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Physich9n Visits:VokwIP3eand IntervalShe@ Last viii,United States, 1980

Estimates of utili~ptio~ of physician services

by volume of.yisit$, $ime interval since last

physician visit and number of visits per

person par year are presented by selected

demographic, socioeconomic, and health

status characteristics. Statistics on the type

of physician visited, the place of visit,

type of service rendered, and the conditions

causing visita for diagnosis or treatment are

also included.

Data From tha National Health SurveySeries 10, Number 144

DHHS Publication No. (PHS) 83-1572

U.S. Department of Health and Human Services

Public Health Service

National Center for Health Statistics

Hyattsville, Md.

June 1983

COPYRIGHT INFORMATION

All material appearing in this report is in the public domain and may be

reproduced or copied without permission; citation as to source, however,

is appreciated.

SUGGESTED CITATION

National Center for Health Statistic, J. G. Collins: Physician visits, volume

and interval since last visit, United Statea, 1980. Series 10, No. 144.

DHHS Pub. No. (PHS) 83-1572. Public Health Service. Washington.

U.S. Government Printing Office, June 1983.

Libraryof Congreae Cataloging in Publication Data

Collins, John Gary.

Physician visits.

(Vital & health statistics. Series 10r Data from the national health

survey ; no. 144) (DHHS publication ; no. (PHS) 83–1 572)

“Rev. 212/83”- P.

Supt. of Dots. no.: HE 20.6209:10/144:

1. Physician services utilization—United Statea—Statistics.

2. United States—Statistics, Medical. 1. National Center for Health

Statistics (U. S.) II. Title. Ill. Series: Vital and health statistics. Series 10,

Data from the national health survey ; no. 144. IV. Series: DHHS

publication ; no. (PHS) 83-1572.

RA407.3.A346 no. 144 [RA41O.7] 312’.0973s 83-600091

ISBN 0-8406 –0276-6 [362.1 ‘72’0973]

For sale by the Superintendent of Doeaments, U. S. Government Printing 05ce, Washington, D. C!.20402

National Center for Health Statistics

MANNING FEINLEIB, M.D., Dr,P.H., Director

ROBERT A. ISR4EL, Deputy Director

JACOB J. FELDMAN, Ph.D., Associate Director forAnalysis and Epidemiology

GARRIE J. LOSEE, Associate Directorjior DataProcessing and Services

ALVAN O. ZARATE, Ph.D., Assistant Director forInternational Statistics

E. EARL BRYANT, Associate Directorfor Interviewand Examination Statistics

ROBERT L. QUAVE, Acting Associate Director forManagement

GAIL F. FISHER, Ph.D., Acting Associate Directorfor Program Planning, Evaluation, and Coordination

MONROE G. SIRKEN, Ph.D., Associate Director forResearch and Methodology

PETER L. HURLEY, Associate Directorfor Vital andHealth Care Statistics

ALICE HAYWOOD, Information Oflcer

Interview and Examination Statistics Program

E. EARL BRYANT, Associate Director

MARY GRACE KOVAR, Dr.P.H., Special Assistantfor Data Policy and Analysis

PAUL D. WILLIAMS, ChieJ Data Applications andResearch Staff

Division of Health Interview Statistics

ROBERT R. FUCHSBERG, Director

OWEN T. THORNBERRY, JR., Ph.D., Deputy Director

CLINTON E. BURNHAM, Chiej Illness and DisabilityStatistics Branch

ROBERT A. WRIGHT, Chief Utilization andExpenditure Statistics Branch

STEWART C. RICE, JR., ChieJ Survey Planning andDevelopment Branch

NELMA B. KEEN, ChieJ Computer Systems andProgramming Branch

Cooperation of the U.S. Bureau of the Census

Under the legislation establishing the National Health Interview Survey,the Public Health Service is authorized to use, insofar as possible, the swvicesor facilities of other Federal, State, or private agencies.

In accordance with specifications established by the Division of HealthInterview Statistics, the Bureau of the Census, under a contractual arrangement,participated in planning the survey and collecting the data.

Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sources and limitations ofthe data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Comments on the data....,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Comparison of NHISwith two other NCHS surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Trends in physician visits ..,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interval since last physician visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Frequency distribution ofvisits in pastyear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Volume of physician visits,,,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Place ofvisit and type ofphysician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Type of service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Conditions causing visits fordiagnosis ortreatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

List of detailed tables . ...,...,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Appendixes

1. Technical notes on methods.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Il. Definitions of certain terms used in this report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ill. Questionnaire items relatingto doctorvisits—1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

List of text figures

1,

2.

3.

4.

5.

6.7.

8.

9:

Number of physician visits peryear: United States, 1967-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average numberof physician visits per person peryear: United States, 1967-80. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent of persons with 5 physician visits or more in the 12 months priorto interview, by family income: United

States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Numberofphysician visits perperson per year, byage and sex: United States, 1980. . . . . . . . . . . . . . . . . . . . . . . . . . .

Number ofphysician visits perperson per year, by age and selected family income groups: United States, 1980 ..,.

Numberofphysician visits perperson per year, byage and race: United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . .

Numberofphysician visits perperson peryear, byage and degree ofactivity limitation: United States, 1980 . . . . . . .

Numberof physician visits per person peryear, byage and perceived health status: United States, 1980 . . . . . . . . . .

Numberofphysician visits perperson peryear, byage and bed days in the last 12 months: United States, 1980....

1

2

3

4

5

7

13

16

20.

24

26

27

29

31

70

77

83

8

9

19

20

21

21

22

22

23

...Ill

List of text tables

A.

B.

c.

D.

E.

F.

G.

H.

J.

K.

Number of physician visits per person per year, by selected characteristics: United States, selected years. . . . . . . . , .

Percent of population with 1 physician visit or more within a year of interview, by selected characteristics: United

States, selected years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of physician visits, by place ofvisit: United States, selected years . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of persons by time interval since last physician visit, according to selected socioeconomic and

demographic characteristics: United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percentdistribution ofpersons bytime interval since last physician visit, according to selected health status character-

istics, place of residence, and geographic region: United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of personsby number of physician visitsin past year, according to selected demographic and

socioeconomic characteristics: United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution ofpersons by number ofphysicianvisits in pastyear, according toselected health status character-

istics, place ofresidence, and geographic region: United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number andpercent distribution ofphysician visits, byplace ofvisit: United States, l98O . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of physician visits, by selected types of physician: United States, selected years. . . . . . . . . . . . . .

Percent distribution of physician visits for diagnosis or treatment by condition causing visit, according to place of visit:

United States, 1980. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10

11

12

14

15

17

18

24

25

27

Symbols

.-. Data not available

. . . Category not applicable

Quantity zero

0.0 Quantity more than zero but less than

0.05

z Quantity more than zero but less than 500where numbers are rounded to thousands

* Figure does not meet standards ofreliability or precision (more than

30-percent relative standard error)

# Figure suppressed to comply withconfidentiality requirements

iv

Physician Visits:Volume and Interval SinceLast Visitby John Gary Collins, M. B.A,, Division of Health InterviewStatistics

Introduction

In this report, data on the utilization of physicianservices by the civilian noninstitutionalized populationof the United States are presented, based on informa-tion collected by the National Center for Health Sta-tistics in its 1980 National Health Interview Survey.Data are presented on the volume of visits, and on thetime interval since a doctor of medicine or osteopathicphysician was last consulted either in person or bytelephone for treatment or advice. Information is also

provided on the type of physician visited, the place ofvisit, type of service rendered, and the conditions causingvisits for diagnosis or treatment. Selected demographic,socioeconomic, and health status characteristics of thepopulation are cross tabulated by these physician visitvariables to provide an indepth picture ofphysician visitutilization. The estimated volume of physician visitsand the number of visits per person per year, as pre-sented in this report, exclude the visits to inpatients inhospitals. Trend data comparing similar Health Inter-view Survey data collected during earlier survey yearsare also included.

