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Sources of Usual Care

By July 5, 2017Commentary

Many changes have occurred in the structure of the physician market, as more doctors are employed and located in large practices or health systems.  A Statistical Brief from the Agency for Healthcare Research & Quality, based on Medical Expenditure Panel Survey data, examines whether these structural changes are affecting where Americans get their medical care.   (AHRQ Brief)    In 2015, around 250 million people, or 80% of the population, reported a usual source of care and 44% of those saw that source at least once during the year.  30% of these people with a usual care source visited a practice with between 4 and 10 physicians and 24.8% visited a solo practice, while 23.2% went to one with 2 to 3 doctors.  So surprisingly, for their usual care source, probably a primary care physician, over three-quarters of Americans still go to relatively small practices.  63% of practices that were used as usual care sources were single specialty, again likely a primary care one.  54.7% of the patients visited practices that were independent, 20% to those owned by a hospital and 17% to a clinic owned by a government or a non-profit.  21% of the practices had at least one nurse practitioner or physician’s assistant and 51% had two or more of these professionals.  More than 90% of the usual care source patients went to a doctor who used an electronic medical record.  An interesting glance at characteristics of where people get their care.

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