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Which physicians are providing health care to America's children? Trends and changes during the past 20 years.
Arch Pediatr Adolesc Med. 2004 Jan; 158(1):22-6.AP

Abstract

BACKGROUND

Although pediatricians and family physicians are trained in the care of children, previous studies have revealed significant differences in the medical care and specialty referral patterns each provides. During the 1990s, several developments in the population and the health care system (eg, aging of the population and increases in Medicaid managed care) may have resulted in changes to the proportion of children seeking care from one or the other specialty.

OBJECTIVE

To determine any changes in the proportion of office visits for children from birth through the age of 17 years provided by pediatricians or family physicians from 1980 to 2000.

DESIGN

Analysis of the National Ambulatory Medical Care Survey data sets from 1980 to 2000. During our years of interest, the total number of visits sampled ranged from 2524 to 9151. Visits were analyzed for physician type and patient age.

RESULTS

There have been marked changes in the proportion of office visits to general pediatricians vs family physicians during the 1990s. Overall, the percentage of all nonsurgical physician office visits for children from birth through the age of 17 years made to general pediatricians increased significantly, from 56.2% in 1990 to 64.2% in 2000 (P<.001). During the same period, the percentage of all nonsurgical physician office visits for children from birth through the age of 17 years made to family physicians declined significantly, from 33.7% in 1990 to 23.9% in 2000 (P<.001). Visits to pediatric specialists, as a proportion of all visits, increased significantly, from 1.6% in 1980 to 4.5% in 2000 (P<.001).

CONCLUSIONS

Pediatricians are providing more primary care visits for children in the United States, and this trend has accelerated during the past 5 years. These findings have implications for the cost of care, the physician workforce, and the training of future physicians. It is unknown if these changes have had a positive or negative impact on the health of our nation's children.

Authors+Show Affiliations

Child Health Evaluation and Research Unit, the Division of General Pediatrics, University of Michigan, Ann Arbor, 48109-0456, USA. gfreed@med.umich.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14706953

Citation

Freed, Gary L., et al. "Which Physicians Are Providing Health Care to America's Children? Trends and Changes During the Past 20 Years." Archives of Pediatrics & Adolescent Medicine, vol. 158, no. 1, 2004, pp. 22-6.
Freed GL, Nahra TA, Wheeler JR. Which physicians are providing health care to America's children? Trends and changes during the past 20 years. Arch Pediatr Adolesc Med. 2004;158(1):22-6.
Freed, G. L., Nahra, T. A., & Wheeler, J. R. (2004). Which physicians are providing health care to America's children? Trends and changes during the past 20 years. Archives of Pediatrics & Adolescent Medicine, 158(1), 22-6.
Freed GL, Nahra TA, Wheeler JR. Which Physicians Are Providing Health Care to America's Children? Trends and Changes During the Past 20 Years. Arch Pediatr Adolesc Med. 2004;158(1):22-6. PubMed PMID: 14706953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Which physicians are providing health care to America's children? Trends and changes during the past 20 years. AU - Freed,Gary L, AU - Nahra,Tammie A, AU - Wheeler,John R C, PY - 2004/1/7/pubmed PY - 2004/2/27/medline PY - 2004/1/7/entrez SP - 22 EP - 6 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 158 IS - 1 N2 - BACKGROUND: Although pediatricians and family physicians are trained in the care of children, previous studies have revealed significant differences in the medical care and specialty referral patterns each provides. During the 1990s, several developments in the population and the health care system (eg, aging of the population and increases in Medicaid managed care) may have resulted in changes to the proportion of children seeking care from one or the other specialty. OBJECTIVE: To determine any changes in the proportion of office visits for children from birth through the age of 17 years provided by pediatricians or family physicians from 1980 to 2000. DESIGN: Analysis of the National Ambulatory Medical Care Survey data sets from 1980 to 2000. During our years of interest, the total number of visits sampled ranged from 2524 to 9151. Visits were analyzed for physician type and patient age. RESULTS: There have been marked changes in the proportion of office visits to general pediatricians vs family physicians during the 1990s. Overall, the percentage of all nonsurgical physician office visits for children from birth through the age of 17 years made to general pediatricians increased significantly, from 56.2% in 1990 to 64.2% in 2000 (P<.001). During the same period, the percentage of all nonsurgical physician office visits for children from birth through the age of 17 years made to family physicians declined significantly, from 33.7% in 1990 to 23.9% in 2000 (P<.001). Visits to pediatric specialists, as a proportion of all visits, increased significantly, from 1.6% in 1980 to 4.5% in 2000 (P<.001). CONCLUSIONS: Pediatricians are providing more primary care visits for children in the United States, and this trend has accelerated during the past 5 years. These findings have implications for the cost of care, the physician workforce, and the training of future physicians. It is unknown if these changes have had a positive or negative impact on the health of our nation's children. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/14706953/Which_physicians_are_providing_health_care_to_America's_children_Trends_and_changes_during_the_past_20_years_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.158.1.22 DB - PRIME DP - Unbound Medicine ER -