Highlights

The following statements briefly summarize thedata contained in this report:

● In 1980, an estimated 75 percent of the civiliannoninstitutionalized population was seen by ortalked to a physician during the 12-month periodprior to the week of interview.

● About 21 percent of the population had five physi-cian visits or more during that period. These highutilizers accounted for approximately two-thirds ofthe total physician visits. Exclusive of visits to in-patients in hospitals, but inclusive of telephone con-sultations, there were about 1.04 billion visits in1980, which amounted to an annual rate of 4.8 visitsper person. This rate has been relatively stable overthe last several years, although it is down slightlyfrom the 5.1 visits per person reported in the 1975survey.

● About 68 percent of all physician visits took place ina doctor’s ofilce, 13 percent took place in a hospitalclinic or emergency room, and 12 percent were bytelephone consultation. Only 0.6 percent of physi-cian visits were to patient’s homes in 1980.

The percent of visits to general practitioners hasdecreased from about 63 percent in the July 1966-June 1967 survey year to about 47 percent in 1980.In the same period, the percent of visits to internistshas doubled from 5.4 to 11.0 percent, and the per-cent of visits to obstetricians/gynecologists has in-creased from 5.2 to 7.2 percent.

Diagnosis or treatment of conditions was by far thepredominant reason that physicians were consulted,accounting for more than 84 percent of all visits.Prenatal or postnatal care was the reason given inalmost 4 percent of the visits. General checkupswas the purpose of more than 8 percent of thevisits.

Fifty-one percent of the doctor visits for diagnosisor treatment were for chronic conditions and 44percent were for acute conditions. There was nocondition reported in the remaining 5 percent.

Earlier reports in Vital and Health Statistics Series10 dealing exclusively withphysicianvisits are Nos. 18,19,49,75, 97, and 128.1-6

Sources and limitationsof the data

Information from the National Health InterviewSurvey (NHIS) of the National Center for Health Sta-tistics (NCHS), as presented in this report, is based ondata collected in a continuing nationwide survey byhousehold interview. Each week a probability sample ofhouseholds in the civilian noninstitutionalized popula-tion of the United States is interviewed by personnel ofthe U.S. Bureau of the Census. Information is obtainedabout the health and other characteristics of each mem-ber of the household. In 1980, because of budgetarylimitations, 4 weeks of data collection were deletedfrom the fourth quarter sample. The data derived fromthe remaining weeks were differentially weighted toproduce a full quarterly estimate.

During 48 weeks in 1980, the sample was com-posed of approximately 39,000 households containingabout 103,000 persons living at the time of the inter-view. The total noninterview rate was about 2.9 per-cent, of which 1,8 percent was due to respondent refusal,and the remainder was primarily due to failure to locatean eligible respondent at home after repeated calls.

A description of the survey design, the methodsused in estimation, and general qualifications of the dataobtained from the survey are presented in appendix I.Because the estimates shown in this report are based ona sample of the population, they are subject to samplingerrors. Therefore, particular attention should be paid tothe section titled “Reliability of estimates.” Samplingerrors for most of the estimates are relatively low. How-ever, where an estimated number, or the numerator ordenominator of a rate or percent is small, the samplingerror may be high. Charts of relative sampling errorsand instructions for their use are shown in appendix 1.

Certain terms used in this report are defined inappendix II. Some of the terms have specified meaningsfor the purpose of the survey. For example, estimates ofthe number of physician visits for acute conditions in-clude, with certain exceptions, visits for those condi-tions that had started during the 3-month period prior tothe interview and that involved medical attention during

the 2-week period prior to interview. The exceptions,listed in appendix II, are certain conditions, such asheart trouble and diabetes, that are always consideredto be chronic regardless of duration or onset.

The probe questions and recording form used toobtain information about physician visits are illustratedin appendix III. The entire questionnaire used during1980 is illustrated in the Current Estimates report forthat period (Series 10, Number 139).7

In addition to the possible sampling errors men-tioned above, response error is also a possibility ininterview data. Response error occurs when householdrespondents do not know the requested information, failto recall accurately events occurring during the refer-ence period, report events that actually happened out-side the reference period as having occurred during it, orwithhold information. Studies mentioned in a previousreport on physician visits (Vital and Health Statistics,Series 10, Number 18)1 suggest that reporting of physi-cian visits is subject to underreporting as well as over-reporting, which tend to compensate for each other.

It is important to note that since NHIS does notinclude visits to hospital inpatients or residents of nursinghomes or other institutions, visits to the elderly maybeunderestimated in this report. Also excluded in NHISare visits to the hospital emergency room that result inhospitalization. The National Medical Care Utilizationand Expenditure Survey (NMCUES) estimates thatthere are about 9 million emergency room visits thatresult in hospitalization yearly. g

In this report, terms such as “similar” and “thesame” mean that no statistically significant differenceexists between the statistics being compared. Termsrelating to difference (for example, “greater” or “less”)indicate that differences are statistically significant.The t-test, with a critical value of 1.96 (0.05 level ofsignificance), was used to test all comparisons that arediscussed. Lack of comment regarding the differencebetween any two statistics does not mean the differencewas tested and found to be not significant.

3

Comments on the data

For the purposes of the National Health InterviewSurvey, a physician visit is defined as a consultationwith a doctor of medicine or osteopathic physician,either in person or by telephone, for examination, diag-nosis, treatment or advice. Services rendered by anassistant or nurse acting under the physician’s super-vision are also included. Data on the interval since aperson last consulted a physician may include a visit to aperson as an inpatient in a hospital if this was the person’sonly visit in the past year. The visit would be includedfor interval data purposes, but not included in the esti-mated volume of physician visits.

To maintain consistency, the estimated 74.9 per-

cent of the population reporting a physician visit in thepast year, as shown in the time interval tables, is alsoused in tables showing the percent of the populationwith one visit or more in the last 12 months. Its comple-ment, (25. 1 percent) is shown as the percent of thepopulation with no visits in the past 12 months. Thus, ifthe only visit a person made was as an inpatient, he istreated as having had a doctor visit in the last 12 months,but the number of visits is not specified.

All of the other tables in this report relative to phy-sician visits contain estimates of the volume of physi-cian visits and exclude all visits for hospital inpatients.

4

Comparison of NH IS withtwo other NCHS surveys

The National Center for Health Statistics sponsorsthree programs that provide data on physician visits:NHIS, the survey which provides the data for this report;the National Ambulatory Medical Care Survey(NAMCS); and NMCUES. These surveys have majormethodological and definitional differences that pre-clude direct comparisons in a large number of instances.Hence, the data sets should be considered comple-mentary of one another and each used to improve theother according to the needs of the user.

The NAMCSg is a national probability sample ofoffice-based physicians selected from master files of theAmerican Medical Association and the American Os-teopathic Association. Selected physicians maintain alisting of all patient visits in their o~ce during a ran-domly assigned 7-day period. The strength ofthese datais in the precision and depth of the medical informationthat it provides. Reliable data on information such asdiagnosis, reason for visit, diagnostic procedures, treat-ments, and medication therapy are reported by the phy-sicians themselves. However, NAMCS includes onlyphysicians classified as non-Federal, office based, andprimarily engaged inpatient care activities. In addition,no visits to chiropractors, podiatrists, and optometristsare possible under NAMCS. While NHIS is designedto screen out visits to the above practitioners, there isthe possibility of response error, as previously men-tioned, which may cause them to be included. TheNAMCS also excludes visits to physicians in Alaskaand Hawaii, which adds to the difference in estimatesbetween the two surveys.

