Article Figures & Data
Figures
- Figure 1.
Distribution of all primary care visits by number of primary care visits in 1997.
- Figure 2.
Persistent high primary care use by model score for adult and pediatric patients in 1998.
- Figure 3.
Results of applying prediction model scores to different samples (1998 vs 1999).
Tables
- Table 1.
Comparison of High-Visit Patients With Remaining Eligible and Persistently High-Visit Patients With Not Persistently High-Visit Patients on Demographic and Visit Characteristics, 1997
Characteristics High-Visit Patients Remaining Patients Number 987 53,087 Demographic characteristics Female, % 83.2 52.0 Pediatric, % 14.0 30.2 Employee, % 61.9 36.1 Age, mean years (SD) 31.3 (15.6) 30.7 (19.8) Visit characteristics ADGs, mean number (SD) 7.3 (3.4) 3.5 (2.8) Excluding nonusers 4.0 (2.7) With ≥5 ADGs 77.4 30.8 Persistently High- Visit Patients Not Persistently High- Visit Patients ADG = ambulatory diagnosis group. Number 173 756 Demographic characteristics Female, % 71.1 86.1 Pediatric, % 18.5 13.5 Employee, % 63.0 61.8 Age, mean years (SD) 34.2 (18.6) 30.1 (14.3) Visit characteristics ADGs, mean number (SD) 9.1 (3.5) 7.0 (3.2) With ≥ 5 ADGs 92.5% 74.6% Number of days from first to last visit 293 (55) 266 (58) - Table 2.
Results of Logistic Regression Model Predicting Persistence of High Primary Care Use Among Patients With ≥ 10 Primary Care Visits in Year 1
Variable Odds Ratio 95% CI Assigned Persistence Score CI = confidence interval; ADG = ambulatory diagnosis groups. ADG 11 – Chronic medical–unstable 2.07 (1.37, 3.12) +2 ADG 23 – Psychosocial: time limited, minor 1.56 (1.01, 2.41) +1 ADG 26 – Signs/symptoms: minor 1.51 (1.02, 2.22) +1 ADG 30 – See and reassure 2.06 (1.24, 3.41) +2 ADG 33 – Pregnancy 0.17 (0.10, 0.28) −4
Supplemental Appendixes
Supplemental Appendix 1. Most Frequent Diagnoses Among Patients With a High Use of Primary Care and Among Remaining Patients, 1997; Supplemental Appendix 2. Persistence of High Primary Care Use by Age-group.
Files in this Data Supplement:
- Supplemental data: Appendix 1 - PDF file, 1 page, 68 KB
- Supplemental data: Appendix 2 - PDF file, 1 page, 57 KB
The Article in Brief
Background: Previous research has shown that a small percentage of patients incur a high amount of health care costs overall. This study set out to better understand the characteristics of patients who use high levels of primary care resources.
What This Study Found: During 1 year, 2% of patients accounted for 18% of visits to their primary care doctors and 11% of total paid insurance claims. Patients who make frequent doctor visits include those with unstable chronic medical conditions (such as rheumatoid arthritis), conditions involving the mind and body (such as stress), and minor medical symptoms (such as headache).
Implications:
� Many patients in this study made repeated doctor visits for relatively minor medical conditions. They are therefore �overserviced� but �underserved� by the medical system.
� Although the medical system focused on easing their physical symptoms, such patients might benefit more from social support, stress reduction programs, psychological treatment, and attention to nonmedical issues.
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