Article

Ambulatory Medical Care Utilization Estimates for 2006

U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health Care Statistics, Hyattsville, MD 20782, USA.
National health statistics reports 09/2008; 8(8):1-29.
Source: PubMed

ABSTRACT This report presents statistics on ambulatory care visits to physician offices, hospital outpatient departments (OPDs), and hospital emergency departments (EDs) in the United States in 2006. Ambulatory medical care utilization is described in terms of patient, practice, facility, and visit characteristics.
Data from the 2006 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) were combined to produce annual estimates of ambulatory medical care utilization.
Patients in the United States made an estimated 1.1 billion visits to physician offices and hospital OPDs and EDs, a rate of 381.9 visits per 100 persons annually. The overall visit rate was not significantly different for white and black persons. However, black persons had higher visit rates than white persons to hospital OPDs and EDs and lower visit rates to office-based surgical and medical specialists. Visit distribution by ambulatory care setting differed by poverty level in the patient's ZIP Code of residence, with higher proportions of visits to hospital OPDs and EDs as poverty levels increased. Between 1996 and 2006, visit rates to medical specialty offices climbed overall by 29 percent, with a significant increase noted for white patients but not black patients. The rate of OPD visits jumped from 25.4 visits per 100 persons in 1996 to 34.7 in 2006, whereas ED visits during the same period increased from 34.1 to 40.5 per 100 persons. About 18.3 percent of all ambulatory care visits in 2006 were for nonillness or noninjury conditions, such as routine checkups and pregnancy exams. Seven in ten ambulatory care visits had at least one medication provided, prescribed, or continued in 2006, for a total of 2.6 billion drugs overall. Analgesics were the most common therapeutic category, accounting for 13.6 drugs per 100 drugs prescribed, and they were most often utilized at primary care and ED visits. The percentage of visits at which medication was prescribed increased significantly in most settings between 1996 and 2006.

