Based on the American Academy of Pediatrics Analysis of the 2004–2007 Medical Expenditure Panel Survey and the 2004–2007 National Ambulatory Care Survey.
Since the early 1990s, a growing pediatric workforce has provided a rising share of children's health care. During this time, pediatricians have provided more sick and well visits to pediatric patients in all age groups, seen gradual changes in source of payment, and found themselves practicing in a changing business environment. By profiling pediatric office visits using data collected by government surveys from 2004 to 2007, the American Academy of Pediatrics (AAP) provides an updated description of national pediatric trends, such as
Infants, children and young adults through age 21 account for 30% of the US population, and only 12% of total health care payment.
After private health insurance, Medicaid and SCHIP programs are the largest source of payment for pediatric (through age 21) health care, followed by family sources. Together, these sources cover 92% of children’s health care expenses, paying 48%, 24% and 20% of total cost, respectively.
Preventive visits account for 29% of all visits by infants, children and young adults through age 21, and over half (52%) of all visits by infants. Pediatricians provide 84% of all well visits and 76% of all sick visits to infants and children under age 6, compared to 44% of well visits and 35% of sick visits to adolescents. Overall, pediatricians provide 66% of all well visits and 52% of all sick visits for the age 0 through 21 population.
87% of all pediatric office visits are provided in private solo or group practice, with the remainder provided in health centers, clinics, HMOs and other settings. 79% of all pediatric office visits are provided in physician or physician-group owned settings.
Almost two-thirds of all pediatric office visits (65%) are provided by physician owners of the practice. The remainder one-third (35%) are provided by employee or contractor physicians.
Only 2% of infants and one-year olds visit any general dentist during the year. The great majority (87%, or 6.8 million) visited office-based physicians but not dentists in a year’s time. The number of physician office visits outnumber visits to general dentists 190 folds for this age group.
Nationally, office visits provided by general pediatricians outnumber visits provided by other primary care physicians by more than 2- fold (56% vs 25% of all visits) for the 0-21 population. There is, however, considerable geographic variation, by region and by metropolitan area classification.
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