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. DOI: 10.1037/e587152010-001
Source: PubMed


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.

Full-text preview

Available from:
  • Source
    • "In many model pathogens (e.g., Salmonella, Vibrio, Yersinia), effector proteins interrupting host cell signaling, kinase activation, cytoskeletal rearrangement, post-translational modification, and other processes are delivered to the target cell via type III secretion. Here, we will outline the distinct immune modulation strategies of uropathogenic Escherichia coli (UPEC), the chief cause of urinary tract infections[5,6]. Unlike other pathotypes of E. coli that modulate host responses (e.g., enterohemorrhagic or enteropathogenic), UPEC do not encode type III secretion machinery[7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Uropathogenic Escherichia coli (UPEC) cause the majority of community-onset urinary tract infections (UTI) and represent a major etiologic agent of healthcare-associated UTI. Introduction of UPEC into the mammalian urinary tract evokes a well-described inflammatory response, comprising pro-inflammatory cytokines and chemokines as well as cellular elements (neutrophils and macrophages). In human UTI, this inflammatory response contributes to symptomatology and provides means for diagnosis by standard clinical testing. Early in acute cystitis, as demonstrated in murine models, UPEC gains access to an intracellular niche that protects a population of replicating bacteria from arriving phagocytes. To ensure the establishment of this protected niche, UPEC employ multiple strategies to attenuate and delay the initiation of host inflammatory components, including epithelial secretion of chemoattractants. Recent work has also revealed novel mechanisms by which UPEC blunts neutrophil migration across infected uroepithelium. Taken together, these attributes distinguish UPEC from commensal and nonpathogenic E. coli strains. This review highlights the unique immune evasion and suppression strategies of this bacterial pathogen and offers directions for further study; molecular understanding of these mechanisms will inform the development of adjunctive, anti-virulence therapeutics for UTI.
    Full-text · Article · Jan 2016 · Pathogens
  • Source
    • "Sandra M. Fox-Moon and Mark E. Shirtliff University of Maryland, Baltimore, MD, USA p0010 Urinary tract infections (UTIs), in particular catheterassociated urinary tract infections (CAUTIs), are the most common healthcare-associated infections globally, accounting for up to 40% of nosocomial infections[1]and are responsible for about 8.1 million visits to healthcare faculties annually[2]. These infections are the most frequently documented source of bacteraemia in the elderly and the most common cause of infections among nursing home residents[3]. "

    Full-text · Chapter · Dec 2015
  • 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.
    Full-text · Article · Aug 2015 · Frontiers in Microbiology
Show more