Using NAMCS to characterize the urban health care safety net

Eduardo LaCalle, Clyde B. Schechter, Melissa D. McKee, Jason Fletcher

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose. Data from the National Ambulatory Medical Care Survey (NAMCS) have been used to describe many facets of ambulatory care, but have been underutilized in their application to the urban health care safety net. Our interest was in comparing the visit characteristics of inner city primary care practices in New York City with those of the rest of the country. Methods. Data were collected in 15 primary care centers affiliated with the New York City Research & Improvement Networking Group (NYC RING), a practice-based research network. Physicians completed the cross-sectional survey after patient visits using a slightly augmented version of the standard NAMCS form. Results were then compared with a subset of the Centers for Disease Control and Prevention's public-use dataset for the 2002 NAMCS, selecting only visits to primary care providers and practices in metropolitan statistical areas (N=8,598). Variables of primary interest were visit lengths and diagnoses, adjusting for age and sex. Results. Physicians in NYC RING collected data on 1,861 encounters. Compared with the national sample, our clinicians see 140% more diabetes visits, 70% more hypertension, and 90% more asthma, and provide 88% more dermatologic care and over 300% more reproductive health services. Visits were, on average, one minute longer in our inner city practices (p<.05), and were generally longer across all diagnosis categories than in the national sample. Conclusions. The prevalence of metabolic syndrome and environmentally-related conditions and the provision of more than average specialty care characterize safety net care in New York City.

Original languageEnglish (US)
Pages (from-to)152-160
Number of pages9
JournalJournal of Health Care for the Poor and Underserved
Volume18
Issue number1
DOIs
StatePublished - Feb 2007
Externally publishedYes

Fingerprint

Urban Health
Health Care Surveys
medical care
Primary Health Care
health care
Delivery of Health Care
Safety
Reproductive Health Services
Physicians
Centers for Disease Control and Prevention (U.S.)
Ambulatory Care
Research
Asthma
Cross-Sectional Studies
Hypertension
physician
hypertension
chronic illness
networking
health service

Keywords

  • Community health centers
  • NAMCS
  • Physician's practice patterns
  • Primary health care
  • Safety net
  • Urban health services

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy
  • Social Sciences (miscellaneous)

Cite this

Using NAMCS to characterize the urban health care safety net. / LaCalle, Eduardo; Schechter, Clyde B.; McKee, Melissa D.; Fletcher, Jason.

In: Journal of Health Care for the Poor and Underserved, Vol. 18, No. 1, 02.2007, p. 152-160.

Research output: Contribution to journalArticle

@article{f7bddd39092c4a56a6c302cfa0c2d98a,
title = "Using NAMCS to characterize the urban health care safety net",
abstract = "Purpose. Data from the National Ambulatory Medical Care Survey (NAMCS) have been used to describe many facets of ambulatory care, but have been underutilized in their application to the urban health care safety net. Our interest was in comparing the visit characteristics of inner city primary care practices in New York City with those of the rest of the country. Methods. Data were collected in 15 primary care centers affiliated with the New York City Research & Improvement Networking Group (NYC RING), a practice-based research network. Physicians completed the cross-sectional survey after patient visits using a slightly augmented version of the standard NAMCS form. Results were then compared with a subset of the Centers for Disease Control and Prevention's public-use dataset for the 2002 NAMCS, selecting only visits to primary care providers and practices in metropolitan statistical areas (N=8,598). Variables of primary interest were visit lengths and diagnoses, adjusting for age and sex. Results. Physicians in NYC RING collected data on 1,861 encounters. Compared with the national sample, our clinicians see 140{\%} more diabetes visits, 70{\%} more hypertension, and 90{\%} more asthma, and provide 88{\%} more dermatologic care and over 300{\%} more reproductive health services. Visits were, on average, one minute longer in our inner city practices (p<.05), and were generally longer across all diagnosis categories than in the national sample. Conclusions. The prevalence of metabolic syndrome and environmentally-related conditions and the provision of more than average specialty care characterize safety net care in New York City.",
keywords = "Community health centers, NAMCS, Physician's practice patterns, Primary health care, Safety net, Urban health services",
author = "Eduardo LaCalle and Schechter, {Clyde B.} and McKee, {Melissa D.} and Jason Fletcher",
year = "2007",
month = "2",
doi = "10.1353/hpu.2007.0012",
language = "English (US)",
volume = "18",
pages = "152--160",
journal = "Journal of Health Care for the Poor and Underserved",
issn = "1049-2089",
publisher = "Johns Hopkins University Press",
number = "1",

