Adolescent Primary Care Visit Patterns

James D. Nordin; Leif I. Solberg; Emily D. Parker

doi:10.1370/afm.1188

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Figure 1.
Mean number of nonpreventive care visits by age and insurance type (commercial or government) in a sample of adolescents between the ages of 11 and 18 years, HealthPartners, 1998–2007.

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Table 1.

Patterns in Health Care Utilization and Insurance Among Adolescents Aged 13 to 18 With Continuous Health Insurance Enrollment, HealthPartners, 1997–2008

	Nonpreventive Care			Preventive Care, %
Visit Characteristics	Commercial, %	Government, %		Commercial, %	Government, %
Note: Among adolescents between the ages of 13 and 18 years with continuous enrollment (333 or more days between birthdays) for 4 or more years.
^aComparing number of total preventive or nonpreventive care visits between insurance types.
Number of visits
0	8	15		30	30
1	9	13		41	36
2	10	10		22	21
3	9	9		5	9
4	9	8		1	2
5 to 10	34	25		0	0
>10	20	20		0	0
	No.	No.	P Value^a	No.	No.	P Value
Mean total visits, No.	6.83	6.41	.028	1.07	1.18	<.001
Mean visit rate per year	1.50	1.47	.570	0.23	0.27	<.001

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Table 2.

Adjusted Mean Number of Preventive and Nonpreventive Care Visits Among Continuously Enrolled Adolescents Between the Ages of 13 and 18 Years, HealthPartners 1998–2007.

Characteristic	Preventive Care Visits Mean No. (SD)	PValue	Nonpreventive Care Visits Mean No. (SD)	PValue
Note: Among adolescents with continuous enrollment (333 or more days between birthdays) for 4 or more years. Regression model adjusted mutually for insurance type and sex.
Insurance type
Commercial	1.070 (0.947)	<.001	6.829 (6.756)	<.005
Government	1.1781 (1.094)		6.412 (8.009)
Sex
Female	1.162 (0.985)	<.001	7.729 (7.514)	<.001
Male	0.991 (0.916)		5.918 (5.937)

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The Article in Brief

Adolescent Primary Care Visit Patterns

James D. Nordin , and colleagues

Background The American Academy of Pediatrics and the American Medical Association recommend annual preventive services visits for all patients aged 11 to 21 years. Little is known, however, about how often adolescents actually visit a medical office or their reasons for visiting. This study set out to quantify the type and frequency of adolescent medical visits.

What This Study Found Less than 2 percent of those studied met the APA and AMA recommendations. One-third of teenagers with four or more years of continuous health plan enrollment had no preventive care visits from age 13 through 17 years, and another 40 percent had only one such visit, despite having insurance without a deductible or co-pay for preventive care. Nonpreventive care visits were more frequent in all age-groups, averaging about one per year at 11 years, climbing to about 1.5 per year at 17 years.

Implications

Adolescent medical visits for nonpreventive care offer an opportunity to provide preventive care services. Systems should be set up to make that possible, even in busy practices with short clinician visits.