Utilization, Individuals, and Expenditures per 1,000 Individuals per Month
| Service | 1996–1997, Value (95%CI) | 2011–2012, Value (95% CI) | Difference | P Value |
|---|---|---|---|---|
| Utilization, no. of services | ||||
| Total visits | 560.9 (530.0 to 591.8) | 568.7 (540.3 to 597.0) | 7.8 (−34.2 to 49.7) | .72 |
| Outpatient visits | 535.4 (505.6 to 565.2) | 542.8 (515.5 to 570.1) | 7.4 (−33.1 to 47.8) | .72 |
| Outpatient physician visits | 293.8 (277.8 to 309.8) | 282.5 (269.0 to 295.9) | −11.3 (−32.2 to 9.6) | .29 |
| Primary care physician visitsa | 134.6 (127.8 to 141.5) | 119.8 (113.9 to 125.6) | −14.9 (−23.9 to −5.9) | .001 |
| Specialty physician visitsa | 158.8 (150.2 to 167.4) | 159.1 (150.6 to 167.5) | 0.27 (−15.5 to 16.1) | .97 |
| Prescribed medicationb | 1,092.6 (924.1 to 1,261.1) | 1,541.0 (1,253.1 to 1,828.9) | 488.4 (127.2 to 769.5) | .008 |
| Dental visits | 89.9 (83.9 to 95.9) | 74.9 (70.8 to 79.0) | −15.0 (−22.3 to −7.7) | .001 |
| PA/NP/nurse/NMW visits | 31.9 (28.4 to 35.4) | 28.1 (25.0 to 31.2) | −3.8 (−8.5 to 0.9) | .11 |
| Therapy visits | 35.8 (31.9 to 39.7) | 51.6 (46.3 to 56.9) | 15.8 (9.2 to 22.4) | <.001 |
| Treatment visits | 29.0 (26.1 to 31.8) | 36.1 (33.1 to 39.0) | 7.1 (3.0 to 11.2) | .007 |
| Optometry/podiatry visits | 5.1 (4.5 to 5.7) | 8.8 (7.8 to 9.8) | 3.6 (2.5 to 4.8) | <.001 |
| Alt/comp medicine visits | 18.8 (16.0 to 21.6) | 39.4 (35.1 to 43.7) | 20.6 (15.4 to 25.7) | <.001 |
| Inpatient visits | 8.4 (7.8 to 8.9) | 7.6 (7.2 to 8.1) | −0.7 (−1.5 to 0.0) | .045 |
| Emergency department visits | 17.5 (16.4 to 18.6) | 18.8 (17.8 to 19.9) | 1.3 (−0.2 to 2.8) | .10 |
| Home health visits | 15.1 (13.3 to 16.9) | 11.3 (10.1 to 12.5) | −3.8 (−5.9 to −1.6) | .006 |
| Individuals, no. | ||||
| Total visits | 285.3 (270.3 to 300.3) | 290.1 (277.1 to 303.1) | 4.8 (−15.0 to 24.7) | .63 |
| Outpatient visits | 278.0 (263.3 to 292.8) | 282.5 (269.7 to 295.2) | 4.5 (−15.1 to 24.0) | .65 |
| Outpatient physician visits | 186.8 (177.1 to 196.4) | 187.6 (179.2 to 196.1) | 0.8 (−12.0 to 13.7) | .90 |
| Primary care physician visitsa | 112.5 (106.9 to 118.1) | 103.2 (98.4 to 108.0) | −9.3 (−16.7 to −1.9) | .01 |
| Specialty physician visitsa | 100.5 (95.2 to 105.8) | 102.0 (97.0 to 107.0) | 1.46 (−5.8 to 8.7) | .69 |
| Prescribed medicationb | 427.4 (375.7 to 479.0) | 492.2 (408.4 to 576.1) | 64.9 (−29.9 to 159.7) | .17 |
| Dental visits | 73.6 (68.7 to 78.5) | 65.1 (61.5 to 68.7) | −8.5 (−14.5 to −2.4) | .007 |
| PA/NP/nurse/NMW visits | 19.8 (18.4 to 21.3) | 19.9 (18.2 to 21.6) | 0.1 (−2.2 to 2.3) | .93 |
| Therapy visits | 10.8 (9.7 to 12.0) | 16.5 (15.1 to 17.9) | 5.6 (3.8 to 7.4) | <.001 |
| Treatment visits | 19.0 (17.5 to 20.5) | 26.3 (24.5 to 28.1) | 7.3 (5.0 to 9.5) | <.001 |
| Optometry/podiatry visits | 4.5 (4.1 to 5.0) | 8.0 (7.1 to 8.8) | 3.4 (2.5 to 4.4) | <.001 |
| Alt/comp medicine visits | 7.7 (6.5 to 8.8) | 18.6 (16.5 to 20.6) | 10.9 (8.5 to 13.2) | <.001 |
