Article Figures & Data
Tables
Characteristic Results (n = 982) Age, mean (SD) 46.4 (22.5) Male sex, No. (%) 380 (38.6) Race/Ethnicity, No. (%) White/Hispanic 532 (54.3) White/Non-Hispanic 233 (23.7) Black 165 (16.8) Asian 37 (3.8) Hawaiian/Pacific Islander 6 (0.6) American Indian 7 (0.7) Body mass index, mean (SD) 31.3 (8.0) Blood pressure, mean (SD) Systolic 126.5 (19.8) Diastolic 73.6 (11.4) History of disease, No. (%) Hypertension 400 (40.7) Obesity 306 (31.2) Diabetes 277 (28.2) Hyperlipidemia 272 (27.7) Depression 178 (18.1) Arthritis 138 (14.1) Anxiety 109 (11.1) Headache 93 (9.5) Asthma 92 (9.5) COPD 56 (5.7) Coronary artery disease 50 (5.1) Chronic kidney disease 49 (5.0) PCP relationship, No. (%) Patient saw personal physician 534 (54.4) Established patient, but did not see personal physician 333 (33.9) Neither the FP nor the practice was the patient’s primary care physician prior to the observed visit 52 (5.3) Unknown prior practice or FP-patient relationship 62 (6.3) Practitioner type, No. (%) Faculty physician 313 (31.9) PGY4/fellow 18 (1.8) PGY3 372 (37.9) PGY2 262 (26.7) PGY1 8 (0.8) Electronic medical record visit, No. (%) 978 (99.6) Number of reasons for visit 5.4 (2.8) Number of issues addressed by the physician 3.7 (2.1) COPD, chronic obstructive pulmonary disease; FP, family physician; PCP, primary care physician; PGY, post graduate year; SD, Standard Deviation.
Reason for Visit Visits (%) RFVs (%) Hypertension 19.4 3.6 Diabetes mellitus 14.8 2.8 Problem with access to medical care 11.8 2.2 Findings of blood tests (eg, cholesterol) 11.7 2.2 Anxiety 8.8 1.6 Headache 8.4 1.5 Back pain, ache, soreness, discomfort 8.4 1.5 Medical counseling, NOS 8.4 1.5 Cough 7.7 1.4 Administrative issues, paperwork 7.0 1.3 Depression 6.8 1.3 Patient seeks referral to a specialist 6.6 1.2 Vertigo, dizziness 6.3 1.2 Diet and nutritional counseling, also exercise and weight-loss counseling 6.3 1.2 Shortness of breath 6.0 1.1 General medical exam 5.8 1.1 Insomnia 5.5 1.0 For results of blood glucose tests 5.4 1.0 For results of cholesterol and triglycerides 5.4 1.0 Heartburn and indigestion (GERD, dyspepsia) 5.2 1.0 Tiredness, exhaustion 5.1 0.9 Constipation 5.0 0.9 For radiological findings 5.0 0.9 Well baby examination 4.8 0.9 GERD, gastroesophageal reflux disease; NOS, no otherwise specified; RFV, reason for visit.
Issues Addressed Visits (%) IAs (%) Essential hypertension 21.8 6.0 Diabetes mellitus 21.2 5.8 Encounters for administrative purposes 15.7 4.3 Disorders of lipid metabolism 9.1 2.5 Anxiety, dissociative, and somatoform disorders 6.7 1.8 Allergic rhinitis 6.6 1.8 Osteoarthrosis and allied disorders 6.6 1.8 Follow-up examination 6.4 1.8 Depressive disorder 6.3 1.7 Health supervision of infant or child 5.5 1.5 Other and unspecified disorders of the back 5.1 1.4 Symptoms involving respiratory system and other chest symptoms 5.1 1.4 Problems related to lifestyle 5.0 1.4 Diseases of esophagus 4.9 1.3 Acquired hypothyroidism 4.6 1.3 Other and unspecified disorders of joint 4.4 1.2 General medical examination (usually well woman) 4.1 1.1 Obesity 3.9 1.1 Other symptoms involving abdomen 3.6 1.0 Nonspecific findings on examination of blood 3.6 1.0 Normal pregnancy 3.6 1.0 Other disorders of soft tissues 3.3 0.9 Other symptoms involving nervous and musculoskeletal systems 3.3 0.9 Special investigations and exams 3.3 0.9 Other disorders of urethra and urinary tract 3.2 0.9 Symptoms concerning nutrition metabolism and development 3.2 0.9 IA, issue addressed.