}

TY - JOUR

T1 - Using NAMCS to characterize the urban health care safety net

AU - LaCalle, Eduardo

AU - Schechter, Clyde B.

AU - McKee, Melissa D.

AU - Fletcher, Jason

PY - 2007/2

Y1 - 2007/2

N2 - Purpose. Data from the National Ambulatory Medical Care Survey (NAMCS) have been used to describe many facets of ambulatory care, but have been underutilized in their application to the urban health care safety net. Our interest was in comparing the visit characteristics of inner city primary care practices in New York City with those of the rest of the country. Methods. Data were collected in 15 primary care centers affiliated with the New York City Research & Improvement Networking Group (NYC RING), a practice-based research network. Physicians completed the cross-sectional survey after patient visits using a slightly augmented version of the standard NAMCS form. Results were then compared with a subset of the Centers for Disease Control and Prevention's public-use dataset for the 2002 NAMCS, selecting only visits to primary care providers and practices in metropolitan statistical areas (N=8,598). Variables of primary interest were visit lengths and diagnoses, adjusting for age and sex. Results. Physicians in NYC RING collected data on 1,861 encounters. Compared with the national sample, our clinicians see 140% more diabetes visits, 70% more hypertension, and 90% more asthma, and provide 88% more dermatologic care and over 300% more reproductive health services. Visits were, on average, one minute longer in our inner city practices (p<.05), and were generally longer across all diagnosis categories than in the national sample. Conclusions. The prevalence of metabolic syndrome and environmentally-related conditions and the provision of more than average specialty care characterize safety net care in New York City.

AB - Purpose. Data from the National Ambulatory Medical Care Survey (NAMCS) have been used to describe many facets of ambulatory care, but have been underutilized in their application to the urban health care safety net. Our interest was in comparing the visit characteristics of inner city primary care practices in New York City with those of the rest of the country. Methods. Data were collected in 15 primary care centers affiliated with the New York City Research & Improvement Networking Group (NYC RING), a practice-based research network. Physicians completed the cross-sectional survey after patient visits using a slightly augmented version of the standard NAMCS form. Results were then compared with a subset of the Centers for Disease Control and Prevention's public-use dataset for the 2002 NAMCS, selecting only visits to primary care providers and practices in metropolitan statistical areas (N=8,598). Variables of primary interest were visit lengths and diagnoses, adjusting for age and sex. Results. Physicians in NYC RING collected data on 1,861 encounters. Compared with the national sample, our clinicians see 140% more diabetes visits, 70% more hypertension, and 90% more asthma, and provide 88% more dermatologic care and over 300% more reproductive health services. Visits were, on average, one minute longer in our inner city practices (p<.05), and were generally longer across all diagnosis categories than in the national sample. Conclusions. The prevalence of metabolic syndrome and environmentally-related conditions and the provision of more than average specialty care characterize safety net care in New York City.

KW - Community health centers

KW - NAMCS

KW - Physician's practice patterns

KW - Primary health care

KW - Safety net

KW - Urban health services

UR - http://www.scopus.com/inward/record.url?scp=33947525754&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947525754&partnerID=8YFLogxK

U2 - 10.1353/hpu.2007.0012

DO - 10.1353/hpu.2007.0012

M3 - Article

VL - 18

SP - 152

EP - 160

JO - Journal of Health Care for the Poor and Underserved

JF - Journal of Health Care for the Poor and Underserved

SN - 1049-2089

IS - 1

ER -