Research ArticleOriginal Research

Family Medicine Outpatient Encounters are More Complex Than Those of Cardiology and Psychiatry

David Katerndahl, Robert Wood and Carlos Roberto Jaén
The Journal of the American Board of Family Medicine January 2011, 24 (1) 6-15; DOI: https://doi.org/10.3122/jabfm.2011.01.100057

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Tables

  • Table 1.

    Quantification of Ambulatory Care Provided across Disciplines

    VariableGeneral/Family Practice (n = 3344)Cardiology (n = 1650)Psychiatry (n = 1567)
    Input (mean per visit)
            Reasons for visit1.61 (0.00001)1.44 (0.00001)1.57 (0.00001)
            Diagnoses1.70 (0.00001)1.97 (0.00001)1.39 (0.00001)
            Examination/testing1.68 (0.00002)1.97 (0.00002)0.14 (0.00001)
            Patient characteristics
        Proportion of new patients0.08 (0.000003)0.13 (0.000006)0.11 (0.000005)
    Output (mean per visit)
            Medications prescribed1.80 (0.00002)2.94 (0.00004)1.60 (0.00002)
            Procedures0.03 (0.00000)0.01 (0.00000)0
            Other therapies0.61 (0.00001)0.59 (0.00001)1.52 (0.00002)

    • Values provided as weighted mean (SE).

    • n, number of visits.

  • Table 2.

    Variability of Ambulatory Care Provided across Disciplines

    VariableGeneral/Family Practice (n = 3344)Cardiology (n = 1650)Psychiatry (n = 1567)
    Input
        Reasons for visit0.49 (0.00000)0.52 (0.00000)0.52 (0.00000)
        Diagnoses0.50 (0.00000)0.45 (0.00001)0.50 (0.00000)
        Examination/testing1.01 (0.00001)0.76 (0.00001)3.05 (0.00007)
        Patient characteristics (age)0.53 (0.00000)0.22 (0.00000)0.44 (0.00001)
    Output
        Medications prescribed0.94 (0.00001)0.78 (0.00001)0.81 (0.00001)
        Procedures6.35 (0.0002)14.67 (0.0018)—
        Other therapies1.68 (0.00002)1.56 (0.00003)0.70 (0.00001)

    • Values provided as weighted coefficient of variation (SE).

    • n, number of visits.

  • Table 3.

    Diversity of Ambulatory Care Provided across Disciplines

    VariablePossible Categories (n)General/Family Practice* (n = 3344)Cardiology* (n = 1650)Psychiatry* (n = 1567)
    Input
        Reasons for visit3550.50 (0.00002)0.24 (0.00001)0.11 (0.00002)
        Diagnoses4910.47 (0.00003)0.19 (0.00003)0.06 (0.00001)
        Examination/testing960.22 (0.00006)0.21 (0.00008)0.28 (0.0009)
        Patient characteristics
            Demographic diversity†160.62 (0.00042)0.63 (0.00000)0.62 (0.00048)
    Output
        Medications prescribed1130.50 (0.00002)0.33 (0.0001)0.09 (0.00005)
        Procedures370.65 (0.00014)0.16 (0.00008)—
        Other therapies460.37 (0.00047)0.20 (0.00098)0.23 (0.00038)
        Disposition50.60 (0.00000)0.60 (0.00000)0.40 (0.00000)

    • Values provided as weighted proportion (SE).

    • * Proportion of possible categories needed to include 95% of patients; n, number of visits.

    • † Proportion of categories (sex × race × ethnicity).

  • Table 4.

    Complexity across Disciplines

    CategoryGeneral/Family Practice (n = 198,577,765)Cardiology (n = 21,598,184)Psychiatry (n = 28,864,201)
    Complexity Per VisitComplexity Per Hour*Complexity Per VisitComplexity Per Hour*Complexity Per VisitComplexity Per Hour*
    Input
        Reasons for visit0.77 (0.00001)2.925 (0.00003)0.60 (0.00001)1.759 (0.00002)0.59 (0.00001)1.053 (0.00002)
        Diagnoses0.80 (0.00001)3.039 (0.00005)0.76 (0.00002)2.228 (0.00005)0.50 (0.00000)0.892 (0.00001)
        Examination/testing0.83 (0.00004)3.153 (0.00019)0.89 (0.00005)2.609 (0.00018)0.09 (0.00000)0.161 (0.00001)
        Patient characteristics1.97 (0.00000)7.484 (0.00004)1.85 (0.00000)5.423 (0.00004)1.93 (0.00000)3.443 (0.00003)
        Total4.35 (0.00004)16.526 (0.00021)4.10 (0.00005)12.018 (0.00021)3.12 (0.00001)5.566 (0.00005)
    Output
        Medications1.03 (0.00001)3.913 (0.00005)1.44 (0.00008)4.221 (0.00027)0.68 (0.00002)1.213 (0.00003)
        Procedures0.019 (0.00000)0.072 (0.00001)0.004 (0.00000)0.012 (0.00000)00
        Other therapies0.37 (0.0001)1.406 (0.00040)0.32 (0.00021)0.938 (0.00056)0.68 (0.00017)1.213 (0.00018)
        Disposition0.73 (0.00000)2.773 (0.00001)0.73 (0.00000)2.140 (0.00002)0.66 (0.00000)1.177 (0.00001)
        Total2.15 (0.0001)8.168 (0.00041)2.49 (0.00022)7.300 (0.00062)2.02 (0.00017)3.604 (0.00018)
    Total encounter44.04 (0.002)167.3 (0.009)42.78(0.004)125.4 (0.012)17.49 (0.001)31.2 (0.003)

    • Values provided as weighted mean (SE).

    • * Adjusted for duration of visit.

    • n, number of weighted visits.

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