TY - JOUR T1 - National Trends in Primary Care Visit Use and Practice Capabilities, 2008-2015 JF - The Annals of Family Medicine JO - Ann Fam Med SP - 538 LP - 544 DO - 10.1370/afm.2474 VL - 17 IS - 6 AU - Aarti Rao AU - Zhuo Shi AU - Kristin N. Ray AU - Ateev Mehrotra AU - Ishani Ganguli Y1 - 2019/11/01 UR - http://www.annfammed.org/content/17/6/538.abstract N2 - PURPOSE Recent evidence shows a national decline in primary care visit rates over the last decade. It is unclear how changes in practice—including the use and content of primary care visits—may have contributed.METHODS We analyzed nationally representative data of adult visits to primary care physicians (PCPs) and physician practice characteristics from 2007–2016 (National Ambulatory Medical Care Survey). United States census estimates were used to calculate visits per capita. Measures included visit rates per person year; visit duration; number of medications, diagnoses, and preventive services per visit; percentage of visits with scheduled follow-up; and percentage of physicians with practice capabilities including an electronic medical record (EMR).RESULTS Our weighted sample represented 3.2 billion visits (83,368 visits, unweighted). Visits per capita declined by 20% (−0.25 visits per person, 95% CI, –0.32 to –0.19) during this time, while visit duration increased by 2.4 minutes per visit (95% CI, 1.1-3.8). Per visit, PCPs addressed 0.30 more diagnoses (95% CI, 0.16-0.43) and 0.82 more medications (95% CI, 0.59-1.1), and provided 0.24 more preventive services (95% CI, 0.12-0.36). Visits with scheduled PCP followup declined by 6.0% (95% CI, –12.4 to 0.46), while PCPs reporting use of EMR increased by 44.3% (95% CI, 39.1-49.5) and those reporting use of secure messaging increased by 60.9% (95% CI, 27.5-94.3).CONCLUSION From 2008 to 2015, primary care visits were longer, addressed more issues per visit, and were less likely to have scheduled follow-up for certain patients and conditions. Meanwhile, more PCPs offered non–face-to-face care. The decline in primary care visit rates may be explained in part by PCPs offering more comprehensive in-person visits and using more non–face-to-face care. ER -