Patient Visits to a Midwestern Primary Care Practice-Based Research Network: A Comparison to Two National Data Sets

J Pascoe, MD ¹, D Little, MD ², E Slora, PhD ³, K Thoma, MA ³ and R Wasserman, MD ^3,4. ¹ Pediatrics, Wright State University, Dayton, Ohio; ² Family Medicine, Wright State University, Dayton, Ohio; ³ PROS, AAP, Elk Grove Village, Illinois and ⁴ Pediatrics, University of Vermont, Burlington, Vermont.

 

Background: There has been a rapid increase in the number of primary care practice-based research networks early in the 21st century. While there have been descriptive studies of patient visits within national networks, such as the American Academy of Pediatrics Pediatric Research in Office Settings (PROS) network, little is known about patient visit characteristics within the numerous, recently developed regional networks.

 

Objective: To compare patient visit characteristics within the Dayton Primary Care Practice-Based Research Network (DPCPBRN) to patient visits within PROS and the National Ambulatory Medical Care Survey (NAMCS).

 

Design/Methods: DPCPBRN data were collected from 25 of the 35 practitioners in the network between July 2003 and June 2004 using the Primary Care Network Survey (PRINS), developed by primary care physicians for the Agency for Healthcare Research and Quality. Thirty patients were selected randomly throughout the two week data collection interval for each participating practitioner. Regional data were compared to data collected by PROS (57 practitioners, 1706 visits) between March and June 2002 and the NAMCS (33 practitioners, 948 visits) between March and June, 2000.

 

Results: There were a total of 736 completed patient surveys in the regional data set.

 

Comparison of Patients and Patient Visits Characteristics
	DPCPBRN	PROS	NAMCS
Mean Age (Years)	6.5	6.45	5.45
% African-American	24.0%	7.5%	17.6%
% Medicaid	42.0%	22.0%	22.4%
%Visit to Primary MD	75.9%	81.8%	91.6%
%Visit for Non-illness	36.3%	31.3%	31.9%

The top six reasons for patient visits were remarkably similar across the three data sets: well child examination, cough, fever, sore throat, earache and skin rash. Practitioners diagnoses were also similar across the three data sets, primarily health supervision visits and infectious diseases (e.g., pharyngitis/otitis).

 

Conclusions: The DPCPBRN has several similarities to PROS and NAMCS (e.g. patient visit characteristics, number of non-illness visits). Differences between DPCPBRN and PROS/NAMCS (e.g., more Medicaid recipients and more African-American families) suggest that DPCPBRN may be a particularly appropriate network for studying vulnerable populations of children and their families.