Table 1.
Characteristics of Outpatient Visits for US Adults with Diabetes by Care Setting
| Yearly visits, 100,000s (% of visits in care setting) | Primary care vs. specialist, P value* | ||||
|---|---|---|---|---|---|
| Primary care office | Specialist office | Hospital OPD | Hospital ED | ||
| Survey year† | n/a | ||||
| 2009 to 2011 | 632.4 | 304.9 | 111.3 | 110.4 | |
| 2012 to 2013 | 539.6 | 290.0 | † | 115.0 | |
| 2014 to 2015 | 661.3 | 371.3 | † | 143.0 | |
| All survey years | 614.1 | 319.6 | 111.3 | 121.0 | |
| Age category | 0.002 | ||||
| 18–44 years | 52.7 (8.7) | 23.6 (7.5) | 14.9 (13.6) | 22.8 (19.1) | |
| 45–64 years | 257.7 (42.4) | 121.3 (38.3) | 54.8 (50.0) | 47.7 (40.0) | |
| ≥ 65 years | 297.3 (48.9) | 171.6 (54.2) | 40.0 (36.5) | 48.7 (40.9) | |
| Sex | 0.031 | ||||
| Female | 323.3 (52.6) | 158.9 (49.7) | 65.3 (58.7) | 66.7 (55.1) | |
| Male | 290.9 (47.4) | 160.7 (50.3) | 46.0 (41.3) | 54.3 (44.9) | |
| Race/ethnicity‡ | 0.002 | ||||
| White, non-Hispanic | 385.9 (62.8) | 221.9 (69.4) | 62.6 (56.3) | 70.9 (58.6) | |
| Black, non-Hispanic | 99.8 (16.3) | 40.1 (12.6) | 27.2 (24.5) | 30.5 (25.2) | |
| Hispanic | 94.5 (15.4) | 32.5 (10.2) | 17.6 (15.8) | 15.6 (12.9) | |
| Other, non-Hispanic | 34.0 (5.5) | 25.1 (7.9) | 3.8 (3.5) | 4.0 (3.3) | |
| Minority race/ethnicity‡ | 228.3 (37.2) | 97.7 (30.6) | 48.7 (43.7) | 50.1 (41.4) | 0.005 |
| Diabetes classification§ | < 0.001 | ||||
| Type 1 diabetes | 18.6 (2.8) | 18.1 (4.9) | § | 8.5 (6.0) | |
| Type 2 diabetes | 433.1 (65.5) | 183.9 (49.5) | § | 54.2 (37.9) | |
| Unspecified diabetes | 209.5 (31.7) | 169.3 (45.6) | § | 80.2 (56.1) | |
| Diabetes was a patient reason for visit | 144.4 (23.5) | 48.7 (15.2) | 24.1 (21.6) | 3.0 (2.5) | 0.002 |
| Diabetes was the chief complaint | 85.6 (13.9) | 28.7 (9.0) | 19.2 (17.3) | 0.4 (0.3) | 0.025 |
| Physician specialty | ‖ | ||||
| Cardiovascular diseases | ‖ | 68.7 (21.5) | ‖ | ‖ | |
| Dermatology | ‖ | 18.7 (5.9) | ‖ | ‖ | |
| Psychiatry | ‖ | 13.0 (4.1) | ‖ | ‖ | |
| Neurology | ‖ | 15.6 (4.9) | ‖ | ‖ | |
| Other medical specialties | ‖ | 203.2 (63.7) | ‖ | ‖ | |
| Source of payment for visit | < 0.001 | ||||
| Private insurance | 231.6 (39.5) | 112.0 (36.6) | 30.2 (28.0) | 24.9 (21.7) | |
| Medicare | 279.4 (47.6) | 162.7 (53.2) | 43.9 (40.8) | 55.5 (48.4) | |
| Medicaid | 51.5 (8.8) | 14.9 (4.9) | 19.4 (18.0) | 21.1 (18.4) | |
| Other | 24.3 (4.1) | 16.4 (5.4) | 14.3 (13.2) | 13.2 (11.5) | |
| Geographic region | 0.209 | ||||
| Northeast | 109.1 (17.8) | 65.8 (20.6) | 34.3 (30.8) | 19.9 (16.5) | |
| Midwest | 130.7 (21.3) | 52.9 (16.5) | 30.8 (27.7) | 29.5 (24.4) | |
| South | 236.5 (38.5) | 126.6 (39.6) | 35.3 (31.7) | 49.1 (40.6) | |
| West | 137.8 (22.4) | 74.4 (23.3) | 10.9 (9.8) | 22.5 (18.6) | |
| Metropolitan statistical area | < 0.001 | ||||
| Yes | 528.5 (86.1) | 301.4 (94.3) | 89.1 (80.1) | 87.8 (83.6) | |
| No | 85.6 (13.9) | 18.3 (5.7) | 22.2 (19.9) | 17.3 (16.4) | |
OPD, outpatient department; ED, emergency department
*P value < 0.005 for all three-way comparisons between primary care, medical specialist, and emergency department visits, except geographic region (P = 0.12). P value < 0.02 for all comparisons between all four care settings from 2009 to 2011, except metropolitan statistical area (P = 0.063)
†Hospital outpatient department data were available from 2009 to 2011
‡Approximately 27% of values imputed by the National Center for Health Statistics using a model-based sequential regression including demographic, clinical, and visit characteristics
§Data for diabetes classification were available only from 2014 to 2015
‖Physician specialty subgroups are only relevant to specialist offices