The major strengths of the NHIS data are in thecomplete coverage of physician visits (offIce based,hospital outpatient departments and emergency rooms;company clinics, telephone consultations, home, and soforth) and its provision of important nonmedical datawith which the visit data may be related. The NHISincludes such relevant variables as family income, familyand individual educational levels, family size, and per-

ceived health status, which are not collected in NAMCS.In addition, because it is a population-based survey,NHIS also provides information on persons who did notreceive care. Thus, both the users and nonusers of med-ical care can be profiled by demographic, socioeco-nomic, and health status variables.

Data for 1975–80 indicate that the number of phy-sician office visits averaged 574 million a year using theNAMCS methodology and 702 million ofiice visitsusing the NHIS methodology. While these two esti-mates of physician office visits vary, the differences inthe survey populations and methodologies outlinedabove, along with the possible underestimation of officevisits in NAMC S, due to accidental omission of patientvisits from the physician logs, explain a portion of thedifference. 10

The NMCUES, like NHIS, is designed to measurehealth-related characteristics of the civilian noninsti-tutionalized population of the United States. There areboth similarities and differences between the two sur-veys. Hence, similar estimates do not necessarily meanthat both surveys have adequately measured the samephenomenon nor do different estimates necessarily in-dicate that one or the other survey is inadequatelymeasuring the phenomenon. The NMCUES is a rela-tively new panel survey, conducted for the first time in1980.8 Although the focus of the survey is on healthcare costs, data on health and health care utilization areobtained as a mechanism to collect cost data, and as abasis to classify and understand health care costs. Phy-sician utilization is one of the primary study areas in thesurvey. The NMCUE S contains nine probe questionsregarding physician visits, including the three used inNHIS.

There are differences betweenNHIS andNMCUESon the definition of a physician visit, as well as in thedepth of related questions. For example, NMCUEScounts emergency room visits resulting in hospitaliza-tion as visits, but NHIS does not.

5

Preliminary results from NMCUES for 1980 show children visits and more visits by older adults thanthat when adjustments were made for telephone calls NHIS did.gand emergency room visits resulting in hospitalizations, Although all three surveys have some similarities,the estimated total number of ambulatory visits were they also have some major differences and should not bevery similar for the two surveys. There were differences compared with each other, but used to complement eachwithin groups; however, as NMCUES estimated fewer other.

6

Trends in physicianvisits

The estimated annual number of physician visits,excluding visits to hospital inpatients, has been rela-tively stable between 1971 and 1980, ranging from alow ofjust under 1 billion visits in 1971 to a high of 1.06billion visits in 1975. This is in contrast with the trend ofthe late 1960’s when the number of physician visitsincreased from mid-800 million to 1 billion (figure 1).The inception of Medicare and Medicaid programsaccounts for some of the increase during these years. 11

Visits per person per year have not varied by morethan 0.1 visit perpersonbetween any 2 successive yearssince 1976. In the previous decade, visits per person peryear, which were estimated at 4.2 in 1968, increased toa high of 5.1 in 1975 before realizing a moderate de-crease and then Ievelling off (figure 2). The rate of visits(table A) continues to be much higher for females thanfor males. This has been true for our entire series ofobservations. The difference in the rate of visits be-tween white persons and persons of other races has beenreduced since the mid- 1960’s. While the utilization forwhite persons is still higher, the magnitude of the dif-ference is considerably less. As in the case of increasedphysician visits, the availability of Medicaid and Medi-care programs probably accounts for a large part ofthese changes.

The percent of the population with one physicianvisit or more, within a year of interview, has stabilized atabout 75 percent. This represents a sizeable increaseover the percent estimated in the mid-1 960’s (table B).The percent of females having at least one visit within ayear of interview has levelled off at about 80percent andcontinues to be higher than the percent of males. Amongthe age groups, persons under 5 years of age continuedto have the highest percent with one physician visit ormore within a year of interview, and persons 75 years ofage and over the second highest. The difference betweenthe percent of white persons and persons of other racesseeing a physician in the past year has been markedlyreduced over the years, similar to the trend noted forvisits per person per year.

The doctor’s oftice was by far the most prevalentplace of visit (table C), accounting for 68 percent of thevisits in 1980. This percent has ranged from 67 to 72percent over the past 20 years. Visits to the home thathave steadily decreased over the years now account foronly 0.6 percent of physician visits. The percent of visitsto hospital clinics and emergency rooms has levelled offafter having reached 12.9 percent in 1975, and tele-phone consultations have decreased moderately to 12.2percent after having peaked at 13.3 percent in 1971.

7

1,100

1,050

1,000

0?:.-=E

950.sLO.=,3>

!%.-.:~nz 900:

2

z

850

800

/ ;

0I I I I I I I I I I I I I I

1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1960

Year

Figure 1. Number of physician visits per yeac United States, 1967-80

8

5,2

5.0

4,8

4.2

4.0

0 J 1 I I I I I I I I I I I t1967 1966 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980

Year

Figure 2. Average number of physician visits per person per yeac United States, 1967-80

9

Table A. Number of physician viaits per person per year, by selected chsracteriatic.% United States, selected years

CharacteristicJuly 1963- July 1966-June 1964 June 1967

1971 1975 1980

All persons’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Age

Under 5 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-14 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25-34 yeers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rsce

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Another . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Family income

Lea.sthan $3,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$3,000-$4,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$5.W0.$6.999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$7.000-’$9,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$10

Table B. Percent of population with 1 physician visit or more within a year of interview, by selected characteristics United States, selected years

Allpereonsl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Age

Under 5 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .f5-14yeara . . . . . .. i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35-44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45-54 yesrs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75yewa and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Another.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Family income

Less thsn $3,000, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$3,000-$4,999 ..! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$5,000-$6,999$7,ooo-$9,999:::::::::::::::::::::::::::::::::::::::::::::::::::::

$10,000-$14,999$15,000 -$24,999::::::::::::::::::: :::::::::::::::::::::::::::::::

$25 JOOOormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education of head of family

Less than 5yesrs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-6 years . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-15 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16years ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Activity limitation

Unable tocarry onmajor activityz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Limited inamount orkindof major activityz. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Limited, butnotin major activity2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Not limited in activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Place of residence

SMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Outside SMSk

Nonfarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Farm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .North Central . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

July 1963- JrJly 1966-June 1964 June 1967

1971 1975 1980

66.1

62.769.3

80.4

61.266.1

66.263.463.463.667.9

70.5

67.456.2

59.564.2

67.169.871.8

}75.4

55.159.467.4

}75.8

. . .

. . .

. . .

. . .

67.6

64.856.9

67.586.963.6

68.4

6B.1

65.170.9

82.7

62.270.068.965.764.766.069.5

72.2

69.359.0

63.865.067.469.972.1

}75.3

58.062.168.8

)76.2

82.581.282.166.3

69.5

66.659.7

70.167.765.9

69.9

Percent

72.4

69.075.5

87.065.472.675.070.870.671.273.5

77.1

73.365.6

71.869.069.972.374.4

76.1

64.166.072.2

}79.1

85.885.283.470.6

73.4

71.265.7

73.072.277.7

73.0

75.2

70.579.5

68.968.7

74.077.673.673.574.877.2

61.5

75.771.5

76.674.573.074.075.077.178.7

)69.0

74.579.782.0

89.267.683.973.2

76.0

73.86B.5

76.275.473.975.8

74.9

69.979.5

90.572.1

72.575.1

71.071.874.977.9

82.0

75.273.1

76.877.974.875.474.575.076.1

}70.3

74.3

77.579.1

89.4

88.884.072.7

75.5

73.969.9

76.275.474.1

74.2

t Includes unknown family income snd unknown educstion of head Of familv.

