Medication therapy in ambulatory medical care. National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1992. 1997

C R Nelson, and D E Knapp
National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, USA.

OBJECTIVE This report describes medications provided or prescribed during ambulatory medical care visits in 1992. Total ambulatory care medication therapy combines data from office-based physicians, hospital outpatient departments (OPD's), and hospital emergency departments (ED's). Drug therapy is described along three dimensions: number of drugs provided or prescribed (drug mention), whether a visit had any drugs mentioned (drug visit), and average number of drugs mentioned per 100 visits (drug mention rate). Utilization in ambulatory care settings is compared in terms of patient, drug, provider, and visit characteristics. METHODS Annual use of medication therapy was determined using data collected in the 1992 National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS). NAMCS includes office visits to nonfederal physicians principally engaged in office practice. The target universe of NHAMCS includes visits to ED's and OPD's of non-Federal, short-stay, or general hospitals. Sample data were weighted to produce annual estimates. Drug mentions are defined as the number of drugs mentioned on the patient record from. RESULTS An estimated 1.1 billion medications were provided or prescribed at ambulatory care visits in 1992. The setting with the greatest percent of visits with medication therapy was the ED; OPD's had the lowest percent with medications. Patients at the ED were provided more pain relief type drugs. The rate of drug mentions and percent of visits with medications were significantly higher in OPD clinics of general medicine and pediatrics compared with other types of OPD clinics. In office-based settings, physicians specializing in cardiovascular diseases were most likely to prescribe medications. Also, cardiovascular-renal type drugs accounted for the largest percent of office-based drug mentions. Visits with illness diagnoses are most likely to receive medication therapy. Trend data comparing 1980 to 1992 office-based mentions showed significant changes on several characteristics: single-ingredient drug status, physician specialty, and patient age. CONCLUSIONS The profile of patients using office- and hospital-based ambulatory care settings are quite different as is the case-mix of conditions. These differences play an important role in medications utilized. The aging of the U.S. population from 1980 to 1992 appeared to have significant effects on several drug mention characteristics.

UI MeSH Term Description Entries
D008297 Male Males
D008511 Medicine The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health. Insurance Medicine,Medical Specialities,Medical Specialties,Medical Specialty,Specialities, Medical,Specialties, Medical,Specialty, Medical,Insurance Medicines,Medical Speciality,Medicine, Insurance,Medicines, Insurance,Speciality, Medical
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009309 National Center for Health Statistics, U.S. A unit of the CENTERS FOR DISEASE CONTROL AND PREVENTION. It is primarily concerned with the collection, analysis, and dissemination of health statistics on vital events and health activities to reflect the health status of people, health needs, and health resources. National Center for Health Statistics (U.S.),United States National Center for Health Statistics,National Center for Health Statistics
D009819 Office Visits Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up. Office Visit,Visit, Office,Visits, Office
D010044 Outpatient Clinics, Hospital Organized services in a hospital which provide medical care on an outpatient basis. Ambulatory Care Facilities, Hospital,Hospital Outpatient Clinics,Clinic, Hospital Outpatient,Clinics, Hospital Outpatient,Hospital Outpatient Clinic,Outpatient Clinic, Hospital
D010045 Outpatients Persons who receive ambulatory care at an outpatient department or clinic without room and board being provided. Out-patients,Out patients,Out-patient,Outpatient
D010824 Physicians' Offices The room or rooms in which the physician and staff provide patient care. The offices include all rooms in the physician's office suite. Physician's Office,Office, Physician's,Office, Physicians',Offices, Physician's,Offices, Physicians',Physician Office,Physician Offices,Physician's Offices,Physicians Office,Physicians Offices,Physicians' Office
D001741 Black or African American A person having origins in any of the black racial groups of Africa (https://www.federalregister.gov/documents/1997/10/30/97-28653/revisions-to-the-standards-for-the classification-of-federal-data-on-race-and-ethnicity). In the United States it is used for classification of federal government data on race and ethnicity. Race and ethnicity terms are self-identified social construct and may include terms outdated and offensive in MeSH to assist users who are interested in retrieving comprehensive search results for studies such as in longitudinal studies. African American,African Americans,African-American,Afro-American,Afro-Americans,Black Americans,Blacks,Negroes,African-Americans,Negro,Afro American,Afro Americans,American, African,American, Black,Black American
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children

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