(10,636) (1,601) (4,200) (3,553) (3,555) (4,070)
(26,677) (1,689) (9,230) (12,861) (7,233) (8,995)
837 60 298 267 212 163
(09) (04) (10) (09) (11) (09)
888 59 294 285 250 112
(11) (06) (17) (14) (19) (11)
762 82 316 221 142 238
Category not applicable 1 Specialty types are defned in the 2015 public use fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf 2 Number of previous visits by established patients to responding physician in the last 12 months NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
(14) (06) (11) (08) (13) (14)
802 (21) 47 (06) 290 (16) 268 (21) 196 (18) 198 (21)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 11. Twenty leading principal reasons for office visits, by patient’s sex: United States, 2015
Number of visits in thousands 1 (standard error in thousands)
Principal reason for visit and RVC code 1 All visits
990,808 (49,038)
Progress visit, not otherwise specifed General medical examination Medication, other and unspecifed kinds Counseling, not otherwise specifed Postoperative visit Cough Gynecological examination Prenatal examination, routine Knee symptoms Back symptoms Hypertension For other and unspecifed test results Stomach and abdominal pain, cramps and spasms Well baby examination Shoulder symptoms Diabetes mellitus Skin rash Preoperative visit for specifed and unspecifed types of surgery Symptoms referable to throat Other special examination
140,842 75,412 35,232 26,528 25,441 20,984 20,735 18,152 16,241 15,875 *15,762 15,159 15,026 13,217 *12,619 12,432 9,464 9,443 9,346 9,092
T800 X100 T115 T605 T205 S440 X225 X205 S925 S905 D510 R700 S545 X105 S940 D205 S860 T200 S455 X240
All other reasons
(12,765) (6,690) (7,003) (5,495) (2,679) (2,718) (4,607) (4,460) (2,629) (3,701) (4,820) (3,625) (2,796) (2,019) (4,604) (2,608) (1,373) (1,424) (2,021) (1,473)
473,807 (24,570)
Percent distribution (standard error of percent)
Female 2
Male 3
Percent distribution (standard error of percent)
Percent distribution (standard error of percent)
1000
1000
1000
142 76 36 27 26 21 21 18 16 16 16 15 15 13 *13 13 10 10 09 09
136 69 29 28 27 19 35 31 17 15 12 16 19 09 *11 11 07 09 10 09
151 86 45 25 24 24 16 17 *22 14 10 19 *16 15 13 11 08 09
(12) (06) (06) (05) (03) (03) (04) (05) (03) (04) (05) (03) (03) (02) (04) (03) (01) (01) (02) (02)
478 (12)
(12) (06) (05) (06) (03) (03) (07) (07) (03) (04) (02) (04) (04) (02) (04) (03) (01) (02) (02) (02)
480 (13)
Category not applicable *Figure does not meet standards of reliability or precision 1 Based on A Reason for Visit Classifcation for Ambulatory Care (RVC), defned in the 2015 public use fle documentation (ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf) 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
(14) (08) (09) (04) (03) (05) (03) (05) (11) (04) (02) (03) (05) (04) (03) (02) (02) (02)
475 (15)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 12. Provider-assessed major reason for office visit, by selected patient and visit characteristics: United States, 2015 Total number of visits in thousands (standard error in thousands)
Total percent
New problem
Chronic problem, routine
Chronic problem, fare-up
Pre-surgery
Post-surgery
Preventive care1
Unknown or blank
1000
309 (11)
333 (15)
70 (06)
15 (02)
46 (05)
204 (12)
23 (06)
(11,829) (3,554) (4,271) (5,758) (7,688) (12,919) (20,537) (22,379) (10,511) (13,072)
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
488 357 552 501 352 309 290 242 241 244
109 * 58 168 214 260 376 453 410 501
* * * * * 14 16 22 24 18
12 * 13 13 35 48 60 47 54 40
338 537 342 258 322 275 140 142 170 111
Female 585,795 (30,238) Male 405,013 (23,023)
1000 1000
Patient and visit characteristic
All visits 990,808 (49,038) Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
125,386 24,522 38,205 62,660 75,861 178,819 305,071 305,670 159,752 145,918
(21) (32) (25) (28) (29) (18) (17) (14) (14) (22)
(17) (14) (24) (32) (18) (19) (23) (23) (29)
28 (05) * *19 (07) 40 (07) 49 (11) 69 (08) 93 (11) 70 (08) 79 (11) 60 (08)
(03) (03) (04) (05) (05)
(02) (03) (03) (10) (06) (09) (05) (06) (05)
(20) (33) (24) (23) (43) (25) (14) (14) (19) (14)
*22 * *15 * *16 25 *24 *24 *21 *27
(08) (05) (06) (07) (09) (08) (07) (10)
312 (12) 304 (14)
301 (17) 379 (18)
74 (08) 64 (05)
14 (02) 17 (03)
44 (05) 48 (06)
231 (17) 166 (10)
23 (07) 23 (07)
1000 1000 1000
303 (11) 298 (23) 367 (25)
334 (15) 319 (29) 342 (56)
71 (05) 75 (18) 53 (15)
16 (02) 16 (05) *
51 (05) 32 (07) *17 (06)
200 (11) 229 (29) 200 (43)
24 (07) *30 (10) *
(14,011) (43,797) (29,476) (13,126) (21,075)
1000 1000 1000 1000 1000
356 301 295 294 356
177 358 364 326 362
58 44 50 32 *15
262 195 187 231 199
*62 17 16 *30 *
Private insurance 552,975 (28,160) Medicare 269,578 (21,510) Medicare and Medicaid5 19,929 (3,053) Medicaid or CHIP or other 6 state-based program 156,303 (14,454) No insurance7 51,720 (10,027) Other8 47,959 (4,740)
1000 1000 1000
323 (12) 243 (14) 257 (46)
311 (14) 456 (26) 408 (59)
75 (08) 73 (09) *91 (29)
17 (03) 22 (04) *
52 (06) 44 (05) 29 (07)
207 (11) 135 (17) 80 (21)
15 (03) *27 (10) *
1000 1000 1000
360 (26) 330 (45) 260 (24)
203 (22) 436 (49) 370 (35)
64 (11) 65 (15) 86 (16)
09 (02) * *
32 (06) *35 (11) 71 (10)
287 (37) 101 (24) 176 (28)
*46 (24) * *
Sex
Race2 White 769,517 (34,016) Black or African American 130,562 (13,454) Other3 90,729 (21,305) Race and ethnicity2 Hispanic or Latino Not Hispanic or Latino White Black or African American Other3
139,853 850,956 640,625 126,527 83,804
(31) (12) (12) (23) (26)
(20) (16) (16) (29) (56)
69 70 72 72 *54
(13) (06) (06) (16) (17)
*16 15 16 15 *
(05) (02) (02) (04)
(17) (04) (04) (07) (05)
(35) (11) (10) (29) (46)
(34) (03) (03) (10)
Expected source(s) of payment4
* Figure does not meet standards of reliability or precision … Category not applicable 1 Preventive care includes routine prenatal, well-baby, screening and insurance, or general exams (see major reason for visit question on the Patient Record Sample Card at https://wwwcdcgov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_Cardpdf) 2 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of modelbased single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 286% of visits, and ethnicity data were missing for 234% of visits 3 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race 4 Combined total of individual sources exceeds “all visits” and percent of visits exceeds 100% because more than one source of payment may be reported per visit 5 The visits in this category are also included in both the Medicaid or CHIP or other state-based program and Medicare categories 6 CHIP is Children’s Health Insurance Program 7 No insurance is defned as having only self-pay, no charge, or charity as payment sources 8 Other includes workers’ compensation, unknown or blank, and sources not classifed elsewhere NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 13. Preventive care visits made to primary care specialists, by selected patient and visit characteristics: United States, 2015
Patient and visit characteristics
Number of visits in thousands Percent distribution (standard error in thousands) (standard error of percent)
All preventive care visits3
202,266 (14,826)
1000
Number of visits per 100 persons per year1 (standard error of rate)
Percent of preventive care visits made to primary care specialists2 (standard error of percent)
640 (47)
829 (22)
Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
42,358 13,157 13,048 16,153 24,445 49,247 42,743 43,473 27,209 16,264
(4,965) (1,992) (1,712) (2,072) (4,791) (6,592) (5,205) (5,738) (3,867) (2,234)
