Americans Make Less Trips to the Doctor

Maria Perrin

Americans are making less trips to the doctor, according to a new U.S. Census Bureau report.

In 2010, working-age adults made an average of 3.9 visits to doctors, nurses or other medical providers, down from 4.8 in 2001, according to Health Status, Health Insurance, and Medical Services Utilization: 2010, a periodic report that examines the relationship between the use of medical services (such as visits to doctors and nights spent in the hospital), health status, health insurance coverage, and other demographic and economic characteristics. The statistics come from the Survey of Income and Program Participation.

Among those with at least one such visit, the average number of visits also declined, from 6.4 to 5.4 over the period.

“The U.S. Census Bureau’s findings that there has been a decline in the use of medical services is one barometer that patient engagement initiatives focused on improving outcomes are working,” says Maria Perrin, chief strategy officer for HMS, which advances the healthcare system by helping payers reduce costs and improve health outcomes, located in Irving, Texas.

“For example, healthcare organizations are leveraging patient engagement technology platforms that prompt healthcare consumers to take part in personalized conversations that motivate them to take action on their health to better manage chronic conditions, schedule wellness and well-child visits, receive regular examinations, maintain prescriptions and take part in other positive health activities,” Perrin tells Managed Healthcare Executive ®. “These initiatives are working and improving outcomes-so it would follow that patients therefore need fewer face-to-face visits with their physicians. While this is just one factor that may be contributing to a reduction in medical service utilization, it is an important one.”

Most Americans consider themselves to be quite healthy: nearly two in three (66%) reported their health as being either “excellent” or “very good,” according to the report. Another 24% said their health was “good,” while 8% described it as “fair” and 2% as “poor.” Non-Hispanic blacks were more likely to consider their health to be fair or poor (13%) than non-Hispanic whites (10%), or Hispanics (9%). Among working-age adults who reported that their health was either fair or poor, the average number of annual visits dropped from 12.9 to 11.6 over the 2001 to 2010 period. The corresponding numbers fell from 5.3 to 4.2 visits for those reporting good health and from 3.2 to 2.5 among those who said their health was excellent or very good.

Related: Retail Clinics Make Important Contribution to Healthcare

Other report findings include:

Visits to a medical provider or dentist

• Respondents were much less likely to visit a dentist at least once in the last year than a medical provider: 59% compared with 73%.

• Medical provider visits become more likely with age, as 37% of young adults aged 18 to 24 years did not visit a provider at all during the year, compared with 8% of those aged 65 years and older.

• Hispanics were the least likely racial or ethnic group to see a medical provider, as 42% never visited one during the year.

• Women were more likely than men to have visited a medical provider during the year (78% compared with 67%).

Hospital stays

• Spending a night in a hospital is a rare event: 92% of the population did not spend a night in a hospital during the previous year, and only 1% spent eight or more nights. The chances of spending no nights in the hospital ranged from 96% for children to 83% for people aged 65 years and older.

Prescription medication

• More than half of the population (57%) did not take prescription medication at any point during the previous year, while 35% reported taking it regularly.

• While 80% of older adults (those aged 65 years and older) reported regular prescription medication use, the same was true for 13% of children.

Health status

• In general, self-rated health declines with age: more than half of children are in excellent health (59%) compared with 9% of those aged 65 years or older.

• While adults with excellent health were less likely to visit a medical provider at least once than those with poor health (68% compared with 94%), the opposite was true for dental visits. Thirty-five percent of those in excellent health visited the dentist twice during the year, compared with 12% in poor health.

• There is a “U-shaped” relationship between health status and having any type of health insurance coverage. Among all people who reported excellent health, 85% were insured, compared with 80% with good health and 85% whose health was poor.

Uninsured adults

• Among uninsured adults who visited a medical provider or dentist during the year, 13 percent visited an emergency room and 10% visited a hospital (excluding the emergency room), while 20% received free services and 30% received a discount on services.

• In 2010, 21% of uninsured adults in poor health received routine check-ups, compared with 12% of all uninsured adults.

• People under aged 65 years whose health was poor, fair or good were more likely to be uninsured (23%, 25%, and 24%, respectively) than those with very good or excellent health (20% and 16%, respectively).