Zfvfajor sctlvity refers tO ability to work, keep house, or engage in school or preschoolactivity.

11

Table C. Percent distribution ofphysician visita, byplace of visit United States, selected years

Place of visitJu/y 1958- July 1963- JU/Y 1966-June 1959 June 1964 June 1967

1971 1975 ‘ 1980

Percent distribution

All visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0

Office (including prepaid group) . . . . . . . . . . . . . . . . . . . . . . . . . . 66.6 69.8 71.8 69.6 68.0 67.9Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2 5.4 3.3 1.7 0.8 0.6Hospital clinic oremergency room. . . . . . . . . . . . . . . . . . . . . . . 8.8 11.9 9.3 10.2 12.9 12.9Company orinduatry health unit... . . . . . . . . . . . . . . . . . . . . . . 1.0 0.6 0.8 1.0Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0.9 0.710.4 10.6 11.3 13.3 12,5 12,2

Other and unknown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.0 1.6 3.4 4.2 5.0 5.7

1DOeS+“Ot include caI1.sfor appmntmentsand Othernonmedicd PWPLW3S.

12

Intervalsince lastphysicianvisit

Data about the interval since last physician visit arebased on responses to the question, “About how longhas it been since you last saw or talked to a medicaldoctor?”

In 1980 unestimated 163.2 million persons, or 74.9percent of the civilian noninstitutionalized population,were reported to have consulted a physician at leastonce during the 12-month period prior to the week ofinterview. For an additional 10.8 percent of the popula-tion it had been at least 1 but less than 2 years since theyhad last consulted a physician, and for 13.3 percent ithad been 2 years or more since their last physicianconsultation. The data on interval since last physicianvisit or consultation by selected demographic, socio-economic, and health status characteristics are found intables D, E, and 1.

An examination of the selected characteristics foundin tables D and E follows:

● A higher percent of females (79.5) than males (69.9)saw a physician within a year.

● A higher percent of children under 5 years of agesaw a physician within a year (90.5) than any of theother age groups. Persons 75 years of age and overhad the second highest percent (82.0).

● Persons in families where the education of the headof family was 16 years or more had the highest

percent (79. 1) of physician visits in the last 12months, and those in families where the head hadless than 9 years of education had the lowest percent(70.3).

. There was a lower percent of persons in large fam-ilies (seven persons or more) having a physicianvisit in the last 12 months (63.6) than in smallerfamilies—77.2 percent in two-person families and76.3 percent in three and four person families.

● Persons with activity limitation were more likely tohave had a physician visit in the last 12 months(87.8 percent) than those with no activity limitation(72.7 percent).

● Persons whose health status was perceived as ex-cellent were less likely to have had a physician visitin the last 12 months (71.1 percent) than thosewhose health status was perceived as good, fair, orpoor (76.0 percent, 84.6 percent and 93.1 percent,respectively).

● Persons who had eight bed days or more in the last12 months were more likely to have had a physicianvisit in the past year (96.7 percent) than those withzero bed days (64. 1 percent) or 1–7 bed days (83.6percent).

13

Table D. Percent distribution of persona by time interval since last physician visit, according to selected demographic and socioeconomic characteristics:United Stetea, 1980

Time interval since last visit

CharacteristicTOt8/ Less than 1 year

pOpulatiorrl 1 yeapless 2 yearsTotal Less than 6-11 than 2 years or more

6 months months

Allpersonsz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sex

Male, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Age

Under 5 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-14 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25-34 yeers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Family income

Less than $5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$5,000-$ 9,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$10,000-$ 14,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$15,000 -$24,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$25,000 or more . . . . . . . . ,. ..,.,, ., ..,,., ., .,.,., ,,!

Education of head of fsmily

Less thsn9 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-n years........,........,.. . . . . . . . . . . . . . . . . . . . .12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-15 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 years or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Size of family

Unrelated individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2pers0ns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-4 persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-6 persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7persons ormore. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0

100.0100,0

100.0100.0100.0100.0100.0100.0100.0100.0100.0

100.0100.0

100.0100.0100.0100.0

100.0

100.0100.0100.0100.0100.0

100.0100.0100.0100.0

100.0

74.9

69.979.5

90.572.172.575.1

71.071.874.977.982.0

75.273.9

77.475.174.575.0

76.1

70.372.874.977.579.1

77.377.276.371.2

63.6


58.4

52.763.8

78.852.454.456.6

52.756.160.967.172.1

58.658.7

64.461.058.357.3

57.7

57.657.557.659.560.9

62.462.659.053.547.2

16.5

17.2i5.7

11.719.718.118.4

18.315.714.010.8

9.9

16.615.2

13.014.116.217.7

18.4

12.715.317.318.018.2

15.014.617.317.616,3

10.8

12.19.6

6.015.612.910.5

11.510.0

8.36.35.4

10.611.9

9.310.210.510.7

11.2

10.711.511.110.3

9.8

8.16.5

10.613.616.1

13.3

16.810.1

1.711.213.413,6

16,617.516.015.112.0

13,412,3

12,313.714.213,5

12,1

17.314.613.111.610.5

14.213.612.113,9

17.7

1 Includes never and unknown.Z]”cludes race other than white Or black, unknown family income, and unknown education Of head of familY.

NOTE Relative standard errorsof estimates for this table are found in appendix 1, figure Il.

14

Table E, Percent distribution of persons by time interval since last physician visit, according to selected health status characteristics, place of residence,

and geographic region: United States, 1980

Time interval since last visit

CharacteristicTotal Less than 1 year

populatiorrlTotal

1 yeat+ess 2 years

Less than 6-11 than 2 years or more

6 months months


58.4 18.5 10.8

55.1 17.6 11.778.0 9.7 5.082,2 7.3 3.6

Allpersons2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Activity limitation

Not limited inactivity.......,.,.. . . . . . . . . . . . . . . . . . . .

Limited in activity, . .,. .,, ,,, .,..... . . . . . . . . . . . . . . . .

Unable to carry on major activity3 ., . . . ., . . . , , . . . . .

Limited in amount and kind of major activit~ . . . . . . .

Limited, but not in major activity3 , , . . . . ., , ., ., , , .,

Perceived health status4

Excellent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Good ,,, ,., .,,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Bed days in last 12 months

None. , .,..,.....,,,,.,.,.,..,,.. . . . . . . . . . . . . . . . . .1-7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8-30 . ...!..... . . . . . . . . . . . . . . . . . . . . . . . . . ...!. ... .,31-365 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Place of residence

SMSA-Centrel city,. , ., ., ., .,, .,..... . . . . . . . . . . . . . . .SMSA-Outside central city...,.,.. . . . . . . . . . . . . . . . . . . .Outside SMSA.. , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .North Central . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South ., . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .West, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0

100.0100.0100.0100.0100,0

100.0100.0100.0100.0

100.0100.0100.0100.0

100.0100.0100.0

100.0100.0100.0100.0

74.9 3.3

72.787.8

89.4

88.884.0

4.46.8

6.5

78.672.4

10.111.5

4.77.3

6.38.3

71.1

76.0

84.6

93.1

52.3

60.3

74.0

87.5

18.8

15.7

10.6

5.6

12.4

10.5

5.83.0

15.5

12.5

6.9

3.7

64.1

83.6

96.597.3

47.3

65.286.082.4

16.6

18.4

10.54.9

14.6

8.12.01.2

20.0

7.7

1.31.2

75.075.973.6

59.358.857.3

15.717.116.2

10.610.711.0

13.2

12.414.7

76.2

75.4

74.1

74.2

60.758.0

57.657.5

15.517.416.316.6

10.710.6

10.810.9

12.313.214.013.7

1Includes never and unknown,21nclude~ ““known heslth ststus snd unknown bad dsys in Isst 12 mOnths.3Majo~ ec~ivi~Y ,efera to ability to work, keep house, or engage in school or pm.chOOl acdvitY.

dparcelved heslth status refers to a“ individual.s health compsred with others his or her s9e.