209 65 65 80 121 243 211 215 135 80
(28) (11) (09) (11) (19) (23) (19) (25) (17) (10)
695 3309 819 393 570 596 513 936 996 850
(81) (501) (108) (50) (112) (80) (62) (123) (142) (117)
936 963 942 909 911 919 774 633 667 577
(29) (19) (35) (35) (33) (19) (40) (56) (56) (64)
Female Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
135,131 19,809 20,945 43,256 25,502 15,177 10,442
(12,483) (2,470) (4,734) (6,499) (3,094) (2,717) (1,854)
668 98 104 214 126 75 52
(23) (14) (19) (24) (12) (12) (08)
836 664 986 1031 594 1043 930
(77) (83) (223) (155) (72) (187) (165)
871 934 955 946 805 706 673
(20) (26) (16) (15) (38) (66) (70)
Male Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
67,134 22,549 3,499 5,991 17,241 12,032 5,822
(5,205) (2,907) (967) (914) (2,844) (1,748) (906)
332 111 17 30 85 59 29
(23) (16) (05) (05) (11) (08) (05)
434 724 162 147 427 942 735
(34) (93) (45) (22) (70) (137) (114)
746 938 651 722 727 618 404
(32) (33) (148) (61) (56) (67) (80)
Sex and age
Race4 White Black or African American Other5
154,164 (10,191) 29,961 (5,362) 18,141 (3,064)
762 (24) 148 (20) 90 (13)
631 (42) 726 (130) 590 (100)
804 (23) 901 (34) 929 (33)
36,649 165,616 119,800 29,173 16,644
181 819 592 144 82
655 636 614 756 623
926 808 769 899 927
Ethnicity4 Hispanic or Latino Not Hispanic or Latino White Black or African American Other5
(6,589) (11,924) (7,601) (5,363) (3,035)
(26) (26) (33) (20) (13)
(118) (46) (39) (139) (114)
(22) (25) (26) (35) (35)
Expected source(s) of payment6 Private insurance Medicare Medicaid or CHIP or other state-based program7 Medicare and Medicaid No insurance8 Other9
114,208 (8,039) 36,292 (6,103) 44,878 (8,157) 1,595 (411) 5,208 (1,033) 8,441 (1,649)
565 (31) 179 (27)
580 (41) 722 (121)
816 (25) 661 (66)
222 08 26 42
807 182
943 * 671 824
(35) (02) (05) (08)
(147) (36)
(20) (103) (58)
* Figure does not meet standards of reliability or precision Category not applicable 1 Visit rates for age, sex, and race and ethnicity are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau Visit rates for expected source(s) of payment are based on the 2015 National Health Interview Survey estimates of health insurance 2 Primary care specialty as defned in the 2015 public use fle documentation (ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf) 3 Preventive care includes routine prenatal, well-baby, screening, insurance or general exams (see “Major reason for this visit” question on the Patient Record Sample card, available at: https://wwwcdcgov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_Cardpdf) 4 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data fle documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 317% of preventive care visits, and ethnicity data were missing for 248% of preventive care visits 5 Other includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race 6 Combined total of individual sources exceeds all visits and percent of visits exceeds 100% because more than one source of payment may be reported per visit 7 CHIP is Children’s Health Insurance Program 8 No insurance is defned as having only self-pay, no charge or charity as payment sources The visit rate was calculated using uninsured as the denominator from the 2015 estimates of health insurance coverage from the National Health Interview Survey 9 Other includes workers’ compensation, unknown or blank, and sources not classifed elsewhere NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 14. Preventive care visits made to primary care specialists, by selected states: United States, 2015
Selected states
Number of visits in thousands (standard error in thousands)
Number of visits per 100 persons per year1 (standard error of rate)
Percent of preventive care visits made to primary care specialists2 (standard error of percent)
All preventive care visits3
202,266 (14,826)
640 (47)
829 (22)
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
3,059 29,139 7,882 3,027 7,515 4,678 *3,264 3,351 *4,326 7,941 *3,406 6,407 *5,475 *21,884 4,212 2,205
(833) (6,703) (2,096) (821) (2,140) (1,186) (1,654) (672) (2,002) (1,916) (1,287) (1,405) (1,676) (8,851) (1,066) (400)
455 755 395 302 593 717 *486 342 *489 406 *347 560 *435 *811 515 312
(124) (174) (105) (82) (169) (182) (246) (69) (226) (98) (131) (123) (133) (328) (130) (57)
627 886 753 *477 855 835 805 919 525 749 717 877 791 976 882 922
(128) (54) (87) (215) (51) (64) (141) (52) (155) (112) (141) (46) (70) (12) (44) (27)
* Figure does not meet standards of reliability or precision 1 Visit rates are based on the July 1, 2015, set of estimates of the civilian noninstitutionalized population of the United States as developed by the Population Division, US Census Bureau 2 Primary care specialty as defned in the 2015 public use fle documentation (ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf) 3 Preventive care includes routine prenatal, well-baby, screening, insurance or general exams (see Major reason for this visit question on the Patient Record Sample Card, available from http://wwwcdcgov/nchs/data/ahcd/2015_NAMCS_PRF_Sample_cardpdf) NOTE: Numbers do not add to total because estimates are only available for 16 states SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 15. Primary diagnosis at office visits, classifed by major disease category: United States, 2015 Major disease category and ICD-9-CM code range1
Number of visits in thousands (standard error in thousands)
All visits
990,808 (49,038)
Infectious and parasitic diseases 001–139 Neoplasms 140–239 Endocrine, nutritional, metabolic diseases, and immunity disorders 240–279 Mental disorders 290–319 Diseases of the nervous system and sense organs 320–389 Diseases of the circulatory system 390–459 Diseases of the respiratory system 460–519 Diseases of the digestive system 520–579 Diseases of the genitourinary system 580–629 Diseases of the skin and subcutanaous tissue 680–709 Diseases of the musculoskeletal and connective tissue 710–739 Symptoms, signs, and ill-defned conditions 780–799 Injury and poisoning 800–999 Supplementary classifcation2 V01–V90 All other diagnoses3 Blank
16,794 37,075 69,845 59,776 89,562 88,343 64,624 32,271 45,388 44,576 108,700 73,149 31,659 198,910 26,802 3,333
(2,027) (6,205) (10,227) (8,211) (6,596) (10,475) (6,269) (5,976) (4,399) (4,672) (17,702) (6,519) (3,848) (13,104) (3,919) (738)
Percent distribution (standard error of percent) 1000 17 37 70 60 90 89 65 33 46 45 110 74 32 201 27 03
(02) (06) (09) (08) (07) (09) (05) (06) (04) (05) (15) (05) (04) (11) (04) (01)
Category not applicable 1 Based on the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) 2 Supplementary classifcation is preventive and follow-up care and includes general medical examination, routine prenatal examination, and health supervision of an infant or child, and other diagnoses not classifable to injury or illness 3 Includes diseases of the blood and blood-forming organs (280–289); complications of pregnancy, childbirth, and the puerperium (630–677); congenital anomalies (740–759); certain conditions originating in perinatal period (760–779); and entries not codable to the ICD–9–CM (eg “illegible entries, left against medical advice, transferred, entries of none, or no diagnoses) NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 16. Twenty leading primary diagnosis groups for office visits: United States, 2015
Primary diagnosis group and ICD-9-CM code(s)
1
