Trend Data On Medical Encounters: Tracking A Moving Target

Abstract

ABSTRACT:The National Health Care Survey (NHCS), conducted by the National Center for Health Statistics, consists of separate data collection activities that can be used to track the number and content of health care encounters in the United States. Tracking even something as simple as the number of encounters, however, is complicated by the fact that the content of these encounters changes over time. Results from the NHCS indicate that the U.S. population has been receiving more drugs, more cardiac procedures, more ambulatory surgery, more therapies in nursing homes, and more home health care over time. Policymakers and researchers who examine health care trends should be wary about judging whether the number or length of encounters is positive or negative without also examining the content of these encounters. The he alt h ca re de li ve ry sy s te m has undergone tremendous changes, particularly over the past few decades. These include advances in technology that have altered the medical treatment patients receive, changing market forces including major new payment policies, new health care delivery models, and evolving population needs. All of these changes have affected the types and content of care that is provided to patients in their encounters with the health care delivery system. New and emerging technologies, including drugs, devices, procedures, and tests, have changed patterns of care and sites where care is provided. The growth of ambulatory surgery has been influenced by improvements in anesthesia and analgesia and by the development of noninvasive or minimally invasive techniques. Procedures that formerly required a few weeks of convalescence now require only a few days.

Prescribing trends by nurse practitioners and physician assistants in the United States

“…This movement has been observed since the early 1980s. In a 14-year span (1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999), the number of prescriptions per visit increased 59% (Bernstein, Hing, Burt, & Hall, 2001;Burt, 2002). Another observation is that the rate of multiple prescriptions per visit is also on the rise (Burt 2000).…”

Physician Assistant and Nurse Practitioner Prescribing: 1997-2002

“…This trend has been observed since the early 1980s; from 1985 through 1999, medications associated with a visit increased by 59%. [17][18] A second observation is that the rate of multiple prescriptions per visit is also on the rise. 18 These observations have implications for workload and demand on physician effort.…”

Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care

“…Up to 90% of patient encounters with health professionals occur in the primary health care setting. 1,2 Performance and quality of primary health care has therefore substantial impact on public health. 3,4 Although the generalisability of clinical practice guidelines has recently been challenged, 5,6 they are still important for decision-making in primary care.…”