Changes in ambulatory health care use during the transition to young adulthood.
OBJECTIVE
To identify changes in ambulatory health care use during the transition from adolescence to young adulthood.


METHODS
We analyzed data from health care encounters for adolescents (13-18 year olds) and young adults (19-24 year olds) in the National Ambulatory Medical Care Surveys or National Hospital Ambulatory Medical Care Surveys from 1997 through 2004. We present bivariate analysis of visit characteristics (including clinician specialty and health care setting, primary reason for the visit, and expected source of payment) for young adults as compared with those for adolescents, using weights provided by the National Center for Health Statistics to make national estimates.


RESULTS
Adolescents and young adults used similar number of health care visits annually; however, a greater proportion of ambulatory care for young adults was delivered in emergency departments as compared with adolescents (20% vs. 14%; p < .001), a smaller proportion was delivered to males (27% vs. 46%; p < .001), and a smaller proportion was covered by private health insurance (58% vs. 67%, respectively; p < .001). Among young adults, preventive care was listed as the reason for 40% of non-emergency department visits for females, whereas it accounted for only 10% of visits for males.


CONCLUSIONS
Significant changes in ambulatory health care use occur during young adulthood. Improving health care during the transition to adulthood will necessitate attention to health care research and delivery agendas that are relevant to the young adult population.
Callahan
S Todd
ST
Division of Adolescent Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee 37232-9060, USA. todd.callahan@vanderbilt.edu
Cooper
William O
WO
D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D014481:United States; D055815:Young Adult