All visits Arthropathies and related disorders Essential hypertension Spinal disorders Routine infant or child health check Diabetes mellitus General medical examination Acute upper respiratory infections, excluding pharyngitis Malignant neoplasms Specifc procedures and aftercare Rheumatism, excluding back Gynecological examination Heart disease, excluding ischemic
710–719 401 720–724 V200–V202 249–250 V70 460–461,463–466 140–208,209–20936,2097–20979,230–234 V50–V599 725–729 V723 391–3920,393–398,402,404,415–416, 420–429 Disorders of lipoid metabolism 272 Normal pregnancy V22 Benign neoplasms 210–229,2094–20969,235–239 Ischemic heart disease 410–4149 Attention defcit disorder 314 Anxiety states 300 Psychoses, excluding major depressive disorder 290–295,2960-2961,2964–299 Follow up examination V67 All other diagnoses4
Number of visits in thousands (standard error in Percent distribution Female2 percent distribution Male3 percent distribution thousands) (standard error of percent) (standard error of percent) (standard error of percent) 990,808 (49,038) 46,997 42,749 37,833 37,473 34,593 32,078 25,162 24,601 23,591 20,864 18,171 15,486
1000
1000
1000
(9,732) (5,982) (7,164) (4,371) (4,971) (5,029) (3,204) (5,887) (4,681) (5,302) (4,469) (2,488)
47 (09) 43 (05) 38 (06) 38 (05) 35 (05) 32 (04) 25 (03) 25 (06) 24 (05) 21 (05) 18 (04) 16 (03)
47 (11) 36 (05) 34 (06) 31 (04) 27 (04) 30 (05) 28 (04) 23 (06) 22 (04) 23 (06) 31 (07) 13 (03)
48 (08) 54 (09) 44 (09) 47 (06) 47 (07) 36 (06) 22 (04) 28 (06) 26 (06) 19 (04) 19 (04)
14,474 (2,973) 14,324 (2,945) 12,474 (1,628) 11,594 (2,599) 11,457 (2,436) 10,943 (1,814) 10,710 (1,954) 9,941 (1,740) 535,293 (25,194)
15 (03) 14 (03) 13 (02) 12 (03) 12 (02) 11 (02) 11 (02) 10 (02) 540 (14)
13 (03) 24 (05) 11 (02) 07 (02) 09 (02) 11 (02) 11 (02) 09 (02) 561 (15)
17 (04) 14 (02) 19 (05) 16 (04) 12 (02) 11 (02) 11 (03) 510 (17)
Category not applicable 1 Based on the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) However, certain codes have been combined in this table to form larger categories that better describe the utilization of ambulatory care services 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males 4 Includes all other diagnoses not listed above, as well as unknown and blank diagnoses NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 17. Injury visits to office-based physicians, by selected patient and visit characteristics: United States, 2015 Patient characteristics
Number of visits in thousands (standard error in thousands)
All injury visits2
82,358 (7,503)
Percent distribution (standard error of percent) 1000
Number of visits per 100 persons per year1 (standard error of rate) 260 (24)
Age Under 15 years Under 1 year 1–4 years 5–14 years 15–24 years 25–44 years 45–64 years 65 years and over 65–74 years 75 years and over
8,720 * 1,861 6,694 9,049 13,247 24,986 26,355 14,421 11,934
(1,738) (416) (1,639) (2,313) (1,601) (2,459) (2,640) (1,715) (1,449)
106 * 23 81 110 161 303 320 175 145
(17) (05) (16) (21) (16) (18) (25) (17) (16)
143 * 117 163 211 160 300 567 528 623
(28) (26) (40) (54) (19) (30) (57) (63) (76)
Female Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
42,267 4,446 *4,398 5,716 12,679 7,943 7,084
(4,598) (1,220) (1,434) (934) (1,490) (1,187) (1,179)
513 54 53 69 154 96 86
(18) (12) (15) (10) (13) (12) (13)
261 149 *207 136 295 546 631
(28) (41) (67) (22) (35) (82) (105)
Male Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over
40,091 4,273 4,651 7,531 12,307 6,478 4,850
(3,396) (739) (1,102) (1,073) (1,274) (1,044) (684)
487 52 56 91 149 79 59
(18) (08) (10) (12) (11) (12) (08)
259 137 215 185 305 507 613
(22) (24) (51) (26) (32) (82) (86)
Sex and age
Race 3 White Black or African American Other 4
68,083 (6,456) 6,898 (954) *7,376 (2,932)
827 (32) 84 (12) *90 (33)
279 (26) 167 (23) *240 (95)
8,271 74,087 61,272 6,554 *6,261
100 900 744 80 *76
148 285 314 170 *234
Race and ethnicity3 Hispanic or Latino Not Hispanic or Latino White Black or African American Other 4
(1,370) (6,972) (5,899) (924) (2,843)
(15) (15) (31) (11) (32)
(24) (27) (30) (24) (106)
* Figure does not meet standards of reliability or precision Category not applicable 1 Visit rates for age, sex, race, and ethnicity are based on the July 1, 2015, set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, US Census Bureau 2 The National Ambulatory Medical Care Survey defnition of injury visits, as shown in this table, changed in 2010 and includes only frst-, second-, third-, fourth-, and ffth-listed reason for visit and diagnosis codes that are injury or poisoning related Adverse effects and complications are excluded Reason for visit was coded using A Reason for Visit Classifcation for Ambulatory Care; diagnosis was coded using the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) Injury visits, using this defnition, accounted for 83% (SE = 07) of all office visits in 2015 For more information on why this defnition changed, see the 2015 National Ambulatory Medical Care Survey Public Use Data File Documentation, available at: http://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf 3 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data File documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 267% of injury visits, and ethnicity data were missing for 255% of injury visits 4 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 18. Office visits related to injury or trauma, overdose or poisoning, and adverse effects, by intent and mechanism: United States, 2015 Intent 1, mechanism 2, and cause-of-injury code 2 All visits related to injury, poisoning, and adverse effect 1 Unintentional injury or poisoning 1 Falls Exposure to radiation Natural and environmental factors Overexertion and strenuous movements Cutting or piercing instruments or objects Motor vehicle traffic Struck against or struck accidentally by objects or persons Poisoning Other mechanism 3
… … E8800–E8869,E888 E926 E900–E909,E9280–E9282 E927 E920 E810–E819
E916–E917 E850–E869 E800–E807(0–3,8–9),E820–E825, E826–E848,E890–E899,E910–E915, E918–E919,E921,E922,E923–E925, E9283–5,8,E9290–5,8 Mechanism unspecifed and blank E887,E9289,E9299 Intentional injury or poisoning 1 … Injury or poisoning—unknown intent 1 … Adverse effect of medical treatment, or surgical care or adverse effect of medicinal drug 1 … Medical or sugical complication E870–E879 Adverse drug effects E930–E949 Other and blank 4 …
Number of visits in thousands (standard error in thousands)
92,217 56,843 13,199 11,709 5,553 5,462 * 4,612
(7,842) (6,159) (2,126) (2,123) (1,439) (1,425) (916)
Percent distribution (standard error of percent)
1000 616 143 127 60 59 * 50
(32) (16) (23) (15) (13) (09)
3,557 (1,017) * 8,157 (1,227)
39 (09) * 88 (11)
3,243 (489) 1,477 (424) 23,180 (3,028)
35 (05) 16 (05) 251 (27)
10,717 (1,883) *4,075 (1,610) 2,416 (639) 4,226 (720)
116 *44 26 46
(20) (17) (07) (08)
