Physician visits increase for older patients
Doctors prescribe more medications for patients of all ages
A Centers for Disease Control and Prevention survey on doctor visits reveals that while Americans overall visited the doctor at about the same rate from 1985 through 1999, Americans 65 years of age and over increased their rate of doctor visits by over 20 percent, to an average of about 6 times per year by 1999.
"The aging of our population has had a major impact on ambulatory medical care in this country," said Dr. Jeffrey P. Koplan, CDC Director. "As the oldest patients make up a larger proportion of the patients seen in a doctor's office, the doctor must be prepared to meet their unique needs, including monitoring multiple prescriptions and providing the best advice to prevent disease and disability and to promote a healthy life," he said.
Offsetting the rise in visits by seniors, the rate declined for teenagers and young adults (ages 15-24).
According to the survey of non-federal, office-based physicians, there were 756.7 million office visits during 1999, a 19 percent increase in the number of visits since 1985, due to population growth and a larger senior population. The visit rate increased for physicians specializing in internal medicine and cardiology, but decreased for general and family practice physicians and general surgeons. This latest study on ambulatory medical care in America profiles doctor visits in 1999 and highlights changes that have occurred in physician office practices, the place where most Americans receive their health care.
"We learn a great deal about the health of Americans by studying what happens in the doctor's office," said Dr. Koplan and, "we are grateful to the physicians who take the time from their busy practices to provide this important information for monitoring and improving health care quality."
CDC's National Center for Health Statistics conducts this annual survey of physician visits as part of its National Health Care Survey which also covers hospitals, nursing homes, hospices, and home health care.
In 1999, doctors spent an average of about 20 minutes with each patient. Hypertension is still the most frequent diagnosis in office visits. Cardiovascular-renal drugs (such as beta blockers, calcium channel blockers and diuretics) — used to treat hypertension — remain the most frequently prescribed medication. At two-thirds of the visits in 1999, one or more medications were provided to patients for a total of 1.1 billion prescriptions.
While the percent of visits with prescriptions has increased slightly since 1985, the average number of drugs prescribed at the visits has increased by 33 percent. Older patients generally receive more prescriptions than younger patients, however, the increase in rate of drug prescriptions was consistent across all age groups from 1985 to 1999.
The survey also looked specifically at 104 new drugs approved between 1997 and 1999 (containing substances not previously approved for marketing in the U.S.) and found that they have gained significant popularity. Within this group of medications, those most frequently prescribed are used to treat osteoarthritis, depression, asthma and erectile dysfunction. Among these newly-approved drugs, those which were most heavily marketed were the most frequently prescribed. Older patients are six times more likely than younger patients to receive one of these new medications and prescribing patterns vary greatly by physician specialty.
Most office visits in 1999 were by patients who had seen the physician previously; only 12 percent of office visits were by new patients, with approximately half of these referred by another physician or health plan. Approximately six out of 10 office visits were to the patient's primary care physician. More than one-third of office visits were for acute problems and another third were for chronic problems. About 16 percent were for preventive care, including check-ups. Diagnostic and screening services were provided at three-fourths of visits while therapeutic and counseling services (including weight management, smoking cessation and injury prevention) were provided at one-third of the visits.
The National Ambulatory Medical Care Survey is a national probability survey of visits to office-based physicians. Information on visits to doctors in hospital outpatient departments is provided in a companion report recently released. For more about the survey visit the website at http://www.cdc.gov/nchs.
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