National impact of 13-valent pneumococcal conjugate vaccine on ambulatory care visits for otitis media in children under 5 years in the United States.

Objective: The 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13) were approved in the US in 2000 and 2010, respectively, for active immunization against invasive disease caused by all vaccine serotypes and otitis media (OM) caused by 7 serotypes common to both vaccines, starting at ∼6 weeks of age. This study assessed the impact of PCV13 on OM by evaluating changes in US ambulatory care visit rates between the period before PCV7 (1997-1999), during PCV7 (2001-2009), and after the introduction of PCV13 (2011-2013) among US children <5 years old.

Methods: This ecological study used US National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data.

Trends in diabetes treatment patterns among primary care providers.

Using data from the National Ambulatory Medical Care Survey, logit models tested for trends in the probability that visits by adult diabetes patients to their primary care providers included recommended treatment measures, such as a prescription for an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin-II receptor blocker (ARB), blood pressure measurement, and diet/nutrition or exercise counseling. Results indicated that the probability that visits included prescription of an ACE or ARB and blood pressure measurement increased significantly over the 1997-2005 period, while the probability that visits documented provision of exercise counseling rose since 2001.

Are there patient disparities when electronic health records are adopted?

Using nationally representative samples of visits from the 2005-2006 National Ambulatory Medical Care Surveys and the National Hospital Ambulatory Medical Care Surveys (N=39,343), this study examines whether electronic health record (EHR) systems have been adopted by primary care physicians or providers (PCPs) for poor minority patients at the same rate as by the PCPs for wealthier non-minority patients. Although we found that electronic health record adoption rates varied primarily by type of practice of the PCP, we also found that uninsured Black and Hispanic or Latino patients, as well as Hispanic or Latino Medicaid patients were less likely to have PCPs using EHRs, compared with privately-insured White patients, after controlling for PCPs' practice type and location, as well as patient characteristics. This finding reflects a mixture of high and low EHR adopters among PCPs for poor minority patients.

National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary.

Objective: This report presents the most current (2006) nationally representative data on visits to hospital emergency departments (ED) in the United States. Statistics are presented on selected hospital, patient, and visit characteristics.

Methods: Data are from the 2006 National Hospital Ambulatory Medical Care Survey (NHAMCS), the longest continuously running nationally representative survey of hospital ED utilization.

Emergency department visits by persons recently discharged from U.S. hospitals.

Background: Emergency department (ED) visits are rarely used as an outcome of prior hospitalization, but could be an indicator of poor inpatient care or follow-up planning.

Study Objective: To examine the rate and characteristics of ED visits of patients recently discharged from any hospital.

Methods: Data from the 2005 and 2006 National Hospital Ambulatory Medical Care Surveys (NHAMCS) and National Hospital Discharge Surveys (NHDS) were used to produce ratios of the numbers of ED visits where patients were discharged from any hospital within the last 7 days to the numbers of hospital discharges.

Characteristics of office-based physicians and their medical practices: United States, 2005-2006.

Objectives: This report describes average annual estimates of nonfederal, office-based physicians who saw patients in the United States during 2005-2006. The report also uses a multiplicity estimator from the physician sample to estimate the number and characteristics of medical practices with which physicians are associated. Selected physician estimates of characteristics obtained only in 2006 are also presented, as well as selected trends in physician practice characteristics between 2001-2002 and 2005-2006.

Factors associated with ability to treat pediatric emergencies in US hospitals.

Objective: The purpose of this analysis is to investigate hospital and community factors associated with the availability of pediatric services, expertise, and supplies in US hospitals for treating pediatric emergencies.

Methods: Data from the Emergency Pediatric Services and Equipment Supplement, a component of the 2002-2003 National Hospital Ambulatory Medical Care Survey, were merged with hospital and community characteristics to model preparedness to treat pediatric emergencies. The National Hospital Ambulatory Medical Care Survey samples nonfederal, short-stay, and general hospitals in the United States.

Electronic medical record use by office-based physicians and their practices: United States, 2006.

Objectives: This report presents the latest information on the use of electronic medical records in physician offices. Percentages of medical practices and physicians within the practices using electronic medical records (EMR) are presented for 2006 by selected physician and practice characteristics.

Methods: Data from the physician induction interviews of the 2006 National Ambulatory Medical Care Survey (NAMCS) are presented.

Emergency response planning in hospitals, United States: 2003-2004.

Objective: This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units.

Methods: Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.

Ambulatory medical care utilization estimates for 2005.

Objective: This report presents statistics on ambulatory care visits to physician offices, hospital outpatient departments (OPDs), and hospital emergency departments (EDs) in the United States in 2005. Ambulatory medical care utilization is described in terms of patient, practice, facility, and visit characteristics.

Methods: Data from the 2005 National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) were combined to produce averaged annual estimates of ambulatory medical care utilization.

National Ambulatory Medical Care Survey: terrorism preparedness among office-based physicians, United States, 2003-2004.