Category not applicable * Figure does not meet standards of reliability or precision 1 The defnition of visits related to injury or trauma, overdose or poisoning, and adverse effect of medical or surgical treatment or adverse effect of medicinal drug used in this table is based on automated Patient Record form entries for patient’s reason for visit, diagnosis, and cause of injury Starting in 2014, up to fve reasons and diagnoses and up to three causes could be coded for each visit Categories shown refect the classifcations used Reason for visit was coded using “A Reason for Visit Classifcation for Ambulatory Care (RVC)” as defned in the 2015 public use fle documentation, available from ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf Diagnosis codes are based on the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM) (US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260) Visits related to injury or trauma, overdose or poisoning, and adverse effect of medical or surgical treatment or adverse effect of medicinal drug accounted for 93% (SE = 07) of all office visits in 2015 For more information, see the 2015 NAMCS Public Use Data File documentation 2 Mechanism of injury is based on the “Supplementary Classifcation of External Cause of Injury or Poisoning” in the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation (ICD–9–CM), US Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services Official version: International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Sixth Edition DHHS Pub No (PHS) 11–1260 Data are based on frst-listed external cause of injury or poisoning Up to three external cause of injury or poisoning codes could be collected per visit 3 Includes injuries caused by drowning, frearms, fre and fames, pedal cycle (nontraffic), motor vehicle (nontraffic and other), suffocation, foreign bodies, other transportation, caught accidentally between objects, machinery, and other mechanism 4 Other includes visits that were classifed as adverse effects of medical or surgical care or adverse effect of medicinal drug based on the PRF in conjunction with frst-, second-, third-, fourth-, or ffthlisted reason for visit and diagnosis codes related to adverse effects but that could not be classifed as such based on frst-listed external cause of injury or poisoning NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 19. Presence of selected chronic conditions at office visits, by patient age and sex: United States, 2015 Chronic conditions1
Total
Under 45 years
45–64 years
65–74 years
75 years and over
Female
Male
Percent distribution (standard error of percent) All visits
1000
1000
1000
1000
1000
1000
1000
None One or more chronic conditions One Two Three or more Blank
373 610 246 146 218 17
(16) (17) (10) (08) (15) (03)
658 318 222 63 34 24
(22) (21) (16) (07) (04) (07)
246 738 301 190 248 16
(14) (15) (13) (11) (18) (03)
163 829 220 209 401 08
(13) (14) (15) (14) (23) (02)
125 864 223 204 437 11
(13) (14) (19) (18) (33) (03)
395 590 256 134 201 15
(17) (17) (11) (06) (14) (03)
341 639 232 164 243 20
(20) (20) (11) (14) (20) (05)
Hypertension Hyperlipidemia Arthritis Diabetes mellitus (DM) Diabetes mellitus (DM), Type 1 Diabetes mellitus (DM), Type 2 Diabetes mellitus (DM), Type unspecifed Depression Obesity Cancer Coronary artery disease (CAD), ischemic heart disease (IHD), or history of myocardial infarction (MI) Asthma Chronic kidney disease (CKD) Chronic Obstructive pulmonary disease (COPD) Obstructive sleep apnea (OSA) Osteoporosis Substance abuse or dependence Cerebrovascular disease, history of stroke (CVA), or transient ischemic attack (TIA) Congestive heart failure (CHF) Alzheimer’s disease and dementia Alcohol misuse, abuse or dependence History of pulmonary embolism (PE), deep vein thrombosis (DVT), or venous thromboembolism (VTE) Autism spectrum disorder HIV infection and AIDS End-stage renal disease (ESRD)
299 202 160 152 06 84 62 104 79 65 64
(16) (15) (15) (09) (01) (08) (06) (07) (06) (07) (06)
62 34 41 33 02 16 16 91 66 11 02
(07) (07) (05) (06) (00) (03) (04) (09) (08) (03) (01)
347 256 189 199 12 103 84 140 105 60 51
(17) (21) (20) (15) (03) (11) (10) (12) (10) (09) (09)
516 367 256 268 08 165 95 87 96 135 131
(25) (22) (23) (15) (02) (15) (10) (10) (11) (16) (13)
575 348 301 238 *06 132 101 80 37 139 176
(29) (29) (32) (15) (02) (16) (14) (14) (06) (17) (19)
270 175 169 136 05 77 54 119 84 59 42
(15) (13) (16) (10) (01) (07) (06) (08) (08) (08) (05)
341 241 146 176 08 94 73 83 71 74 95
(21) (20) (15) (12) (02) (11) (09) (08) (07) (08) (09)
62 45 32 26 25 23
(04) (12) (03) (03) (02) (03)
66 * 05 11 * 19
(06) * (01) (02) * (03)
69 36 28 37 18 37
(06) (08) (05) (04) (03) (06)
59 82 68 43 59 14
(08) (24) (10) (07) (09) (03)
40 *135 74 24 64 *12
(06) (41) (10) (04) (09) (05)
67 *38 30 20 37 18
(05) (12) (04) (03) (04) (03)
54 54 36 34 07 30
(05) (13) (05) (04) (02) (04)
18 16 09 06
(02) (03) (02) (01)
* * * * * * 06 (01)
10 (02) 12 (03) * * 08 (02)
31 36 11 06
(05) (08) (03) (02)
60 (10) 46 (07) 44 (10) * *
18 17 10 04
(03) (04) (02) (01)
17 16 09 10
(02) (02) (02) (02)
06 02 *02 *02
(01) (01) (01) (01)
* * 05 (01) * * * *
*08 (03) * * * * * *
*10 (04) * * * * * *
11 (03) * * * * * *
05 (01) * * * * * *
08 *04 *03 *02
(02) (01) (01) (01)
Category not applicable * Figure does not meet standards of reliability or precision 1 Presence of chronic conditions was based on the checklist of chronic conditions and reported diagnoses Combined total visits by patients with chronic condtions and percent of visits exceeds 100% because more than one chronic condition may be reported per visit NOTE: Numbers may not add to totals because more than one chronic condition may be reported per visit SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 20. Presence of selected chronic conditions at office visits, by selected states: United States, 2015 Selected states
Hypertension
Hyperlipidemia
Arthritis
Diabetes1
Depression
Obesity
Asthma
Cancer
COPD2
Osteoporosis
Percent of visits (standard error of percent) All visits
300 (21)
213 (18)
171 (20)
158 (11)
96 (08)
81 (08)
64 (05)
67 (09)
35 (04)
26 (03)
273 (45) 340 (73) 425 (64) 277 (40) 334 (52) 322 (42) 166 (41) 305 (35) 274 (53) 255 (36) 246 (46) 299 (53) 329 (42) 237 (37) 249 (63) 309 (41)
152 (32) 237 (53) 370 (67) *135 (42) 182 (42) 249 (41) *96 (44) 221 (33) 229 (66) 257 (59) 173 (43) 175 (38) 212 (45) *118 (36) *157 (48) 235 (36)
127 (27) 200 (55) 195 (30) 173 (29) 158 (31) 141 (24) 128 (34) 162 (25) 143 (39) 174 (44) 87 (23) *101 (34) 149 (37) *219 (91) *99 (31) 181 (31)
152 (26) 204 (36) 161 (27) 132 (21) 152 (34) 181 (32) 67 (18) 130 (17) 132 (32) 163 (24) 112 (29) 118 (29) 148 (26) 150 (26) 140 (42) 129 (21)
106 (21) 72 (19) 66 (16) *166 (51) 97 (24) 152 (20) 178 (52) 161 (42) *135 (61) *53 (16) 82 (17) 152 (38) *98 (35) 87 (14) *65 (20) 171 (29)
*56 (18) 79 (18) 103 (29) 49 (09) *71 (26) 103 (26) * 77 (15) 101 (25) 80 (19) 78 (17) *96 (39) 77 (18) *78 (38) 63 (19) 103 (25)
63 (14) 49 (11) 79 (21) 84 (18) 50 (10) 67 (18) *75 (27) 71 (09) 74 (17) 62 (10) 64 (18) 68 (11) 66 (13) 66 (14) *75 (30) 68 (11)
56 (15) *54 (28) 133 (31) 66 (17) 54 (12) *95 (48) 53 (15) 44 (08) * 73 (15) *66 (21) 63 (12) 75 (16) *49 (17) *144 (93) 52 (11)
* * 83 (22) * * 57 (15) * 44 (08) * * * * 31 (07) *22 (07) *87 (31) 37 (11)
* * *47 (17) * * 25 (07) * *23 (07) * *32 (13) * * * * * 28 (07)
State Arizona California Florida Georgia Illinois Indiana Massachusetts Michigan New Jersey New York North Carolina Ohio Pennsylvania Texas Virginia Washington
* Figure does not meet standards of reliability or precision 1 Diabetes includes both Type I diabetes mellitus (insulin dependent or IDDM), Type II diabetes mellitus (non-insulin dependent or NIDDM), and diabetes with type unspecifed Excludes diabetes insipidus and gestational diabetes 2 COPD is chronic obstructive pulmonary disease NOTES: Presence of chronic conditions was based on the checklist of chronic conditions and reported diagnoses Combined total visits by patients with chronic condtions and percent of visits exceeds 100% because more than one chronic condition may be reported per visit Numbers may not add to totals because more than one chronic condition may be reported per visit SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 21. Selected services ordered or provided at office visits, by patient sex: United States, 2015