NOTE Rslative standard errors of aatimates for this table are found in appendix 1, figure Il.

15

Frequency distribution ofvisits in past year

Data on the frequency distribution of visits in thepast year are based on responses to the question, “Dur-ing the past 12 months, how many times did you see ortalk to a medical doctor?” Visits already reported to theinterviewer in prior questions were included, but visitsas hospital inpatients were excluded.

Data in tables F, G, and 2 show the number andpercent distribution of persons by frequency of phy-sician visits in the past year, according to selected demo-graphic, socioeconomic, and health status character-istics of the population.

An estimated 54.7 million, or 25.1 percent of per-sons in the population in 1980, had no physician visits inthe 12 months prior to interview, 22.6 percent saw aphysician only once, 30.3 percent saw a physician 2–4times, 16.3 percent from 5– 12 times, and 4.5 percenthad 13 or more physician visits.

Persons with five visits or more in the past 12 months,although representing only a little more than one-fifthof the population, accounted for approximately two-thirds of the doctor visits.

An analysis of these high utilizers (five visits ormore) follows. It should be noted that age and sex have alarge effect on physician utilization. Since these dataare not age or sex specific, some of the apparent dif-ferences among population groups may be due in part todifferences in age-sex distributions.

A higher percent of females than males had fivevisits or more, 24.6 percent to 16.6 percent, respectively.

The elderly and the very young were the highestutilizers among the age groups with 31.8 percent ofthose 65 years of age and over and 31.5 percent of thoseunder 5 years of age having five physician visits or morein the 12 months preceding the interview. In contrast,

only 12.3 percent of those 5– 14 years of age were in thehigh utilization category.

Persons in families with the lowest average income(less than $5,000) had the largest proportion with fivevisits or more, and those in families in the highest in-come group ($25 ,000 or more) had the lowest propor-tion. In general, it appears that the higher the familyincome, the lower the percent of high utilizers (figure3).

Persons in larger families had a lower proportion ofhigh utilizers than those in smaller families did. The per-cent of persons with five physician visits or more was23.8 percent in two-person families and 14.6 percent infamilies of seven or more.

There was a significant difference in the proportionof persons having five physician visits or more in thepast year by activity limitation status. A total of 45.4percent of persons with activity limitation due to achronic condition had five visits or more, comparedwith only 16.6 percent of those persons who were notlimited in activity.

Of those persons whose health status was perceivedto be excellent, 13.2 percent had five physician visits ormore in the past year. The proportion of persons withfive visits or more was 21.9 percent for those with goodhealth, 41.9 percent for those with fair, and 65.1 percentfor those whose health was perceived as poor.

An estimated 74.7 percent of persons with31 beddays or more in the last 12 months had five physicianvisits or more. Those with zero bed days had only 11.1percent high utilizers, persons with 1-7 bed days had22.1 percent high utilizers, and those with 8-30 beddays had 55.4 percent high utilizers.

16

Table F, Percent distribution of persona by number of phyaicien vieits in past year, according to selected demographic and socioeconomic chsracteriaticsUnited States, 1980

Number of visits in past year

CharacteristicTotall None 1 2-4 5-12

13 ormore

Allpersons2 ...,..,...,.....,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sex

Male , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Age

Under 5yetms,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5-14 yeara . . . . . ..$ . . ..l . . . . . .. c.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-24 yesrs, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 yeera. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

75yeera snd over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Race

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Black. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Family income

Lesathan $5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$5,000-$9,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$10,000-$14,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$15,000-$ 24,899 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$25,000 or more ,, .0..,.0.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education of head of family

Leaathan 9 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-11 years . . . . . . . . . . . . . . . . . . ...0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-15 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16yeara ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Size of family

Unrelated individuala . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 persona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-4 persona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-6 persona, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7persons ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0

00.000.0

00.000.0100.0100.0100.0100.0100.0100.0100.0

100.0100.0

100.0100.0100.0100.0100.0

100.0100.0100.0100.0100.0

100.0100.0100.0100.0100.0

25.1

30.1

20.5

9.527.9

27.524.928.026.2

25.1

22.1

16.0

24.826.1

22.624,925.525,023.9

29.727.225.122.5

20.9

22.7

22.823.728.836.4


22.6

23.3

22.0

16.930.0

25.023.024.5

21.818.7

13.7

13.2

22.721.5

17.919.421.723.525.9

17.621.023.624.125.6

18.9

19.823.425.8

23.7

30.3

28.7

31.8

40.328.9

29.029.827.7

29.429.9

31.9

32.5

30.429.7

30.1

30.230.430.331.4

27.328.630.532.032.9

32.0

32.130.728.024.0

16.3

13.3

19.2

27.210.013.3

16.213.6

14.819.1

24.4

26.6

16.515.6

20.418.716.815.914.3

18.216.815.616.0

15.9

19.2

18.616.512.911.5

4.6

3.4

5.5

4.32.3

3.95.04.1

4.7

6.0

6.4

7.0

4.44.9

7.2

5.24.54.23.6

5.44.94.14.4

4.0

5.8

5.04.53.33.1

1ln~ludsg unknown number of visits.21ncludes race other than white or bla~k, unknown family inc~me, s“d unknown education of head of family.

NOTE Relative standard errors of estimatea for this tabls are found in appandix 1, figure Il.

17

Table G. Percent distribution of persona by number of physician visits in paat year, according to selected health status characteristics, place of residence,and geographic region: United States, 1980

Characteristic

Number of visits in past year

Total’ None 1 2-4 5-1213 ormore


Allpersons2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 25.1 22.6 30.3 16.3 4.5

Activity Iimitationz

Not limited in sctivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 27.3 24.7 30,3 13.7 2.9Limited in activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 12.2 10.5 30.0 31.7 13.7

Unable tocarry onmajor activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 10,6 7.5 26.8 34.6Limited inamcmnt andkind ofmsjoractivit~. . . . . . . . . . . . . . . . . . . . . . . . . . .

18.6100.0 11.2 10.4 29,8

Limited, butnotin msjoractivi$ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33.2 13.7

100.0 16.0 13.6 34.6 25.6 8.8

Perceived health status4

Excellent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Good . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Fair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Bed days in last 12 months

100,0100.0100.0100.0

100.0100.0100.0100.0

28,9 27.4 29.4 11.1 2.124.0 20.6 32.2 17.6 4.1

15.4 11.0 30.1 30.9 11.06.9 5.5 19.4 37.8 27.3

35.9 26.0 26.2 9.4 1.616.4 22.9 37.3 18.3 3.7

3.5 6.1 30.8 40.7 14.72.7 3.1 15.7 41.2 33.4

Place of residence

SMSA-Central city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100,0 25.0 21.2 30.2 17.2 5.0SMSA-Outside central city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 24.1 24.1 30.4 15.9 4.4Outside SMSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 26.4 22.0 30.2 16.2 4.0

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 23.8 23.0 30.7 16.7 4.7North Central . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100,0 24.6 22.9 30.5 16,6 4.1

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 25.9 22.4 30.3 15,7 4.3West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 25.8 22.1 29.4 16.5 5.0

1,nc,udes unknown number of visits.

