Changes in the daily practice of primary care for children

Abstract

Background: The environment in which medicine is practiced has changed in the past 2 decades, but little information has been available on how the day-to-day practice of primary care for children has changed during this period. Objective: To identify aspects of primary care practices for children that are undergoing substantial changes. Design: Analysis of National Ambulatory Medical Care Surveys from 1979 to 1981, 1985, and 1989 to 1994. Participants: Primary care practitioners recorded data on 58 488 child visits. Main Outcome Measures: Characteristics and insurance status of children, physician activities during visits, and disposition after visit. Results: Child visits to primary care physicians increased by 22% between 1979 and 1994. The mean age of children visiting primary care physicians decreased from 6.7 years in 1979 to 5.7 years in 1994 (P for trend,