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Fewer patient encounters drive decline in total primary care office visits


Despite seeing gains in insurance coverage for preventive health services under the Affordable Care Act, the US has seen a declining rate of primary care visits over the past fifteen years. Are fewer individuals seeing primary care physicians? The authors of this study compared two factors that contribute to that decline to determine whether it was the number of primary care patients or the frequency of their clinical visits that contributed most to the overall decline. Over a fifteen year period from 2002 to 2017, both the number of unique patients seeing PCPs and the number of visits per patient declined. At the start of their analysis in 2002, most Americans saw a primary care physician about 4.3 times in a two-year span. By the end of the study in 2016, frequency of contact dropped to about 3.7 visits. Additionally, the total number of unique patients who had contact with a primary care physician decreased by 2.5% over 15 years and declined across all age groups at varying rates. Applying the rates to adjusted population estimates, the authors conclude that less frequent visits by the average American makes up a larger proportion of the primary care decline compared to the number of primary care patients overall.


Decreasing Use of Primary Care: A Repeated Cross-Sectional Study of MEPS 2007-2017

Michael E. Johansen, MD, MS and Joshua D. Niforatos, MD, MTS

OhioHealth, Grant Family Medicine, Columbus, Ohio and The Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland



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