ArticleAnnals of family medicine
Ambulatory care provided by office-based specialists in the United States.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed.
- Educational and research utility of the registrar clinical encounters in training (ReCEnT) project: an exploration of mechanisms using the context, input, process and product (CIPP) framework.Family medicine and community health · 2025Article
- Racial/Ethnic Residential Segregation, Neighborhood Health Care Provision, and Choice of Pediatric Health Care Provider Across the USA.Journal of racial and ethnic health disparities · 2024Article
- Saxon Epidemiological Study in General Practice-6 (SESAM-6): protocol of a cross-sectional study.BMJ open · 2024Article
- The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol.BMC primary care · 2022Article
- Lean Implementation for Graduating Optimally Controlled Stable Type 2 Diabetics from Endocrine Specialty Clinic Back to Primary Care.Journal of general internal medicine · 2022Article
- Use of Primary Care and Specialty Providers: Findings from the Medical Expenditure Panel Survey.Journal of general internal medicine · 2020Article
- Gastroenterologist and primary care perspectives on a post-endoscopy discharge policy: impact on clinic wait times, provider satisfaction and provider workload.BMC health services research · 2018Article
- Impact of Type of Medical Specialist Involvement in Chronic Illness Care on Emergency Department Use.Healthcare policy = Politiques de sante · 2016Article
- Finding the Primary Care Providers in the Specialist-Dominant Primary Care Setting of Korea: A Cluster Analysis.PloS one · 2016Article
- When to repatriate? Clinicians' perspectives on the transfer of patient management from specialty to primary care.Journal of general internal medicine · 2014Article
- Delivering PACT-principled care: are specialty care patients being left behind?Journal of general internal medicine · 2014Article
- Trends and quality of care in outpatient visits to generalist and specialist physicians delivering primary care in the United States, 1997-2010.Journal of general internal medicine · 2014Article
- Indonesian primary care physicians profile in 2011: Did practicing hours and conversion program for family medicine differentiate their services and continuing medical education activities?Asia Pacific family medicine · 2014Article
- Primary care utilization and colorectal cancer incidence and mortality among Medicare beneficiaries: a population-based, case-control study.Annals of internal medicine · 2013Article
- Turned off and burned out: what will it take for "front-line" medicine to tune back in?Journal of graduate medical education · 2013Article
- Refining physician quality indicators for screening mammography in older women: distinguishing appropriate use from overuse.Journal of the American Geriatrics Society · 2013Article
- Article
- Primary care utilization and colorectal cancer outcomes among Medicare beneficiaries.Archives of internal medicine · 2011Article
- Article
- Physician visits and colorectal cancer testing among Medicare enrollees in North Carolina and South Carolina, 2005.Preventing chronic disease · 2011Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIncreasing use of specialist services in the United States is leading to a perception of a specialist shortage. Little is known, however, about the nature of care provided by this secondary level of services. The aim of this study was to examine the content of care provided by specialists in community settings, including visits for which the patient had been referred by another physician.
methodsNationally representative visit data were obtained from the National Ambulatory Medical Care Survey (NAMCS) for the years 2002 through 2004. To describe the nature of care, we developed a taxonomy of office-based visit types and constructed logistic regression models allowing for adjusted comparisons of specialty types.
resultsOverall, 46.3% of visits were for routine follow-up and preventive care of patients already known to the specialist. Referrals accounted for only 30.4% of all visits. Specialists were more likely to report sharing care with other physicians for referred, compared with not referred, patients (odds ratio [OR] = 2.99; 95% confidence interval [CI], 2.52-3.55). Overall, 73.6% of all visits resulted in a return appointment with the same physician, in more than one-half of all cases as a result of a routine or preventive care visit.
conclusionsAmbulatory office-based activity of specialists includes a large share of routine and preventive care for patients already known, not referred, to the physician. It is likely that many of these services could be managed in primary care settings, lessening demand for specialists and improving coordination of care.
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