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Relationship between patient age and duration of physician visit in ambulatory setting: does one size fit all?
J Am Geriatr Soc. 2005 Jul; 53(7):1162-7.JA

Abstract

OBJECTIVES

To determine whether patient age, the presence of comorbid illness, and the number of prescribed medications influence the duration of a physician visit in an ambulatory care setting.

DESIGN

A cross-sectional study of ambulatory care visits made by adults aged 45 and older to primary care physicians.

SETTING

A probability sample of outpatient follow-up visits in the United States using the National Ambulatory Medical Care Survey (NAMCS) 2002 database.

PARTICIPANTS

Of 28,738 physician visits in the 2002 NAMCS data set, there were 3,819 visits by adults aged 45 and older included in this study for analysis.

MEASUREMENTS

The primary endpoint was the time that a physician spent with a patient at each visit. Covariates included for analyses were patient characteristics, physician characteristics, visit characteristics, and source of payment. Visit characteristics, including the number of diagnoses and the number of prescribed medications, the major diagnoses, and the therapeutic class of prescribed medications, were compared for different age groups (45-64, 65-74, and > or =75) to determine the complexity of the patient's medical conditions. Endpoint estimates were computed by age group and were also estimated based on study covariates using univariate and multivariate linear regression.

RESULTS

The mean time+/-standard deviation spent with a physician was 17.9+/-8.5 minutes. There were no differences in the duration of visits between the age groups before or after adjustment for patient covariates. Patients aged 75 and older had more comorbid illness and were prescribed more medications than patients aged 45 to 64 and 65 to 74 (P<.001). Patients aged 75 and older were also prescribed more medications that require specific monitoring and counseling (warfarin, digoxin, angiotensin-converting enzyme inhibitors, diuretics, and levothyroxine) than were patients in other age groups (P<.001). Hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, cerebrovascular disease, and transient ischemic attack were more common in patients aged 75 and older than in other age groups (P<.001). Despite these differences, there were no differences in unadjusted or adjusted duration of physician visit between the age groups.

CONCLUSION

Although patients aged 75 and older had more medical conditions and were at higher risk for drug-related problems than younger patients, the duration of physician visits was similar across the age groups. These findings suggest that elderly patients may require a multidisciplinary approach to optimize patient care in the ambulatory setting.

Authors+Show Affiliations

Department of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38103, USA. alo@utmem.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16108934

Citation

Lo, Agnes, et al. "Relationship Between Patient Age and Duration of Physician Visit in Ambulatory Setting: Does One Size Fit All?" Journal of the American Geriatrics Society, vol. 53, no. 7, 2005, pp. 1162-7.
Lo A, Ryder K, Shorr RI. Relationship between patient age and duration of physician visit in ambulatory setting: does one size fit all? J Am Geriatr Soc. 2005;53(7):1162-7.
Lo, A., Ryder, K., & Shorr, R. I. (2005). Relationship between patient age and duration of physician visit in ambulatory setting: does one size fit all? Journal of the American Geriatrics Society, 53(7), 1162-7.
Lo A, Ryder K, Shorr RI. Relationship Between Patient Age and Duration of Physician Visit in Ambulatory Setting: Does One Size Fit All. J Am Geriatr Soc. 2005;53(7):1162-7. PubMed PMID: 16108934.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between patient age and duration of physician visit in ambulatory setting: does one size fit all? AU - Lo,Agnes, AU - Ryder,Kathryn, AU - Shorr,Ronald I, PY - 2005/8/20/pubmed PY - 2005/9/15/medline PY - 2005/8/20/entrez SP - 1162 EP - 7 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 53 IS - 7 N2 - OBJECTIVES: To determine whether patient age, the presence of comorbid illness, and the number of prescribed medications influence the duration of a physician visit in an ambulatory care setting. DESIGN: A cross-sectional study of ambulatory care visits made by adults aged 45 and older to primary care physicians. SETTING: A probability sample of outpatient follow-up visits in the United States using the National Ambulatory Medical Care Survey (NAMCS) 2002 database. PARTICIPANTS: Of 28,738 physician visits in the 2002 NAMCS data set, there were 3,819 visits by adults aged 45 and older included in this study for analysis. MEASUREMENTS: The primary endpoint was the time that a physician spent with a patient at each visit. Covariates included for analyses were patient characteristics, physician characteristics, visit characteristics, and source of payment. Visit characteristics, including the number of diagnoses and the number of prescribed medications, the major diagnoses, and the therapeutic class of prescribed medications, were compared for different age groups (45-64, 65-74, and > or =75) to determine the complexity of the patient's medical conditions. Endpoint estimates were computed by age group and were also estimated based on study covariates using univariate and multivariate linear regression. RESULTS: The mean time+/-standard deviation spent with a physician was 17.9+/-8.5 minutes. There were no differences in the duration of visits between the age groups before or after adjustment for patient covariates. Patients aged 75 and older had more comorbid illness and were prescribed more medications than patients aged 45 to 64 and 65 to 74 (P<.001). Patients aged 75 and older were also prescribed more medications that require specific monitoring and counseling (warfarin, digoxin, angiotensin-converting enzyme inhibitors, diuretics, and levothyroxine) than were patients in other age groups (P<.001). Hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, cerebrovascular disease, and transient ischemic attack were more common in patients aged 75 and older than in other age groups (P<.001). Despite these differences, there were no differences in unadjusted or adjusted duration of physician visit between the age groups. CONCLUSION: Although patients aged 75 and older had more medical conditions and were at higher risk for drug-related problems than younger patients, the duration of physician visits was similar across the age groups. These findings suggest that elderly patients may require a multidisciplinary approach to optimize patient care in the ambulatory setting. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16108934/Relationship_between_patient_age_and_duration_of_physician_visit_in_ambulatory_setting:_does_one_size_fit_all L2 - https://doi.org/10.1111/j.1532-5415.2005.53367.x DB - PRIME DP - Unbound Medicine ER -