Services
Number of visits in thousands 1 (standard error in thousands)
Both sexes
Male3
Female2
Percent distribution (standard error of percent) All visits One or more services ordered or provided 4 None
990,808 (49,038) 967,598 (48,591) 23,211 (4,619)
1000 (00) 977 (05) 23 (05)
1000 (00) 979 (05) 21 (05)
1000 (00) 973 (05) 27 (05)
Examinations and screenings Skin Retinal or eye Neurologic Pelvic Foot Depression screening Breast Alcohol misuse screening (includes AUDIT, MAST, CAGE, T-ACE) Rectal Substance abuse screening (includes NIDA/NM ASSIST, CAGE-AID, DAST-10) Domestic violence screening
184,944 149,662 145,770 52,258 50,962 43,525 37,671
(17,327) (16,076) (22,465) (7,747) (10,601) (7,964) (5,411)
187 151 147 53 51 44 38
(16) (15) (20) (08) (10) (08) (05)
177 145 138 89 51 47 60
(16) (14) (17) (12) (10) (07) (08)
200 160 160 * 52 40 *06
(19) (19) (29) (11) (10) (03)
*17,694 (7,665) 17,274 (3,529)
*18 (08) 17 (04)
*18 (08) 18 (04)
*18 (07) 17 (04)
10,782 (2,816) *5,436 (2,481)
11 (03) *05 (02)
12 (03) *06 (03)
*09 (03) *
Vital signs Weight Height Blood pressure Temperature
753,804 698,091 677,507 383,829
(45,727) (46,892) (47,416) (39,819)
761 705 684 387
(17) (20) (20) (29)
773 710 709 376
(17) (21) (20) (31)
743 696 647 403
(20) (22) (24) (31)
130,395 101,742 99,152 97,237 69,212 56,184 41,147 36,263 28,643 28,450 23,402 *21,410 15,859 *13,150 *12,093 *11,701 *9,981 9,764 8,498 *7,964
(18,298) (16,199) (13,957) (17,445) (12,547) (8,312) (6,860) (8,687) (7,493) (5,312) (5,455) (7,278) (2,572) (9,358) (3,976) (4,762) (4,369) (2,718) (2,252) (2,833)
132 103 100 98 70 57 42 37 29 29 24 *22 16 *13 *12 *12 *10 10 09 *08
(15) (14) (13) (15) (11) (07) (07) (09) (07) (05) (05) (07) (02) (09) (04) (05) (04) (03) (02) (03)
142 105 114 100 74 67 45 45 *31 49 26 *26 * *18 *14 *15 *12 14 15 *11
(20) (18) (18) (18) (16) (10) (10) (13) (10) (08) (05) (11) (11) (05) (05) (05) (04) (04) (05)
117 100 80 95 64 41 37 25 26 * 20 *15 39 * 10 *07 * * * *
(12) (11) (10) (13) (09) (05) (06) (06) (07) (05) (05) (06) (03) (04)
24,632 (6,779) *5,698 (2,000) 4,475 (1,302) 5,211 (884)
25 *06 05 05
(07) (02) (01) (01)
*31 *05 05 07
(10) (02) (02) (01)
*16 *07 *03 02
(05) (03) (02) (00)
41 19 18 12 11 *10 *08 08 *07 *07 06 06 *04 *03 01 *
(07) (05) (04) (01) (02) (03) (05) (01) (03) (03) (02) (02) (02) (01) (00)
35 19 *20 10 09 *10 *12 05 *10 *11 04 *06 *05 *04 *01 *
(06) (05) (06) (01) (02) (04) (08) (01) (05) (05) (01) (02) (03) (01) (00)
51 20 14 16 13 *10 *02 11 * * *10 05 *03 * 01 *
(09) (06) (03) (02) (03) (04) (01) (02) (03) (02) (01) (00)
Laboratory tests Complete blood count (CBC) Lipids or cholesterol Urinalysis (UA) Comprehensive metabolic panel (CMP) Glycohemoglobin (HgbA1C) TSH or thyroid panel Basic metabolic panel (BMP) Glucose Creatinine or renal function panel Pap test Vitamin D test Liver enzymes or hepatic function panel Prostate specifc antigen (PSA) HPV DNA test 5 Rapid strep test Hepatitis testing HIV test6 Chlamydia test Pregnancy or HCG test Gonorrhea test Culture Urine Throat Blood Other Procedures Electrocardiogram (EKG or ECG) Biopsy Colonoscopy Excision of tissue Audiometry Spirometry Sigmoidoscopy Cryosurgery (cryotherapy) Upper gastrointestinal endoscopy or EGD Fetal monitoring Cardiac stress test Tonometry Electromyogram (EMG) Tuberculosis skin testing or PPD Electroencephalogram (EEG) Peak fow See footnotes at end of table.
40,886 19,035 17,531 12,347 10,737 *10,000 *7,576 7,438 *6,977 *6,458 6,260 5,677 *4,221 *3,105 1,246 *
(7,408) (5,260) (4,381) (1,327) (2,188) (3,544) (4,829) (1,321) (2,934) (2,802) (1,740) (1,586) (1,892) (1,187) (299)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 21. Selected services ordered or provided at office visits, by patient sex: United States, 2015—Con.
Services
Number of visits in thousands 1 (standard error in thousands)
Both sexes
Male3
Female2
Percent distribution (standard error of percent) Imaging Any imaging X ray Ultrasound, excluding echocardiogram Mammography Magnetic resonance imaging (MRI) Computed tomography (CT) scan Echocardiogram Bone mineral density Other imaging
164,853 58,537 49,104 22,587 21,309 17,428 11,604 7,724 *4,443
(16,460) (6,531) (10,501) (4,080) (3,007) (3,054) (2,706) (2,040) (1,497)
166 59 50 23 22 18 12 08 *04
(12) (06) (09) (04) (03) (03) (03) (02) (01)
190 56 63 38 22 18 12 12 *03
(14) (06) (11) (06) (03) (04) (03) (03) (01)
132 63 31 * 21 17 12 * *06
(12) (07) (08) (03) (03) (03) (03)
21,330 14,949 14,325 11,347 *10,818 7,622 6,833 *2,507 *914 *
(3,224) (3,476) (1,814) (2,619) (3,494) (1,416) (1,844) (1,288) (299)
22 15 14 11 *11 08 07 *03 *01 *
(03) (04) (02) (03) (03) (01) (02) (01) (00)
24 15 13 11 *12 07 04 *02 * *
(04) (04) (02) (03) (04) (01) (01) (01)
18 16 17 13 *10 09 *11 * * *
(03) (04) (03) (03) (04) (02) (04)
146,889 101,678 47,237 28,068 27,280 25,735 19,481 8,297 *6,571 5,910 5,413 5,036 *4,032 *2,336 *2,239
(16,427) (15,386) (8,054) (5,844) (3,575) (7,098) (3,729) (1,765) (2,537) (1,486) (1,072) (1,361) (2,025) (1,335) (740)
148 103 48 28 28 26 20 08 *07 06 05 05 *04 *02 *02
(15) (13) (08) (06) (03) (07) (04) (02) (02) (01) (01) (01) (02) (01) (01)
153 102 42 28 26 22 19 12 *05 05 06 06 *03 *04 *
(17) (14) (08) (08) (04) (06) (04) (03) (02) (01) (01) (02) (01) (02)
142 104 55 29 30 31 21 * *08 *08 *05 *04 *06 * *
(15) (14) (10) (06) (04) (08) (04) (03) (03) (01) (01) (03)
Treatment Physical therapy Other mental health counseling Wound care Psychotherapy Home health care Cast, splint, or wrap Durable medical equipment Complementary and alternative medicine (CAM) Occupation therapy Radiation therapy Health education and counseling Diet or nutrition Exercise Injury prevention Growth or evelopment Weight reduction Tobacco use or exposure Diabetes education Family planning or contraception Substance abuse counseling Asthma Stress management STD Prevention Alcohol abuse counseling Genetic counseling Asthma action plan given to patient
Category not applicable 00 Quantity more than zero but less than 005 * Figure does not meet standards of reliability or precision -- Quantity zero 1 Combined total of all listed services exceeds “all visits” and percent of visits exceeds 100% because more than one service may be reported per visit 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males 4 Includes up to nine write-in procedures from the Services item on the Patient Record Form Procedures are coded to the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation, Volume 3, Procedure Classifcation Records with write-in procedures that overlap checkboxes (for example, procedure 9311, “Physical therapy exercises: Assisting exercise,” which could also be coded in the checkbox for physical therapy) are edited to ensure that the check box is marked; in this way the check box always provides a summary estimate, but should not be added to the corresponding ICD–9–CM procedure to avoid double counting Procedures that could not be included in one of the checkboxes are included in the estimated total number of visits with services, but are not shown separately 5 HPV is human papilloma virus; DNA is deoxyribonucleic acid 6 HIV is human immunodefciency virus SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 22. Initial blood pressure measurements recorded at office visits to primary care providers for adults aged 18 and over, by selected patient characteristics: United States, 2015 Initial blood pressure 1 Patient characteristic