0 Followers
 · 
121 Views
  • Source
    • "Urinary Tract Infections (UTIs) are among the most common infections that necessitate a hospital visit; some estimates claim UTI to be the second most common infection after the common cold, and being the primary cause of over eight million annual hospital appointments (Schappert and Rechtsteiner, 2008). The infection can be asymptomatic where there is no apparent indication of the infection, or can degenerate into a symptomatic version, with the usual symptoms being frequent and/or painful urination accompanied with abdominal pain and cloudy or bloody rancid-smelling urine. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Urinary Tract Infection (UTI) is a globally widespread human infection caused by an infestation of uropathogens. Eventhough, Escherichia coli is often quoted as being the chief among them, Staphylococcus aureus involvement in UTI especially in gestational UTI is often understated. Staphylococcal accessory regulator A (SarA) is a quorum regulator of S. aureus that controls the expression of various virulence and biofilm phenotypes. Since SarA had been a focussed target for antibiofilm agent development, the study aims to develop a potential drug molecule targeting the SarA of S. aureus to combat biofilm associated infections in which it is involved. In our previous studies, we have reported the antibiofilm activity of SarA based biofilm inhibitor, (SarABI) with a 50% minimum biofilm inhibitory concentration (MBIC50) value of 200 μg/mL against S. aureus associated with vascular graft infections and also the antibiofilm activity of the root ethanolic extracts of Melia dubia against uropathogenic E. coli. In the present study, in silico design of a hybrid molecule composed of a molecule screened from M. dubia root ethanolic extracts and a modified SarA based inhibitor (SarABIM) was undertaken. SarABIM is a modified form of SarABI where the fluorine groups are absent in SarABIM. Chemical synthesis of the hybrid molecule, 4-(Benzylamino)cyclohexyl 2-hydroxycinnamate (henceforth referred to as UTI Quorum-Quencher, UTIQQ) was then performed, followed by in vitro and in vivo validation. The MBIC50 and MBIC90 of UTIQQ were found to be 15 and 65 μg/mL, respectively. Confocal laser scanning microscopy (CLSM) images witnessed biofilm reduction and bacterial killing in either UTIQQ or in combined use of antibiotic gentamicin and UTIQQ. Similar results were observed with in vivo studies of experimental UTI in rat model. So, we propose that the drug UTIQQ would be a promising candidate when used alone or, in combination with an antibiotic for staphylococcal associated UTI.
    Frontiers in Microbiology 08/2015; DOI:10.3389/fmicb.2015.00832 · 3.94 Impact Factor
  • Source
    • "For the ADE question providers are instructed to Mark " Adverse effect of medical/surgical care or adverse effect of medicinal drug if the visit was due to any type of injury, poisoning, or adverse effect of medical treatment. " (Center for Disease Control) We applied techniques utilized by prior studies to merge these data sets (Bourgeois et al. 2009; Burris, and Werler; Schappert, and Rechtsteiner 2008). Visit-level data includes geographic region of Northeast, South, Midwest, West; outpatient versus ED; and primary care vs. non-primary care visit (for outpatient visits only). "
    [Show abstract] [Hide abstract]
    ABSTRACT: To estimate the incidence of adverse drug events (ADEs) associated with health care visits among U.S. adults across all ambulatory settings. We analyzed data from two nationally representative probability sample surveys: the National Ambulatory Medical Care Survey and the National Hospital and Ambulatory Medical Care Survey. From 2005 to 2007, the presence of an ADE was specifically defined, requested, and recorded in these surveys. Secondary data analysis. An estimated 13.5 million ADE-related visits occurred between 2005 and 2007 (0.5 percent of all visits), the large majority (72 percent) occurring in outpatient practice settings, and the remaining in emergency departments. Older patients (age ≥65 years) had the highest age-specific ADE rate, 3.8 ADEs per 10,000 persons per year. In adjusted analyses of outpatient visits, there was an increased odds of an ADE-related visit with increased medication burden (odds ratio [OR] for six to eight medications compared with no medications, OR 3.83 [2.20, 6.65]), and increased odds of ADEs associated with primary care visits compared with specialty visits (OR 2.22 [1.70, 2.89]). Approximately 4.5 million ambulatory visits related to ADEs occur each year, the majority of these in outpatient office practices. A greater focus on ADE prevention and detection is warranted among patients receiving multiple medications in primary care practices.
    Health Services Research 05/2011; 46(5):1517-33. DOI:10.1111/j.1475-6773.2011.01269.x · 2.49 Impact Factor
  • Source
    • "For example, national data for 2007-2008 indicate that 50% of black women and 43% of Hispanic women have a BMI ≥ 30 kg/m 2 , compared to 33% of white women [1]. The numbers of primary care office visits for African American and Hispanic adults are substantial, in spite of relatively lower rates of health insurance coverage [8] [9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Primary care offices are critical access points for obesity treatment, but evidence for approaches that can be implemented within these settings is limited. The Think Health! (¡Vive Saludable!) Study was designed to assess the feasibility and effectiveness of a behavioral weight loss program, adapted from the Diabetes Prevention Program, for implementation in routine primary care. Recruitment of clinical sites targeted primary care practices serving African American and Hispanic adults. The randomized design compares (a) a moderate-intensity treatment consisting of primary care provider counseling plus additional counseling by an auxiliary staff member (i.e., lifestyle coach), with (b) a low-intensity, control treatment involving primary care provider counseling only. Treatment and follow up duration are 1 to 2 years. The primary outcome is weight change from baseline at 1 and 2 years post-randomization. Between November 2006 and January 2008, 14 primary care providers (13 physicians; 1 physician assistant) were recruited at five clinical sites. Patients were recruited between October 2007 and November 2008. A total of 412 patients were pre-screened, of whom 284 (68.9%) had baseline assessments and 261 were randomized, with the following characteristics: 65% African American; 16% Hispanic American; 84% female; mean (SD) age of 47.2 (11.7) years; mean (SD) BMI of 37.2(6.4) kg/m(2); 43.7% with high blood pressure; and 18.4% with diabetes. This study will provide insights into the potential utility of moderate-intensity lifestyle counseling delivered by motivated primary care clinicians and their staff. The study will have particular relevance to African Americans and women.
    Contemporary clinical trials 11/2010; 32(2):215-24. DOI:10.1016/j.cct.2010.11.002 · 1.99 Impact Factor
Show more

Preview

Download
2 Downloads
Available from