- Table 4.
Characteristics of Visits with at Least One Diagnosis or Issue That Was Not Explicitly Reportable
Factor Visits with Element Not Explicitly Reportable, No. (%) P Value FP status Patient saw personal physician 333 (62.4) Established patient, but did not see personal physician 204 (61.3) .025 Neither the FP nor the practice was the patient’s primary care physician prior to the observed visit 26 (50.0) Unknown prior practice or FP-patient relationship 28 (45.2) Continuity status Established patient 533 (60.4) .83 New patient 59 (59.0) Practitioner type, No. (%) Faculty physician 201 (64.2) PGY4/fellow 11 (61.1) PGY3 216 (58.1) .53 PGY2 153 (58.4) PGY1 5 (62.5) Patient gender, No. (%) Male 225 (59.4) .66 Female 366 (60.8) Patient race/ethnic group White/Hispanic 321 (60.3) White/non-Hispanic 131 (56.2) Black 113 (68.5) .056 Asian 17 (45.9) Hawaiian/Pacific Islander 5 (83.3) American Indian 4 (57.1) Age (years) <65 445 (58.1) .005 ≥65 144 (68.9) Factor Mean if Visit Reportable (SD) Mean if Visit Not Explicitly Reportable (SD) P Value Number of visits to that clinic in the previous 12 months 3.7 (4.1) 4.3 (4.2) .051 Patient age (years) 39.3 (24.6) 51.0 (19.7) <.001 Patient body mass index 30.4 (6.9) 31.7 (8.5) .020 Clinical experience of the physician (years) 7.2 (9.0) 7.0 (8.4) .81 FP, family physician; PGY, post graduate year; SD, Standard Deviation.
Site 1 N = 76 Site 2 N = 110 Site 3 N = 94 Site 4 N = 21 Site 5 N = 101 Site 6 N = 100 Site 7 N = 194 Site 8 N = 100 Site 9 N = 86 Site 10 N = 99 P Value Patient Characteristics Age (mean) 50.7 49.3 49.3 48.5 54.4 47.9 37.7 32.7 51.6 53.7 <.001 % Female 57% 63% 66% 76% 58% 60% 63% 62% 63% 55% .70 Race/Ethnicity % Hispanic 75.0% 10.9% 17.0% 14.3% 60.0% 30.0% 94.8% 68.0% 36.0% 71.7% % Non-Hispanic White 18.4% 19.1% 19.1% 33.3% 38.0% 51.0% 4.6% 21.0% 40.7% 19.2% <.001 % African-American 5.3% 70.0% 45.7% 42.9% 1.0% 13.0% 0% 9.0% 4.7% 5.1% BMI 31.2 32.9 31.6 33.2 30.7 32.2 30.1 32.2 30.3 30.7 .24 Systolic blood pressure (mm Hg) 127 134 131 127 126 124 118 125 129 127 <.001 Diastolic blood pressure (mm Hg) 77 71 79 79 71 77 72 70 74 72 <.001 Number of clinic visits in last 12 months 1.3 3.7 4.2 5.8 4.1 4.0 5.0 3.3 .8 4.5 <.001 Physician-Patient Visit Results # Reasons for Visit 4.0 4.3 7.2 3.8 4.7 6.0 4.6 7.5 4.6 6.9 <.001 # Issues Addressed 2.9 3.2 5.2 3.3 3.3 3.5 3.2 4.7 2.6 4.6 <.001 # Chronic medications managed and continued 2.8 3.7 5.1 2.1 5.5 1.2 3.7 2.5 7.2 4.3 <.001 # New medications prescribed 0.6 0.9 0.6 0.8 1.0 0.8 0.6 0.7 0.4 0.7 .006 # Total medications managed 3.5 4.7 5.9 3.1 6.6 2.2 4.5 3.6 7.6 5.2 <.001 % Visits with at least One Element Not Reportable to CMS, by Reason Too many issues addressed 61% 60% 80% 48% 55% 56% 52% 68% 41% 83% <.001 System barriers addressed 1% 5% 12% 10% 3% 2% 9% 14% 2% 7% .001 Social determinants addressed 0% 0% 7% 0% 0% 1% 2% 1% 1% 2% .001 Cared for another family member in that visit 0% 3% 1% 10% 0% 0% 2% 3% 1% 0% .019 % visits not reportable with CPT 99204/14 or less 60.5% 60.9% 79.8% 47.6% 55.4% 58.0% 53.6% 70.0% 41.9% 83.0% <.001