Objectives: This investigation describes terrorism preparedness among U.S. office-based physicians and their staffs in identification and diagnosis of terrorism-related conditions, training methods and sources, and assistance with diagnosis and reporting.

Terrorism preparedness: have office-based physicians been trained?

Background And Objectives: Terrorism may have a severe impact on physicians' practices. We examined terrorism preparedness training of office-based physicians.

Methods: The National Ambulatory Medical Care Survey uses a nationally representative multi-stage sampling design.

Office-based medical practices: methods and estimates from the national ambulatory medical care survey.

Objectives: The report uses a multiplicity estimator from a sample of office-based physicians to estimate the number and characteristics of medical practices in the United States. Practice estimates are presented by characteristics of the practice (solo or group, single, or multi-specialty group, size of practice, ownership, location, number of managed care contracts, use of electronic medical records, and use of computerized physician order entry systems).

Methods: Data presented in this report were collected during physician induction interviews for the 2003-04 National Ambulatory Medical Care Survey (NAMCS).

Characteristics of office-based physicians and their practices: United States, 2003-04.

Objective: This report presents demographic and practice characteristics of nonfederal physicians who were primarily engaged in office-based patient care in the United States during 2003-04.

Methods: The data in this report were collected during the physician induction interview for the 2003 and 2004 National Ambulatory Medical Care Surveys (NAMCS). NAMCS includes a national probability sample of nonfederal office-based physicians who saw patients in an office setting.

Making patient-level estimates from medical encounter records using a multiplicity estimator.

The National Ambulatory Medical Care Survey (NAMCS) is a nationally representative survey of medical encounters in physician offices in the United States. Data from this survey and its counterpart in hospitals, the National Hospital Ambulatory Medical Care Survey (NHAMCS), have been used to investigate physician treatment and prescribing patterns. A limitation of these data, however, is that they represent visits rather than patients.

Training for terrorism-related conditions in hospitals: United States, 2003-04.

Objective: This study estimates baseline data to determine which hospital characteristics are associated with providing terrorism preparedness training to clinical staff.

Methods: Information from a Bioterrorism and Mass Casualty Supplement to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in terrorism preparedness training by eight hospital characteristics. Of 874 hospitals in scope, 739 (84.

Staffing, capacity, and ambulance diversion in emergency departments: United States, 2003-04.

Objective: The increased demand for emergency department (ED) services over the past decade has resulted in crowding. This report presents estimates of structure and process characteristics of hospital EDs related to their capacity to treat medical and surgical emergencies. Estimates of EDs experiencing crowded conditions are also presented.

Analysis of ambulance transports and diversions among US emergency departments.

Study Objective: We describe emergency department (ED) visits in which the patient arrived by ambulance and estimate the frequency of and reasons for ambulance diversion. Using information on volume of transports and probabilities of being in diversion status, we estimate the number of patients for whom ED care was delayed because of diversion practices.

Methods: Data from the 2003 ED component of the National Hospital Ambulatory Medical Care Survey, an annual sample survey of visits to US hospital EDs, were used for the analysis.

Availability of pediatric services and equipment in emergency departments: United States, 2002-03.

Objectives: This report presents estimates on the availability of pediatric services, expertise, and supplies for treating pediatric emergencies in U.S. hospitals.

Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 2001-02.

Objective: This report presents statistics on ambulatory care visits to physician offices, hospital outpatient departments, and hospital emergency departments. Ambulatory medical care utilization is described in terms of patient, practice, facility, and visit characteristics. Office-based care is further subdivided into the categories of primary care, surgical specialties, and medical specialties.

Bioterrorism and mass casualty preparedness in hospitals: United States, 2003.

Objectives: This study examined the content of hospital terrorism preparedness emergency response plans; whether those plans had been updated since September 11, 2001; collaboration of hospitals with outside organizations; clinician training in the management of biological, chemical, explosive, and nuclear exposures; drills on the response plans; and equipment and bed capacity.

Methods: The National Hospital Ambulatory Medical Care Survey (NHAMCS) is an annual survey of a probability sample of approximately 500 non-Federal general and short-stay hospitals in the United States. A Bioterrorism and Mass Casualty Supplement was included in the 2003 survey and provided the data for this analysis.

Which physicians and practices are using electronic medical records?

Greater use of electronic medical records (EMRs) has the potential to improve the quality of medical care and has become a goal of the U.S. administration.

Ambulatory care visits for treating adverse drug effects in the United States, 1995-2001.

Background: Adverse d[rug events (ADEs) are a well-recognized patient safety 4concern, but their magnitude is unknown. Ambulatory viisits for treating adverse drug effects (VADEs) as recordeed in national surveys offer an alternative way to estimatte the national prevalence of ADEs because each VA]DE indicates that an ADE occurred and was seriousenough to require care.

Methods: A nationallyrepresentative sample of visits to physician offices, hospital outpatient departments, and emergency departments was analyzed.