RT Journal Article
SR Electronic
T1 Family Medicine Outpatient Encounters are More Complex Than Those of Cardiology and Psychiatry
JF The Journal of the American Board of Family Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 6
OP 15
DO 10.3122/jabfm.2011.01.100057
VO 24
IS 1
A1 David Katerndahl
A1 Robert Wood
A1 Carlos Roberto Jaén
YR 2011
UL http://www.jabfm.org/content/24/1/6.abstract
AB Background: Comparison studies suggest that the guideline-concordant care provided for specific medical conditions is less optimal in primary care compared with cardiology and psychiatry settings. The purpose of this study is to estimate the relative complexity of patient encounters in general/family practice, cardiology, and psychiatry settings.Methods: Secondary analysis of the 2000 National Ambulatory Medical Care Survey data for ambulatory patients seen in general/family practice, cardiology, and psychiatry settings was performed. The complexity for each variable was estimated as the quantity weighted by variability and diversity.Results: There is minimal difference in the unadjusted input and total encounter complexity of general/family practice and cardiology; psychiatry's input is less complex. Cardiology encounters involved more input quantitatively, but the diversity of general/family practice input eliminated the difference. Cardiology also involved more complex output. However, when the duration of visit is factored in, the complexity of care provided per hour in general/family practice is 33% more relative to cardiology and 5 times more relative to psychiatry.Conclusions: Care during family physician visits is more complex per hour than the care during visits to cardiologists or psychiatrists. This may account for a lower rate of completion of process items measured for quality of care.