21ncIudes “nkn~~n health status and unknown bed daw in last 12 months.

3M~jo~ activi~ refers tO ability to work, keep house, or engage in school Or Preschool sctivitY.4perceived health .qatus refers to an individual’s health compared with others his or her a9e.

NOTE Relative stsndard errors of estimates for this table are found in sppendix 1, figure II.

16

30

25

20

15

10

5

0Less $5,000- $10,000- $15,000-$25,000than $9,999 $14,999 $24,999 and

$5,000 over

Family income

Figure 3. Percent of persons with 5 physicisn visits or more in the12 months prior to interview, by family income: United States, 1980

19

Volume of physician visits

Data on the volume of physician visits in 1980 arebased on responses to questions 14, 15 and 16 on thesixth page of the NHIS questionnaire, presented inappendix III.

During 1980, the estimated annual number of phy-sician visits, exclusive of visits to inpatients in hospitals,was about 1.04 billion, or 4.8 visits per person per year(table 3).

The number and rate of physician visits for selecteddemographic, socioeconomic, and health status char-acteristics of the population are presented in tables 3–15. Since age has a large association with the rates ofphysician visits as well as with health status character-istics, and because the age distribution can vary con-siderably for a particular characteristic, it is advisableto make comparisons of age-specific rates for subgroupsof the population rather than comparing rates for personsof all ages.

Comparisons of age-specific rates by sex are shownin figure 4. Although the rates did not differ much formales and females in the youngest and oldest age groups,for the age span from about 15 years of age to 64 years ofage, females had a higher rate of physician visits thanmales did. A portion of this difference is related to visitsconcerning childbirth and pregnancy, particularly in the15–44 year age bracket.

The number and rate of physician visits by place ofresidence, sex, and age, are shown in table 3. The ratewas highest for persons living in the central city portionof standard metropolitan statistics areas (SMSA’S).This appears to be due primarily to the relatively largedifferences in rates for persons 45 years of age andover.

The number and annual rate of physician visits bygeographic region, sex, and age are presented in table 4.Although there were no major age-sex relationships inthese data, high utilization was observed among womenover 65 years of age residing in the West Region.

Estimates of the number and rate of physician visitsby family income, sex, and age are presented in table 5.The rates for the lowest and highest family income

8.0

r

(3.. ~

10, 20 30 40 50 60 70 80

Age in years

Figure 4. Number of physician visita Der Derson per year, by age and sex:

United Stat’es, 1980

groups are illustrated in figure 5. It is interesting to notethat although the rates for persons in the high incomegroup were greatest for persons under 5 years and 65years of age and over, the highest utilizers in the lowincome group were in the 45-64 year age range. Thehigher rate of utilization for persons 45-64 years of agein the low family income group maybe due to the effectthat poor health has on income. For example, althoughonly 14.5 percent of persons in the 45-64 year agegroup were limited in activity in the high income group,56.2 percent of persons in the 45-64 year age groupwere limited in activity in the low income group.

The number of physician visits and the number ofphysician visits perpersonper year by race, sex, and age

20

10.0

9.0

8.0

9 7.0

1: 6.0)

2L; 5.0L1

~

: 4.0I))

! 3.0

2.0

1.0

0,0

t

I\

1 I I I I I I I J10 20 30 40 50 60 70 80

Age in years

Figure5. Numbarof physician visits perperson peryesr, by age

andselected family income groups: United States, 1980

arepresented in table 6. The data indicate that whitepersons had higher utilization through 24 years of age;however, the utilization for black persons was higher inthe 35-44 and 55–64 year age groups (figure 6). Theaverage number of physician visits per person per yearwas highest for both black and white persons in the lessthan $5,000 family income group (table 7). High utili-zation among persons 45-64 years of age, in both races,appears to account for this finding.

The number and annual rate of physician visits byeducation of head of family, sex, and age are shown intable 8, and by education of head of family, age, andfamily income in table 9. Among persons 14 years ofage or under, the utilization rate was higher for thosewhose family head had 12 years or more of educationthan for those whose family head had less than 9 years ofeducation. The utilization rates for females were con-sistently higher than those for males across all the edu-cation levels (table 8).

Data on the volume and rate of physician visits bysize of family, sex, and age are presented in table 10,and by size of family, family income, and age in table11. These data show that physician visit rates werehigher in smaller families and lower in larger families.This finding is true for both sexes up to a family size offive to six persons.

8.0

7,0

$ 6.0>;a

: 5.0f’0a

k 4.0W.=.;

6 3.0.-.Q;

n 2.0

1.0

i

\

I

v-

0.0 ~10 20 30 40 50 60 70 80

Age in years

Figure 6. Number of physician visits per person per year, by age and race,United States, 1980

When family size is analyzed by family income, it isfound that for those in families of two, three, or fourpersons, physician utilization appeared to be higherthan average in the lowest (less than $5,000 a year)fhmily income group, although, in families of five personsor more utilization in the low income group was aboutaverage. This may indicate that persons in large in-digent families have transportation and/or other diffi-culties getting family members to the doctor, or thatexperience gained in past sibling treatment is substitutedfor a doctor visit.

The rates of physician visits for persons with limita-tion of activity due to chronic disease were, as might beexpected, higher than the rates for persons who were notlimited in activity. Utilization rates by activity limita-tion, sex, and age are shown in table 12, and by activitylimitation, family income, and age in table 13. In general,the rate of physician visits was higher when the limita-tion was more severe. These rates were higher for thepopulation as a whole and for several of the age-specificgroups (figure 7). Although activity limitation statuswas closely related to physician utilization, there wasno discernible utilization pattern between family in-come and activity limitation status.

Persons whose perceived health status was poorhad the highest annual rate of physician visits, andpersons whose perceived health status was excellenthad the lowest rate. This was true for both males andfemales and most of the age groups as presented in table14. Persons whose health status was perceived as fair or

21

24.0

22.0

20.0

18.0

: 16.0al2al: 14.0020n

& 12.0nIn.=.;c 10.0.:.-2m 8.0

6.0

4.0

2.0

0.0

— Not limited

. . . . . m Limited, but not in major activity

_ _ Limited in amount or kind of major activity

_ = m Unable to carry on major activity

.1I

.11

.1I

.1I

.1IIt

*4

/“p‘\*/’ \‘\*

\“’\,

-\\#*\ \●**---+”

●9.*●** ●m

1 I I I I I I !10 20 30 40 50 60 70 80

Age in years

Figure 7. Number of physician visits per person per year, by age anddegree of activity limitation: United States, 1980

poor had considerably higher physician utilization thanthose whose health status was perceived as good orexcellent (figure 8).

33.0

30.0

27.0

24.0

9.0

I—. Excellent

■ m.wmm Good

-\_ _ Fair

_ _ - Poor

.\

\A9

\

ii

i, ~ i,

-\\* ~ 1,

\ v \*-\ \\ ●\.9*\ \\ ‘t---~

-\_#-’-8●.