| Inpatient visits | 7.7 (7.2 to 8.2) | 7.2 (6.7 to 7.6) | −0.6 (−1.2 to 0.1) | .09 |
| Emergency department visits | 14.6 (13.7 to 15.5) | 14.8 (14.0 to 15.6) | 0.2 (−1.1 to 1.4) | .78 |
| Home health visits | 11.8 (10.5 to 13.2) | 9.7 (8.7 to 10.6) | −2.2 (−3.8 to −0.5) | .009 |
| Expenditures, $c | ||||
| Total visits | 245,900 (231,523 to 260,276) | 361,784 (342,354 to 381,213) | 115,884 (91,714 to 140,054) | <.001 |
| Outpatient visits | 104,972 (99,010 to 110,934) | 153,141 (144,316 to 161,966) | 48,169 (37,519 to 58,819) | <.001 |
| Outpatient physician visits | 51,094 (48,056 to 54,131) | 83,246 (78,090 to 88,403) | 32,153 (26,169 to 38,138) | <.001 |
| Primary care physician visitsa | 19,357 (18,221 to 20,493) | 19,706 (18,623 to 20,788) | 349 (−1,220 to 1,918) | .66 |
| Specialty physician visitsa | 45,687 (42,783 to 48,591) | 62,450 (57,981 to 66,919) | 16,763 (11,434 to 22,092) | <.001 |
| Prescribed medicationb | 30,691 (28,893 to 32,488) | 79,580 (72,723 to 86,437) | 48,889 (41,801 to 55,978) | <.001 |
| Dental visits | 19,580 (18,153 to 21,007) | 22,986 (21,355 to 24,617) | 3,406 (1,239 to 5,572) | .002 |
| PA/NP/nurse/NMW visits | 3,344 (2,763 to 3,924) | 5,287 (4,490 to 6,084) | 1,943 (957 to 2,929) | .001 |
| Therapy visits | 5,243 (4,512 to 5,975) | 8,048 (7,066 to 9,030) | 2,804 (1,580 to 4,029) | <.001 |
| Treatment visits | 7,350 (6,662 to 8,038) | 12,017 (10,779 to 13,254) | 4,666 (3,250 to 6,082) | <.001 |
| Optometry/podiatry visits | 731 (619 to 843) | 1,435 (1,275 to 1,595) | 704 (509 to 899) | <.001 |
| Alt/comp medicine visits | 1,149 (962 to 1,336) | 3,121 (2,708 to 3,533) | 1,972 (1,518 to 2,425) | <.001 |
| Inpatient visits | 93,808 (84,707 to 102,909) | 107,007 (98,132 to 115,881) | 13,199 (487 to 25,910) | .04 |
| Emergency department visits | 7,753 (6,979 to 8,527) | 14,544 (13,568 to 15,520) | 6,791 (5,546 to 8,036) | <.001 |
| Home health visits | 14,155 (11,842 to 16,468) | 14,469 (12,018 to 16,921) | 314 (−3,056 to 3,684) | .85 |
Alt/comp=alternative/complementary; NMW=nurse midwife; NP=nurse practitioner; PA=physician assistant.
↵a Primary and specialty physician visits in 2002–2003 were compared with those in 2011–2012. The first year that physician specialty was reported in the Medical Expenditure Panel Survey (MEPS) was 2002.
↵b Prescribed medication expenditure data came from the 1996–1997 and 2011–2012 MEPS. The utilization and individual prescribed medication data were from the 1999–2000 and 2011–2012 National Health and Nutrition Examination Survey (NHANES).
↵c Expenditures are inflation adjusted (using the Consumer Price Index) to 2012 US dollars. Expenditure numbers do not add up to the total because of the exclusion of other medical expenditures.
Note: Total prescribed medication use and the number of individuals who used a prescribed medication came from the NHANES. All other data came from the MEPS.