Number of visits in thousands
Total
Not high
Mildly high
Moderately high
Severely high
Percent distribution (standard error of percent) All visits 2
371,911
1000
299 (17)
461 (16)
28,869 103,263 130,766 57,546 51,467
1000 1000 1000 1000 1000
549 436 194 229 229
323 436 503 477 463
245,420 126,491
1000 1000
356 (23) 188 (15)
273,033 69,867 29,011
1000 1000 1000
61,851 310,060 215,747 67,603 26,710
1000 1000 1000 1000 1000
185 (13)
56 (09)
Age 18–24 years 25–44 years 45–64 years 65–74 years 75 years and over
(40) (29) (16) (22) (20)
(37) (24) (24) (37) (39)
*104 103 229 240 220
(36) (17) (23) (22) (22)
* *26 (08) 74 (13) *53 (22) *89 (34)
458 (18) 466 (27)
138 (12) 275 (25)
48 (12) 71 (09)
317 (17) 202 (26) 363 (51)
464 (17) 466 (27) 418 (41)
172 (16) 253 (31) 147 (32)
48 (09) 79 (15) *
372 284 297 206 376
376 478 489 461 429
185 185 172 252 *
* 53 (08) 41 (07) 81 (15) *
Sex Female Male Race 3 White Black or African American Other 4 Ethnicity 3 Hispanic or Latino Not Hispanic or Latino White Black or African American Other 4
(51) (14) (15) (25) (47)
(49) (15) (17) (28) (49)
(43) (13) (15) (32)
Category not applicable * Figure does not meet standards of reliability or precision 1 Blood pressure (BP) levels were categorized using the following hierarchical defnitions: Severely high BP is defned as 160 mm Hg systolic or above, or 100 mm Hg diastolic or above Moderately high BP is defned as 140–159 mm Hg systolic or 90–99 mm Hg diastolic Mildly high BP is defned as 120–139 mm Hg systolic or 80–89 mm Hg diastolic Not high BP is defned as any BP less than 120 mm Hg systolic and less than 80 mm Hg diastolic High BP classifcation was based on the “Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC–7)” Mildly high BP corresponds to the (JNC–7) prehypertensive range Moderately high BP corresponds to the (JNC–7) stage 1 hypertensive range Severely high BP corresponds to the JNC–7 stage 2 hypertensive range 2 Visits where blood pressure was taken represent 943% (SE = 12) of all office visits made to primary care specialists by adults (aged 18 and over) 3 The race groups white, black or African American, and other include persons of Hispanic and not of Hispanic origin Persons of Hispanic origin may be of any race Starting with 2009 data, the National Center for Health Statistics adopted the technique of modelbased single imputation for NAMCS race and ethnicity data The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black The imputation technique is described in more detail in the 2015 National Ambulatory Medical Care Survey Public Use Data File documentation, available at: ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2015pdf For 2015, race data were missing for 276% of adult visits made to primary care specialists, and ethnicity data were missing for 165% of adult visits made to primary care specialists 4 Other race includes visits by Asian, Native Hawaiian or other Pacifc Islander, American Indian or Alaska Native, and persons with more than one race NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 23. Medication therapy and number of medications mentioned at office visits, by patient sex: United States, 2015 Medication therapy 1
Number of visits in thousands 1 (standard error in thousands)
Both sexes
Female2
Male3
Percent distribution (standard error of percent) All visits
990,808 (49,038)
Visits with mention of medication Visits without mention of medication
755,286 (43,578) 235,523 (14,437)
4
1000 762 (13) 238 (13)
1000 765 (15) 235 (15)
1000 759 (15) 241 (15)
Number of medications provided or prescribed All visits
990,808 (49,038)
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 or more
235,523 176,873 124,529 94,793 65,726 52,756 43,980 37,156 30,389 25,144 19,611 16,780 14,696 11,102 7,915 33,837
(14,437) (11,490) (10,390) (8,203) (5,153) (4,437) (4,463) (3,794) (2,990) (3,137) (2,578) (1,860) (3,237) (1,927) (1,287) (4,349)
1000 238 (13) 179 (09) 126 (07) 96 (05) 66 (04) 53 (04) 44 (04) 38 (03) 31 (03) 25 (03) 20 (02) 17 (02) 15 (03) 11 (02) 08 (01) 34 (04)
1000 235 (15) 187 (10) 127 (09) 91 (06) 61 (06) 54 (05) 44 (04) 41 (05) 32 (04) 26 (03) 20 (03) 17 (02) 12 (02) 12 (02) 08 (02) 33 (04)
1000 241 (15) 166 (11) 123 (07) 102 (08) 74 (06) 52 (04) 46 (05) 32 (04) 29 (03) 24 (03) 19 (03) 17 (02) 19 (06) 10 (02) 08 (02) 36 (05)
Category not applicable 1 Includes prescription drugs, over-the-counter preparations, immunizations, and desensitizing agents 2 Based on 585,795,000 visits made by females 3 Based on 405,013,000 visits made by males 4 A drug mention is documentation in a patient’s record of a drug provided, prescribed, or continued at a visit (up to 30 per visit) Also defned as drug visits NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 24. Office drug visits and drug mentions, by physician specialty: United States, 2015 Drug visits 1
Drug mentions 2
Number in thousands Percent distribution Number in thousands Percent distribution (standard error in thousands) (standard error of percent) (standard error in thousands) (standard error of percent)
Physician speciality All specialties
755,286 (43,578)
General and family practice Internal medicine Pediatrics Obstetrics and gynecology Ophthalmology Psychiatry Orthopedic surgery Cardiovascular diseases Dermatology Otolaryngology Urology Neurology General surgery All other specialties
163,903 116,773 66,633 54,640 39,651 38,929 35,754 35,055 27,102 15,621 15,273 12,463 9,727 123,763
(28,434) (25,385) (8,816) (10,614) (5,201) (8,329) (5,859) (7,038) (4,334) (2,459) (2,066) (2,872) (1,877) (25,480)
1000 217 155 88 72 52 52 47 46 36 21 20 17 13 164
(33) (30) (13) (14) (07) (11) (08) (09) (06) (03) (03) (04) (03) (30)
3,657,642 (266,769) 869,427 733,527 167,576 168,049 176,307 113,183 139,084 258,006 104,961 71,267 76,974 67,903 52,129 659,249
(141,910) (190,288) (25,277) (36,698) (27,765) (24,041) (23,459) (59,119) (19,225) (14,393) (11,528) (19,495) (11,901) (134,813)
1000 238 201 46 46 48 31 38 71 29 19 21 19 14 180
(35) (44) (08) (10) (08) (07) (07) (16) (06) (04) (04) (05) (03) (33)
Percent of office visits with drug mentions 3 (standard error of percent)
Drug mention rates 4 (standard error of rate)
762 (13)
3692 (174)
850 840 702 674 684 849 634 850 730 630 737 797 579 743
4510 5276 1767 2074 3043 2468 2465 6259 2828 2874 3712 4343 3102 3958
(25) (44) (23) (49) (47) (41) (43) (54) (29) (37) (30) (52) (54) (38)
Category not applicable 1 Visits at which one or more drugs were provided or prescribed 2 A drug mention is documentation in a patient’s record of a drug provided, prescribed, or continued at a visit (up to 30 per visit) Also defned as drug visits 3 Percent of visits that included one or more drugs provided or prescribed (number of visits divided by number of office visits multiplied by 100) 4 Average number of drugs that were provided or prescribed per 100 visits (total number of drug mentions divided by total number of visits multiplied by 100) NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
(383) (629) (139) (246) (418) (252) (293) (699) (254) (352) (324) (765) (456) (548)
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 25. Twenty most frequently mentioned drugs by therapeutic drug category at office visits: United States 2015
Therapeutic drug category
1
Analgesics 3 Antihyperlipidemic agents Antidepressants Vitamins Antidiabetic agents Dermatological agents Anxiolytics, sedatives, and hypnotics Antiplatelet agents Anticonvulsants Proton pump inhibitors Beta-adrenergic blocking agents Vitamin and mineral combinations Bronchodilators Immunostimulants Diuretics Angiotensin converting enzyme inhibitors Antihistamines Calcium channel blocking agents Ophthalmic preparations Minerals and electrolytes 1 2 3