F-- ~6.0 ‘,

●●

,m.. =m=B* 8** Ue~=mmmmmm*.8 ●

●..***”. . ...**’

3.0

0.0 ~

10 20 30 40 50 60 70 80

Age in years

Figure 8. Number of physician visits per person per year, by age andDerceived health status: United Statea, 1980

The final table reflecting volume of visits (table 15)presents average number of physician visits per year bysex, age, and number of bed days in the last 12 months.These data show that utilization of physician visits waslowest, 2.7 per person per year for~hose with zero beddays and highest, 16.8 perpersonper year for those with31 bed days or more. This positive relationship betweenphysician utilization and bed days is significant for bothmales and females and for virtually all the age groups(figure 9).

22

26.0

I

—j O days

\. . . . . ..l-7 days

24.0 _ D 8—30 daya

i ---31—365 days22,0

t\

m

20.0 \

*\*,.’*\

18,0 ‘\&,”+*\

2al~ 16.0 -\ ●\,alQ

\s

_l

\*

~ 14.0

I\,

:

,; 12.() -1\

/-\:.;

I 0--HA

c,!2~ 10.0.- 1 /“2sn

~z-

8,0

6.0

4.0

2.0I●sss●s●K=

0.0 ~

10 20 30 40 50 60 70 80

Age in years

Figure 9, Number of physician visits per person per year, by age and

bed daya in the last 12 months: United States, 1980

23

Place of visit andtype of physician

The National Health Interview Survey obtains databoth on the place of physician visit and on the type ofphysician seen. These data are obtained through theresponses generated for questions 3 and 4 of the 2-weekdoctor visit section of the questionnaire (appendix III).Estimates of the number and percent distribution ofphysician visits by place of visit for selected demo-graphic, socioeconomic, and health status variables arepresented in tables 16 and 17. A summary distributionof the estimates is presented in table H.

In 1980 more than two-thirds of all physician visits(67.9 percent) took place in the doctor’s office. Otherprimary places of visits were hospital outpatient clinicsor emergency rooms (12.9 percent) and telephone con-sultation (12. 2 percent). Physician visits to the homeare now a rare occurrence, accounting for only 0.6percent of the visits.

An examination of place of visit data by selectedcharacteristics shows the following:

. A higher percent of of.tlce visits and telephone con-sultations were made by females. Proportionatelymore visits to hospital clinics or emergency roomswere made by males.

Table H. Number and percent distribution of physician visits,by place of visit United States, 1980

Place of visitNumber

Parcentof visits

distributionin thousands

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,036,092

Office (including prepaid group). . . . . . . . . . 703,416Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,659Hospital clinic or emergency room. . . . . . . . 133,988Company or industry health unit. . . . . . . . . . 6,823Telephona conaultationl . . . . . , , ., ., ., . . . 126,010Other and unknown . . . . . . . . . . . . . . . . . . . . 59,196

1Does not include CCJIS for appointments and other nonmedicd PurPOses.

100.0

67.90.6

12.90.7

12+25.7

● The highest percent of physician office visits was forpersons 65 years of age and over. The lowest percentwas for persons under 5 years of age. Conversely,the largest proportion of telephone consultationswas for persons under 5 years of age, and a relativelylow proportion was for persons 65 years of age andover,

● The percents of oi%cevisits and telephone consulta-tions were higher for white persons. However, thepercent of hospital clinic or emergency room visitswas twice as high for black persons.

● A larger proportion of oi%ce visits was made bypersons in the higher family income groups ($15,000or more) than persons in the lowest family incomegroup (less than $5,000). The highest proportion ofhospital clinic or emergency room visits was forpersons in the lowest family income group.

. The percent of visits to hospital clinics or emergencyrooms was lowest for persons whose head of familyhad 16 years of education or more; however, thepercent of visits to the physician’s oflice was highestfor persons whose family head had less than 9 yearsof education. This is probably an age-related phe-nomenon.

. A greater percent of hospital clinic or emergencyroom visits was made by persons in large families(seven persons or more) than in families with two,three, or four members. In addition, the highestpercent of visits to the physician’s office was forpersons in families of two.

● A smaller percent of physician office visits and alarger percent of hospital clinic or emergency roomvisits were made by persons with a perceived healthstatus of “poor.”

● A larger percent of physician office visits and aconsiderably smaller percent of telephone consulta-tions were made by persons having zero bed days inthe last 12 months.

24

● There was a lower percent of physician office visitsand a higher percent of hospital clinic or emergencyroom visits among persons residing in SMSA-centralcity locations.

The percent distributions of physician visits byselected types of physician seen are presented in table J.Only four physician specialties accounted for approxi-mately 75 percent of all physician visits, with generalpractitioners and internists combined accounting for58.4 percent. The percent of other specialties are notlisted due to the relatively small number in each groupand the large variability due to errors in reporting a&curacy of specialists.lz

Table J. Percent distribution of physician visits, by selected types

of phyaicisn: United Statea, selected yeara

Type of physician.July 1966-June 1967

197r 1975 1980


Total . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0

General Practitioner . . . . . . . . 62.9 56.0 50.4 47.4Internist . . . . . . . . . . . . . . . . . . 5.4 8.0 10.0 11.0Pediatrician . . . . . . . . . . . . . . . 9.0 9.8 9.7 9.7Obstetrician/Gynecologist . . . 6.2 5.7 7.1 7.2Other and unknown. . . . . . . . . 17.5 20.5 22.8 124.6

1,C~r198o, dOrmatOIQgists,ophthalmologists,orthopedists,0t0faryn90k39ists,psychia-

trists, snd”surgeonsaccount for the majority of the “Other and unknown” doctor visits.

25

Type of service

In the National Health Interview Survey, respond-ents who reported a physician visit were asked why theyconsulted a physician. Responses to that question wereclassified into the following type of service categories:

Diagnosis or treatment

Prenatal and postnatal care

General checkup

Immunization and vaccination

Other

Since more than one type of service may be ren-dered during a physician visit, the sum of types of serv-ice (1.05 billion) exceeds the number of physician visits(1.04 billion) as shown in table 18.

In 1980 the proportion of visits that were made foreach of the types of service categories was as follows:

Service category Percant of visits

Diagnosis ortreatment . . . . . . . . . . . . . . . . . . 84.4

Prenatal and postnatal care . . . . . . . . . . . . . . 3.9

General checkup . . . . . . . . . . . . . . . . . . . . . . . 8.3Immunization and vaccination . . . . . . . . . . . . 1.9Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.0

The percent distribution of physician visits by typeof service for selected demographic, socioeconomic,and health status characteristics of the population ispresented in table 19. Highlights of these data are asfollows.

● When prenatal and postnatal visits are excluded,there is no difference in the percent of other cate-gorical types of visits between males and females.

● As might be expected, the largest proportion ofvisits for immunizations and vaccinations and forgeneral checkups were by persons under 5 years ofage.

● A smaller percent of visits for diagnosis or treat-ment and a larger percent of visits for general check-ups were made by persons who were not limited inactivity.

● Diagnosis or treatment was the reason for consultinga physician in 96.2 percent of the visits made bypersons whose perceived health status was poor.There was a much lower percent of visits for diag-nosis or treatment (76.0 percent), but a considerablyhigher percent for general checkups and prenataland postnatal care for persons whose perceivedhealth was excellent.

● A higher percent of visits for general checkups andimmunizations and vaccinations and a lower percentof visits for diagnosis or treatment were made bypersons with zero bed days in the last 12 months.The highest percent of visits for diagnosis or treat-ment was for persons with eight bed days or more inthe last 12 months.

