Ambulatory Care Visits Outside the Private Sector. Executive Summary and Final Report

摘要

The project evaluates sampling methodologies for extending the National Medical Care Survey (NAMCS) to hospital clinics. Three nationwide surveys were examined: the American Hospital Association Annual Survey of Hospitals, the Special Survey of Ambulatory Care, and the Immersion Medical Association Periodic Survey of Physicians. Comparison with benchmark data collected by the United Hospital Fund in New York City revealed the AHA data to be unreliable in the number of visits reported. The AMA Periodic Survey, form which NAMCS is sampled for private office-based practice, became the sampling frame of choice. Examination of actual AMA data revealed a number of problems including the difficulty in identifying first year resident status and the need to use physician's home addresses to determine hospital affiliation. One conceptual problem which was never solved was whether the universe for sampling visits to clinics should consist only of visits to physicians. Approximately a quarter of clinic visits are to non-physicians. Because satisfactory methodology for using the conflicting data sets could not be developed, work was halted before fieldwork began with the AMA sample. Pursuing the issue at a future date would have much to offer in extending NAMCS to non-office-based ambulatory visits.