Table 2.
Average Number of Clinical Items Addressed, Visit Duration, and Average Available Time Per Clinical Item for Primary Care Visits from 1997 to 2005 by Age and Payer Type
| Year | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 |
|---|---|---|---|---|---|---|---|---|---|
| Clinical items | 5.4 | l5.6 | 5.9 | 5.8 | 5.8 | 6.0 | 6.3 | 6.3 | 7.1 |
| P value by year◊ | – | 0.26 | 0.02 | 0.08 | 0.10 | 0.002 | <0.001 | <0.001 | <0.001 |
| Age: | |||||||||
| 18–39 | 4.5 | 4.5 | 4.6 | 4.5 | 4.7 | 4.7 | 5.1 | 5.0 | 5.6 |
| 40–49* | 5.1 | 5.2 | 5.4 | 5.4 | 5.4 | 5.8 | 5.7 | 6.1 | 6.3 |
| 50–64* | 5.9 | 6.1 | 6.4 | 6.1 | 6.0 | 6.2 | 6.7 | 6.7 | 7.5 |
| 65–79+ | 6.1 | 6.6 | 6.8 | 6.8 | 6.5 | 6.8 | 7.3 | 6.8 | 8.3 |
| ≥80+ | 6.3 | 6.6 | 6.6 | 6.5 | 6.6 | 7.2 | 7.3 | 7.1 | 8.3 |
| p value by year† | – | 0.23 | 0.03 | 0.13 | 0.23 | 0.004 | <0.001 | <0.001 | <0.001 |
| Payer type: | |||||||||
| Private | 5.2 | 5.3 | 5.3 | 5.5 | 5.4 | 5.7 | 6.0 | 6.1 | 6.7 |
| Medicare* | 6.2 | 6.7 | 6.9 | 6.8 | 6.8 | 7.0 | 7.2 | 6.8 | 8.3 |
| Medicaid* | 5.7 | 5.6 | 6.3 | 6.6 | 5.8 | 6.6 | 6.5 | 6.6 | 7.3 |
| Self-pay* | 4.8 | 5.2 | 4.8 | 4.8 | 4.1 | 4.9 | 5.7 | 5.9 | 5.5 |
| p value by year‡ | – | 0.18 | 0.02 | 0.07 | 0.15 | 0.002 | <0.001 | <0.001 | <0.001 |
| Duration (min) | 18.0 | 18.0 | 19.3◊ | 18.4 | 18.3 | 18.0 | 19.8^ | 18.7 | 20.9+ |
| P value by year◊ | – | 0.98 | 0.04 | 0.50 | 0.64 | 0.94 | 0.007 | 0.24 | <0.001 |
| Age: | |||||||||
| 18–39 | 17.7 | 18.2 | 18.2 | 17.5 | 17.3 | 16.8 | 18.7 | 17.9 | 20.0 |
| 40–49 | 17.3 | 18.1 | 18.9 | 17.9 | 18.5 | 17.2 | 19.4 | 18.5 | 20.4 |
| 50–64Δ | 18.4 | 17.8 | 19.9 | 18.7 | 18.0 | 18.3 | 20.3 | 19.2 | 21.5 |
| 65–79° | 18.1 | 18.0 | 19.7 | 19.0 | 18.9 | 19.0 | 20.4 | 19.1 | 20.4 |
| ≥80Δ | 19.1 | 18.8 | 20.7 | 19.0 | 19.2 | 19.2 | 20.5 | 18.6 | 23.0 |
| p value by year† | – | 0.98 | 0.05 | 0.54 | 0.73 | 0.99 | 0.008 | 0.28 | <0.001 |
| Payer type: | |||||||||
| Private | 18.1 | 18.2 | 18.9 | 18.4 | 17.7 | 17.8 | 19.7 | 18.7 | 20.8 |
| Medicare§ | 18.8 | 18.3 | 20.1 | 18.9 | 19.3 | 19.2 | 20.1 | 18.8 | 21.1 |
| Medicaid | 15.7 | 16.0 | 17.8 | 18.8 | 16.7 | 17.7 | 19.8 | 20.0 | 20.6 |
| Self-pay | 16.7 | 19.1 | 18.7 | 18.0 | 17.7 | 15.0 | 18.1 | 17.5 | 19.2 |
| p value by year‡ | – | 1.00 | 0.05 | 0.51 | 0.71 | 0.98 | 0.007 | 0.27 | <0.001 |
| Time/clin. item (min.) | 4.4 | 4.3 | 4.3 | 4.2 | 4.2 | 3.9 | 4.0 | 3.8 | 3.8 |
| P value by year◊ | – | 0.51 | 0.79 | 0.39 | 0.59 | 0.03 | 0.15 | 0.02 | 0.04 |
| Age: | |||||||||
| 18–39 | 5.2 | 5.0 | 5.1 | 5.0 | 4.7 | 4.6 | 4.5 | 4.5 | 4.5 |
| 40−49* | 4.4 | 4.6 | 4.5 | 4.2 | 4.5 | 3.7 | 4.3 | 3.9 | 4.1 |
| 50−64Δ | 4.3 | 3.8 | 4.0 | 4.0 | 4.0 | 3.8 | 3.9 | 3.6 | 3.7 |
| 65−79+ | 3.8 | 3.6 | 3.8 | 3.6 | 3.9 | 3.6 | 3.7 | 3.6 | 3.1 |
| ≥80Δ | 3.9 | 3.9 | 4.0 | 3.9 | 4.1 | 3.3 | 3.6 | 3.2 | 3.6 |
| p value by year† | − | 0.51 | 0.79 | 0.39 | 0.59 | 0.03 | 0.15 | 0.02 | 0.04 |
| Payer type: | |||||||||
| Private | 4.7 | 4.4 | 4.3 | 4.3 | 4.2 | 3.9 | 4.1 | 4.0 | 4.0 |
| Medicare# | 3.9 | 3.6 | 3.7 | 3.6 | 3.9 | 3.5 | 3.6 | 3.5 | 3.3 |
| Medicaid | 3.9 | 3.8 | 4.6 | 3.8 | 4.1 | 3.3 | 4.3 | 4.0 | 3.5 |
| Self-pay | 4.6 | 5.2 | 5.1 | 5.0 | 5.2 | 4.3 | 3.9 | 3.7 | 4.5 |
| p value by year‡ | – | 0.48 | 0.71 | 0.34 | 0.54 | 0.03 | 0.17 | 0.02 | 0.04 |
◊Using linear regression with 1997 as reference year
†Using linear regression controlling for age with 1997 as reference category
‡Using linear regression controlling for payer type with 1997 as reference category
*Strata for stratified variable significantly different (p < 0.001) from other strata using regression of variable by strata and year with as appropriate: age 18–39 as reference for age, private insurance as reference for payer type, and 1997 as reference for year
ΔStrata for stratified variable significantly different (p < 0.001) from ages 18–39 and 40–49 using regression of variable by age and year with age 18–39 as reference for age and 1997 as reference for year
+Strata for stratified variable significantly different (p < 0.001) from ages 18–39, 40–49, and 50–64 using regression of variable by age and year with age 18–39 as reference for age and 1997 as reference for year
°Strata for stratified variable significantly different (p < 0.01) from ages 18–39 and 40–49 using regression of variable by strata and year with age 18–39 as reference for age and 1997 as reference for year
§Strata for stratified variable significantly different (p < 0.01) from other strata using regression of variable by strata and year with private insurance as reference for payer type and 1997 as reference for year
#Strata for stratified variable significantly different (p < 0.001) from private insurance and self-pay using regression of variable by strata and year with private insurance as reference for payer type and 1997 as reference for year