26

Conditions causing visits fordiagnosis or treatment

In the National Health Interview Survey, visits fordiagnosis or treatment are classified by the conditioncausing the visit as reported by the household respond-ent. Summary data for conditions causing physicianvisits by chronic and acute status and by major organicsystems are presented in table K. A disease-specificbreakdown of the conditions is as shown in tables 20 and21,

For the year 1980, of the estimated 874 millionphysician visits for diagnosis or treatment, 51.2 percentwere for chronic conditions and 44.2 percent for acuteconditions. Of the chronic conditions, diseases of thecirculatory system, diseases of the musculoskeletal sys-tem and connective tissues, and diseases of the respira-

tory system were the most frequently reported. Res-piratory diseases and injuries were the acute conditionsmost often reported.

The estimated number of visits by disease-specificgroups is shown in table 20. The largest number ofvisitsreported for chronic conditions was for hypertensivedisease, 41.7 million visits. Other chronic conditionsaccounting for large numbers of visits were arthritis andrheumatism, 39.0 million visits; other diseases of themusculoskeletal system, 31.1 million visits; asthma,28.9 million visits; and diseases of the upper respiratorytract, 27.5 million visits,

The largest number of visits reported for acute con-ditions was for influenza, 45,6 million visits, The com-

Table K. Percent distribution of physician visits for diagnosia or treatment by condition causing visit, according to place of visit United States, 1980

Place of visit

Condition group TotallOffice Hospital

(including clinic or Telephoneprepaid emergency contactgroup) room

All conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

All chronic conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mentslend nervous system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ! . . . . . . . . . . . . . . .Circulatory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , .,,...,!, . . . . . . .

Respiratory system . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Digestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Skin diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Musculoskeletal system andconnbctive tissue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Genitourinery sy.stem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .All acute conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Infectious and parasitic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Acute respiratory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Disaa.ses of the ear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Genitourinary disordera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

No condition reported ,,, ,,, ,, .,. ., .,,,...,, ,, . . . . . . . . . , .,.,,,!,,, . . . . . . . . . . . . . .

100.0

51.2

3.19.87.33.32.78.03.4

13.644.2

5.113.811.3

2.92.48.74,6


100.0 100.0

55.8 43.32.9 3.6

11.1 7.4

8.7 4.03.2 3.3

3.2 1.5

8.5 8.1

3.3 2.6

14.8 12.939.7 52.4

4.5 4.212.9 8.5

8.9 25.53.0 2.32.3 2.28.0 9.64.5 4.3

100.0

37.93.44.8

.5.74.02.3

6.43.2

8.158.4

9.223.5

7,22.83.9

11.8

3.6

1Includesother places of visit.

NOTE: Sae appendix II for International Classification of Diseases, 9th Revision code numbers.

27

mon cold was next, accounting for 30.5 million visits. office (55.8 percent to 39.7 percent), and, conversely, aOther infective and parasitic diseases, diseases of the higher percent of visits for acute conditions in hospitalear, other upper respiratory conditions, open wounds clinics or emergency rooms (52.4 percent—acute, toand lacerations, sprains and strains, and fractures and 43.3 percent—chronic) and for telephone consultationsdislocations were other acute conditions accounting for (58.4 percent to 37.9 percent).large numbers of physician visits. The population figures used in computing rates in

With regard to place of visit, there was a higher this report are found in tables 22–30.percent ofvisits for chronic conditions in the physicians’

28

References

lNational centerfor He~th Statistics, c. H. Hoffman: Volume ofphysician visits by place of visit and type of service, United States,July 1963-June 1964. Vital and Health Statistics. PHS Pub. No.1000-Series 1O-NO. 18. Public Health Service. Washington. U.S.Government Printing Office, June 1965.

2National Center for Health Statistics, C. S. Wilder: Physicianvisits, interval ofvisits and childrens routine checkup, United States,July 1963-June 1964. Vital and Health Statistics. PHS Pub. No.1000-Series 1O-NO. 19. Public Health Service. Washington. U.S.Government Printing Ofllce, June 1965.3National Center for Health Statistics, C. S. Wilder: Volume ofphysician visits, United States, July 1966-June 1967. Vital andHealth Statistics, Series 1O-NO.49. DHEW Pub. No. (HRA) 76-1299, Health Resources Administration, Washington. U.S. Gov-ernment Printing OffIce, Nov. 1968.

4National Center for Health Statistics, C. S. Wilde~ Physicianvisits, volume and interval since last visit, United States, 1969.Vital and Health Statistics. Series 1O-NO. 75. DHEW Pub. No.(HSM) 72-1064. Health Services and Mental Health Administra-tion. Washington. U.S. Government Printing Oftlce, July 1972.

5National center for He~th Statistics, K. M. &nchik Physicianvisits, volume and interval since last visit, United States, 1971.Vital and Health Statistics. Series IO-NO. 97. DHEW Pub. No.(HRA) 75-1524. Health Resources Administration. Washington.U.S. Government Printing OfYice,Mar. 1975.

6National Center for Health Statistics, A. Gentile: Physician visits,volume and interval since last visit, United States, 1975. Vital andHealth Statistics. Series 1O-NO. 128. DHEW Pub. No. (PHS) 79-1556. Public Health Service. Washington. U.S. Government Print-ing Oftlce, Apr. 1979.

7Nationa1 Center for Health Statistics, S. S, Jack: Current estimatesfrom the National Health Interview Survey, United States, 1980.Vital and Health Statistics. Series 1O-NO. 139. DHHS Pub. No.(PHS) 82-1567. Public Health Service. Washington. U.S. Gov-ernment Printing Otlice, Dec. 198 i.

8National center for Health Statistics: Compmison of nationalestimates, National Medical Care Utilization and ExpendituresSurvey and National Health Interview Survey, A working paper byGordon Scott Bonham, Division of Health Interview Statistics,National Center for Health Statistics. November 1981.

9National center for Health Statistics, J. B. Temy, K. L. White,andJ. W. Williamson: National Ambulatory Medical Care Survey,background and methodology, United States, 1967-72. Vital andHealth Statistics. Series 2-No. 61. DHEW Pub. No. (HRA) 74-1335. Health Resources Administration. Washington. U.S. Gov-ernment Printing Otllce, Apr. 1974.

locational Center for Health Statistics, R. O. Gagnon, J. E.DeLozier, and T. McLemore: The National Ambulato~ MedicalCare Survey, United States, 1979 Summary, United States, 1979.Vital and Health Statistics. Series 13-No. 66. DHHS Pub. No.(PHS) 82-1727. Public Health Service. Washington. U.S. Gov-ernment Printing Office, Sept. 1982.

1lR. w. Wilson and E. White: Changes in morbidity, disability, andutilization differentials between the poor and the non-poor, Datafrom the Health Interview Survey: 1964 and 1973. &fed Care,XV(8), Aug. 1977.

12National center for Health Statistics, M. M. Hanntiord Chm-acteristics of patients of selected types of medical specialists andpractitioners, United States, July 1963–June 1964. VitalandHealthStatistics. PHS Pub. No. 1000-Series 1O-NO. 28. Public HealthService. Washington. U.S. Government Printing Office, May1966.

13National Center for Health Statistics: Health survey procedure,concepts, questionnaire development, and definitions in the HealthInterview Survey. VitalandHealth Statistics. PHS Pub. No. 1000-Series l-No. 2. Public Health Service. Washington. U.S. Gov-ernment Printing Ofllce, May 1964.

14National Center for Health Statistics: Health Interview SurveyProcedure, 195 7– 1974. Vital and Health Statistics. Series l-No.11. DHEW Pub. No. (HRA) 75– 1311. Health Resources Admin-istration. Washington. U.S. Government Printing Ofilce, Apr. 1975.

15u.s. National Health Survey, W. R. Simons: The sta

physich9n visits: vokwip3eand interval she@ last viii, united … · 2019. 6. 11. · sultations,...

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