Utilization of Health Services in Physician Offices and Outpatient Clinics by Adolescents and Young Women in the United States: Implications for Improving Access to Reproductive Health Services

• Published in: Journal of adolescent health Vol. 46; no. 4; pp. 324 - 330
• Main Authors: Hoover, Karen W., M.D., M.P.H, Tao, Guoyu, Ph.D, Berman, Stuart, M.D., M.P.H, Kent, Charlotte K., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-04-2010; Elsevier
• Subjects: Adolescent; Adolescent Health Services - utilization; Age Distribution; Ambulatory Care - utilization; Attitude to Health; Biological and medical sciences; Child; Child Health Services - utilization; Doctors; Female; Health care; Health care utilization patterns; Health Services Accessibility - organization & administration; Health Services Accessibility - statistics & numerical data; Hospitals; Humans; Medical sciences; Office Visits - utilization; Outpatient Clinics, Hospital - utilization; Patient Acceptance of Health Care - statistics & numerical data; Pediatrics; Prevention and actions; Primary health care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Health Care; Reproductive health; Reproductive health services; Reproductive Health Services - utilization; Specific populations (family, woman, child, elderly...); United States; Women's Health Services - utilization; Young Adult; Young women; United States; North America; America; Reproductive health services; Health care utilization patterns; Adolescent; Human; Use; Sexual behavior; Health service; Infection; Prevention; Sexually transmitted disease; Young adult; Female; Woman; Service quality; Public health
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2009.09.002

Abstract Purpose We examined utilization patterns of adolescents and young women as they seek general and reproductive health services in physician offices and hospital outpatient clinics. Methods We analyzed physician office visits in the 2003–2006 National Ambulatory Medical Care Surveys, and hospital outpatient clinic visits in the National Hospital Ambulatory Medical Care Surveys, to examine utilization patterns of females aged 9–26 years by 2-year age intervals and other characteristics such as physician specialty or clinic type. Results The number of visits to primary care physician offices increased with age, from 4.9 million for ages 9–10 years to 9.0 million for ages 25–26 years. The proportion of visits made to obstetrician-gynecologists and family practitioners increased with age, and by ages 15–16 years fewer than half of all visits to primary care providers were made to pediatricians. The proportion of visits to family practitioners increased from 25% at ages 9–10 years to 30% at ages 25–26 years. By ages 17–18 years, a larger proportion of visits were made to obstetrician-gynecologists (33% of 7.0 million visits) and to family practitioners (34%) than to pediatricians (23%). The proportion of visits for reproductive health services peaked at 53% of 7.5 million physician visits at ages 20–21 years. Similar utilization patterns were observed for the 11.0 million hospital outpatient visits to primary care providers. Conclusions Because adolescents and young women most commonly utilize healthcare services provided by obstetrician-gynecologists and family practitioners, these specialties should be priority targets for interventions to improve the quality and availability of reproductive health services.