Number of occurrences in thousands (standard error in thousands)
Percent of drug mentions 2 (standard error of percent)
402,939 173,523 166,198 150,302 142,685 139,609 127,757 124,670 122,286 115,079 106,098 99,127 97,887 97,297 92,510
(35,239) (14,480) (14,134) (13,587) (15,118) (12,218) (10,529) (13,177) (12,559) (13,579) (9,255) (10,605) (9,001) (14,985) (9,332)
110 47 45 41 39 38 35 34 33 31 29 27 27 27 25
(04) (02) (03) (02) (02) (03) (02) (02) (02) (03) (01) (02) (02) (04) (01)
83,966 75,194 73,840 73,150 71,653
(7,735) (6,194) (7,713) (7,867) (8,256)
23 21 20 20 20
(01) (01) (01) (02) (01)
Based on Multum Lexicon second level therapeutic drug category (see https://wwwcernercom/solutions/drug-database) Based on an estimated 3,657,642,000 drug mentions Includes narcotic and nonnarcotic analgesics and nonsteroidal anti-infammatory drugs
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 26. Twenty most frequently mentioned drug names at office visits, by new or continued status: United States, 2015 New
Drug name
Number of mentions in thousands Percent distribution (standard error in thousands) (standard error of percent)
1
All drug mentions
3,657,642 (266,769)
Aspirin Multivitamin Omeprazole
103,951 (10,194) 77,015 (8,404) 62,408 (6,919)
Lisinopril Albuterol Levothyroxine Atorvastatin Amlodipine Metoprolol Metformin Acetaminophen-hydrocodone Simvastatin Omega-3 polyunsaturated fatty acids Ibuprofen Hydrochlorothiazide Losartan Gabapentin Furosemide Acetaminophen Ergocalciferol Other
60,917 (6,014) 59,480 (6,041) 58,081 (6,143) 53,372 (4,709) 50,894 (4,958) 50,373 (4,544) 46,660 (4,508) 46,033 (8,990) 43,262 (4,347) 40,252 (4,667) 40,154 (4,063) 36,645 (4,529) 36,605 (4,497) 35,461 (4,421) 35,382 (4,217) 34,986 (4,367) 34,948 (3,424) 2,650,765 (193,899)
1000 28 (01) 21 (02) 17 (01) 17 16 16 15 14 14 13 13 12 11 11 10 10 10 10 10 10 725
(01) (01) (01) (01) (01) (01) (01) (02) (01) (01) (01) (01) (01) (01) (01) (01) (01) (06)
Total
Continued
Unknown2
Percent distribution (standard error of percent)
1000
200 (15)
791 (16)
09 (02)
1000 1000 1000
41 (08) 48 (09) 108 (20)
952 (10) 945 (09) 889 (20)
*07 (03) *07 (03) *03 (01)
925 824 948 927 903 934 931 789 941 951 744 849 875 865 915 750 873 752
*07 *09 *06 *09 *06 *11 *06 *05 *03 *05 *01 *05 *02 *31 *05 *08 *05 *10
1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
68 166 46 65 91 55 63 206 56 *44 254 *146 *123 105 80 242 122 239
(15) (33) (11) (18) (25) (12) (15) (57) (15) (16) (28) (51) (39) (27) (19) (39) (21) (18)
(16) (33) (11) (18) (25) (13) (15) (58) (16) (16) (28) (51) (38) (28) (19) (39) (21) (18)
(03) (04) (02) (04) (02) (04) (03) (03) (02) (02) (01) (03) (01) (19) (02) (03) (02) (02)
Therapeutic drug category 3 Analgesics, Antiplatelet agents Vitamin and mineral combinations Proton pump inhibitors Angiotensin converting enzyme inhibitors Bronchodilators Thyroid hormones Antihyperlipidemic agents Calcium channel blocking agents Beta-adrenergic blocking agents Antidiabetic agents Analgesics Antihyperlipidemic agents Nutraceutical products Analgesics Diuretics Angiotensin II inhibitors Anticonvulsants Diuretics Analgesics Vitamins Other
Category not applicable * Figure does not meet standards of reliability or precision 1 Based on Multum Lexicon terminology, drug name refects the active ingredient(s) of a drug provided, prescribed, or continued 2 Unknown includes drugs provided or prescribed that did not have either the new drug or continued drug checkboxes marked 3 Based on Multum Lexicon second-level therapeutic drug category (see https://wwwcernercom/solutions/drug-database) SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 27. Providers seen at office visits: United States, 2015 Type of provider
Number of visits in thousands 1 (standard error in thousands)
Percent of visits (standard error of percent)
All visits
990,808 (49,038)
Physician RN2 or LPN3 Physician assistant Nurse practitioner or midwife Mental health provider Other provider Blank
980,750 175,988 74,786 *30,845 *4,234 340,604 2,169
(48,769) (27,226) (19,105) (10,413) (1,425) (36,922) (586)
990 178 75 *31 *04 344 02
(02) (25) (18) (10) (01) (29) (01)
Category not applicable * Figure does not meet standards of reliability or precision 1 Combined total of individual providers exceeds “all visits” and “percent of visits” exceeds 100%, because more than one provider may be reported per visit The sample of visits was drawn from all scheduled visits to a sampled physician during the 1-week reporting period However, at 1% of these visits, the physician was not seen; instead, the patient saw another provider 2 RN is registered nurse 3 LPN is licensed practical nurse NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 28. Disposition of office visits: United States, 2015 Disposition
Number of visits in thousands 1 (standard error in thousands)
All visits
990,808 (49,038)
Return to referring physician Refer to other physician Return in less than 1 week Return in 1 week to less than 2 months Return in 2 months or greater Return at unspecifed time Return as needed (prn) Refer to emergency room/ Admit to hospital Other disposition Blank
29,287 81,808 35,022 305,110 270,959 55,298 226,859
Percent of visits (standard error of percent)
(4,597) (10,749) (4,282) (19,999) (17,023) (6,573) (26,647)
30 (05) 83 (09) 35 (04) 308 (16) 273 (14) 56 (06) 229 (22)
6,798 (1,403) 86,435 (12,309) 16,027 (3,000)
07 (01) 87 (12) 16 (03)
Category not applicable 1 Combined total of individual dispositions exceeds “all visits,” and “percent of visits” exceeds 100% because more than one disposition may be reported per visit SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 29. Time spent with physician: United States, 2015 Time spent with physician
Number of visits in thousands (standard error in thousands)
All visits
990,808
Visits at which no physician was seen Visits at which a physician was seen
10,058 (1,663) 980,750 (48,769)
Total 1
980,750
1–5 minutes 6–10 minutes 11–15 minutes 16–30 minutes 31–60 minutes 61 minutes and over
9,452 85,784 326,626 411,324 138,070 9,494
(2,339) (13,024) (27,844) (24,603) (11,430) (2,193)
Percent distribution (standard error of percent) 1000 10 (02) 990 (02) 1000 10 87 333 419 141 10
(02) (13) (21) (16) (10) (02)
Category not applicable 1 Time spent with physician was reported only for visits where a physician was seen Time spent with physician was missing for 304% of visits where a physician was seen Estimates presented include imputed values for missing data NOTE: Numbers may not add to totals because of rounding SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 30. Time spent with physician, by physician specialty: United States, 2015
Physician specialty
Mean time in minutes spent with physician (standard error of mean) 1
25th percentile
Median
75th percentile
All visits
228 (04)
144
192
292
Psychiatry Neurology Ophthalmology General surgery Cardiovascular diseases Internal medicine Urology Orthopedic surgery Pediatrics Otolaryngology General and family practice Obstetrics and gynecology Dermatology All other specialities
343 289 288 228 226 222 221 217 217 211 203 201 179 240
199 150 145 144 145 145 143 143 144 143 141 142 115 145
297 250 201 190 191 191 164 158 191 164 158 150 147 197
448 392 342 292 291 292 292 290 279 246 247 238 197 292
