Ambulatory specialist use by nonhospitalized patients in us health plans: correlates and consequences.
Approximately 7 of 10 (and 95% of the elderly) people in US health plans see one or more specialists in a year. Controlling for extent of morbidity, discontinuity of primary care physician visits is associated with seeing more different specialists. Having a general internist as the primary care physician is associated with more different specialists seen. Controlling for differences in the degree of morbidity, receiving care from multiple specialists is associated with higher costs, more procedures, and more medications, independent of the number of visits and age of the patient.
Starfield
Barbara
B
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. bstarfie@jhspb.edu
Chang
Hsien-Yen
HY
Lemke
Klaus W
KW
Weiner
Jonathan P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007345:Insurance Claim Review; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D013038:Specialization; D014481:United States; D055815:Young Adult