(17) (26) (29) (12) (12) (14) (09) (14) (11) (07) (08) (08) (08) (14)
1 Only visits where a physician was seen are included Time spent with physician was missing for 304% of visits where physician was seen Estimates presented include imputed values for missing data
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 31. Physician characteristics, by response status: United States, 2015
Physician characteristic1 All office-based physicians
Total in-scope Number of sample percent sampled in-scope distribution3 (weighted) physicians2
Responding Nonresponding physician percent physician percent distribution4 distribution5 (weighted) (weighted)
Physician response rate (weighted)6
Participants 7
Particpation rate (weighted) 8
4,910
1000
1000
1000
0296
1,737
0365
1,896 3,014
393 607
402 598
389 611
0303 0291
654 1,083
0353 0373
3,591 1,319
676 324
677 323
676 324
0296 0295
1,259 478
0362 0371
4,550 360
918 82
927 73
914 86
0299 0263
1,617 120
0368 0328
4,707 203
947 53
951 49
946 54
0297 0277
1,671 66
0364 0388
358 275 274 263 383 396 342 406 396 278 302 418 411 408
184 131 89 30 72 47 39 22 20 58 20 38 19 232
189 96 130 32 69 40 44 22 18 47 16 37 19 240
182 146 72 30 73 50 37 22 20 62 22 38 19 228
0303 0217 0432 0314 0284 0251 0338 0291 0277 0240 0239 0294 0288 0307
147 90 128 97 141 129 107 146 139 90 86 159 135 143
0403 0309 0504 0360 0359 0313 0360 0349 0376 0358 0284 0377 0338 0337
1,248 2,032 1,630
465 207 328
470 200 329
463 209 327
0299 0287 0297
491 715 531
0389 0340 0347
1,018 219 2,935 109 168 461
214 47 576 20 33 110
224 40 567 18 36 115
210 50 581 20 31 108
0310 0254 0291 0272 0326 0309
371 80 1,030 33 64 159
0425 0343 0346 0325 0397 0354
1,228 1,228 1,227 1,227
225 230 322 223
351 221 187 241
171 234 379 215
0463 0284 0172 0320
559 376 298 504
0528 0353 0209 0440
Age Under 50 years 50 years and over Sex Male Female Metropolitan status 9 MSA Non-MSA Type of doctor Doctor of medicine Doctor of osteopathy Physician specialty 10,11 General or family practice Internal medicine Pediatrics General surgery Obstetrics and gynecology Orthopedic surgery Cardiovascular diseases Dermatology Urology Psychiatry Neurology Ophthalmology Otolaryngology All other specialties Specialty type11 Primary care Surgical Medical Practice type Solo Two physicians Group or HMO12 Medical school or government Other Unclassifed Annual visit volume10 0–25 percentile 26–50 percentile 51–75 percentile 76–100 percentile
Characteristic information is from a combination of sources: the master fles of the American Medical Association, the American Osteopathic Association, and the NAMCS physician induction form In-scope physicians are those who verifed that they were nonfederal and involved in direct patient care in an office-based practice, excluding the specialties of radiology, pathology, and anesthesiology 3 Total in-scope sample physicians are those who were selected from (a) the master fles of the American Medical Association, and (b) the American Osteopathic Association In-scope determination was also used for inclusion in NAMCS 4 Responding physicians are those who were in-scope and participated fully in completion of PRFs or were unavailable to complete PRFs 5 Nonresponding physicians are those who were in-scope and participated minimally or refused to participate in the NAMCS 6 Values represent a response rate among physicians selected from the core office-based sample Numerator is the number of in-scope physicians from the physician sample who participated fully in NAMCS or who did not see any patients during their sampled reporting week Denominator is all in-scope physicians selected from the physician sample 7 Participants are physicians for whom at least one Patient Record form was completed (full and minimal responders) and also include physicians who saw no patients during their sample week 8 Participation rate is the number of participants divided by the number of in-scope physicians 9 MSA is metropolitan statistical area 10 Chi-square test of association is statistically signifcant (p<005) between physician response and indicated physician characteristic 11 Physician specialty type defned in the 2015 National Ambulatory Medical Care Survey Public Use Data File Documentation (see ftp://ftpcdcgov/pub/Health_Statistics/NCHS/Dataset_Documentation/ NAMCS/doc2015pdf) 12 HMO is health maintenance organization 1 2
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
National Ambulatory Medical Care Survey: 2015 State and National Summary Tables Table 32. State location of physician office, by response status: United States, 2015 Total in-scope sample Percent percent Percent distribution distribution distribution of of non(weighted) respondents 4 respondents 5
Region and state 1
Number of sampled in-scope physicians 2,3
Total
4,910
553
164
389
0296
1,737
0365
178 258 286 239 262
23 40 78 39 30
16 20 59 42 28
26 48 86 37 30
0204 0150 0225 0326 0278
52 59 90 79 97
0278 0234 0347 0382 0362
224 305 244 231 289
37 24 30 34 84
31 21 57 24 86
39 26 19 38 83
0248 0258 0558 0206 0305
67 107 129 70 96
0295 0297 0577 0264 0330
206 178 161 279 239 272
54 19 18 81 28 127
44 28 09 64 24 169
58 15 22 89 29 110
0243 0441 0152 0232 0261 0393
93 98 61 72 85 130
0436 0580 0324 0252 0352 0515
251 288 232 288
19 148 24 65
20 152 27 79
19 146 23 59
0302 0304 0329 0360
79 82 82 109
0359 0319 0330 0418
Response rate 6 (weighted)
Participants 7
Participation rate 8 (weighted)
Northeast Massachusetts New Jersey New York Pennsylvania Remainder states (CT, ME, NH, RI, VT) Midwest Illinois Indiana Michigan Ohio Remainder States (IA, KS, NE, ND, SD, MN, MO, WI) South Florida Georgia North Carolina Texas Virginia Remainder states (AR,AL,DE,DC,KY,MD,MS,LA,OK,SC,TN,WV) West Arizona California Washington Remainder states (CO, ID, MT, NV, NM, OR, UT, WY, AK, HI). . . . .
Chi-square test of association is statistically signifcant (p<005) between physician response and state location of office where most visits were seen In-scope sample physicians are those confrmed during the survey to be nonfederal and involved in direct patient care in an office-based practice, excluding the specialities of radiology, pathology, and anesthesiology 3 Total in-scope sample physicians are those who were selected from (a) the master fles of the American Medical Association, and (b) the American Osteopathic Association In-scope determination was also used for inclusion in NAMCS 4 Responding physicians are those who were in-scope and participated fully in completion of PRFs or who saw no patients during their sample week 5 Non-responding physicians are those physicians who were in-scope and participated minimally or refused to participate in the NAMCS 6 Values represent a response rate among physicians selected from the office-based sample Numerator is the number of in-scope physicians from the physician sample who participated fully in NAMCS or who did not see any patients during their sampled reporting week Denominator is all in-scope physicians selected from the physician sample 7 Participants are physicians for whom at least one Patient Record form was completed (full and minimal responders) and also include physicians who saw no patients during their sample week 8 Participation rate is the number of participants divided by the number of in-scope physicians 1 2
SOURCE: NCHS, National Ambulatory Medical Care Survey, 2015
U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • National Center for Health Statistics
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