FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS 

LE. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE � Public Health Service I Nurnter38 w August 25, 1978 

OFFICE VISITS TO PSYCHIATRISTS: NATIONAL 

AMBULATORY MEDICAL CARE SURVEY, 

UNITED STATES, 1975-76’ 

During combined calendar years 1975 and 

1976 psychiatrists’ offices were the settings for 

30.6 million ambulatory care visits by patients 

who presented a broad spectrum of emotional, 

ideational, amdbehavioral problems. 

The data were obtained during the National 

Ambulatory Medical Care Survey (NAMCS), a 

sample survey conducted by the Division of 

Health Resources Utilization Statistics of the 

National Center for Health Statistics. The estimates in this report are based on information 

recorded by participating psychiatrists on brief 

encounter forms (see TechnicaI Notes) during 

sampled office encounters. A brief description 

of the sample design and an explanation of the 

sampling emors associated with selected aggregate statistics can be found in the Technical 

Notes of this report. 

Most visits to psychiatrists were to offices 

Iocated in metropolitan areas (94 percent); this 

was a higher proportion than that for all specialkts (figure 1). 

The proportion of visits to psychiatrists engaged in solo practice (78 percent) exceeded 

those to other types of arrangements. In this 

respect office based psychiatric practice also 

differed from the average of 60 percent for aIl 

specialists. 

Reflecting the continuous nature of psychiatric care, 9 of 10 visits were made by patients 

the physician had seen before and who returned 

for care of a problem the physician had treated 

1This report was p;epared by Beulah K. Cypress, 

Ph.D., Division of Health Resources Ufllzation Statistics, 

. 

Fi9ure 1. PERCENT DISTRIBUTIONS OF OFFICE VISITS TO 

PSYCHIATRISTS AND TO ALL SPECIALISTS BY LOCATION 

AND TYPE OF PRACTICE UNITED STATES, 1S75-76 

visits:0 psychiiisls 

visitsto allspecialism 1 

9S.8 

Metropolitan area 73.3 

6.2 Nonmwropditan area 

2S.7 

77.9 

so:.$.rwtim 

Sn.o


22.1


Other types of prmticc 

~ 

o 

F40 

40.0 

Sa 80 100 

PERCENT OF VISIT3 

previously (figure 2). The ratio of return visits to 

new problem visits was higher for psychiatrists 

than for any other speciaIty. New probIem visits 

included initial visits and those made by patients 

known to the physician but presenting a ,new 

problem. For each new problem visit to a 

psychiatrist there were 8.6 “oId” problem visits 

in contrast to an oId to new ratio of 1.6 for all 

specialists. 

Of the 2.1 million new patients seen by 

psychiatrists, 30 percent were referred by another physician or agency. 

Distributions of visits by patient age, sex, 

and race are shown in tabIe 1. The majority of 

visits included patients between the ages of 25 

and 44 years. The visit rate was also higher for 

this age range than for any other group. Patients 

65 years and over comprised the smzdlest group 

visiting. For each 100 persons of that age in the 
2 

H 

Figura 2. PERCENT DISTRIBUTIONS OF OFFICE VISITS TO 

PSYCHIATRISTS AND TO ALL SPECIALISTS BY VISIT 

STATUS: UNITED STATES, 1975-76 

- !kv%tiem 

Returnicqpatient: 

= N.. fmblm 

~ CM problem 

Psvchiatrisb All xialii 

Table 1. Nutier, percent distribution, and rate of office visits to 

psychiatrists by patient 

1975-76 

Age, sex, and race 

All visits ... .......... ...... ...... 

Age

— 

Under15Years.................. 15-24years ................. ........ 

25-34 years ............ .......... ... 

3544 y~rs, ... .....m............... 

46-54 years ........ ................. 

55-64yearn........................m 

65 years and over ........ ........ 

sex

— 

Female ............ .................... 

Male ........... .. .... .. ................ . 

Race 

White ........ ........ ...... .... ........ 

Bleck and other races .......... 

age, sex, and race: United States, 

Number c Visit 

visits in Percent rate per 

thousand Iistributio 100 in 

Copulation 

30,61[ 100.0 7.3 

2,632 8.6 2.5 

4,662 15.2 6.0 

9,10s 29.8 15.0 

7,053 23.0 15.8 

4,284 14.0 9.2 

1,934 6.3 4.9 

933 3.0 2.2 

18,406 60.1 8.5 

12,210 39.9 6.1 

29,319 95.8 8.1 

1,297 4.2 2.4 

population only two visits were made to psychiatrists’ offices, whereas there were about 15 

visits for each 100 persons aged 25-44 years. 

Females visited at a significantly higher rate than 

did males. Members of the white race clearly 

outnumbered other persons in visits with the 

visit rate for the former group about three 

times the rate of the latter group. The distribution of mental disorders among different 

races, or the total pattern of psychiatric care by 

race, should not be inferred from these data. 

First, disease incidence and prevalence cannot be 

equated with visits for a disease; and second, 

care may be obtained from facilities other than 

physicians’ offices. For example, in 1975 members of bIack and all other races utilized outpatient departments of hospitals and freestanding psychiatric clinics, settings not 

presently included in NAMCS, at a higher rate 

than did white persons.z 

Seriousness of the patient’s problem was 

evaluated by the psychiatrist using the criterion 

of the extent of impairment that might result if 

no care were available. On a four-point scale 

ranging from not serious to very serious, psychi- -. 

atnsts judged 65 percent of their visiting patients to be serious or very serious. Only 11 percent were considered not serious in contrast to 

the finding of about 49 percent for all specialists 

(figure 3). 

Patients’ problems were more often diagnosed in the nonpsychotic group of mental disorders (79.5 percent) then in the psychotic 

(20.5 percent). Despite a broad array of symptoms and complaints presented by visiting patients, 84 percent of the visits were diagnosed by 

psychiatrists in only seven diagnostic classes 

(table 2). Primary diagnoses listed on the Patient 

Record by participating physicians were classified according to the Eighth Revision International Classification of Diseases, Adapted for 

Use in the United States (ICDA).3 Another 

2 Division of Biometry and Epidemiology, National 

Institute of Mental Health. Unpublished data from the 

National Reporting Program of the National Institute of 

Mental Health. 

3NationaJ Center for Health Statistics: Eighth Revision International Classifica tim of Diseases, Adapted 

for Use in the United States. PHS Pub. No. 1693. Public 

Health Service. Washington. U.S. Government Printing -

Office, 1967. 
1

2

3

4

5

6

7

admced-3 

Figure 3. PERCENT DISTRIBUTIONS OF OFFICE VISITS TO 

PSYCHIATRISTS AND TO ALL SPECIALISTS BY DEGREE 

OF SERIOUSNESS OF THE PATIENT’S PROBLEM: UNITED 

STATES, 1975-76 

100
—


90 -

so70 -


: 60 –


$M


~


:


c 

?4 o


Not s?rious 

30-
 Sli htly swims 

m 

2o– Serious or very serious 

& 

1o– 

o— 

Pwchiatrists All specialists 

taxonomy of mental disorders, the Dia.mostic 

and Statistical Manual of Mental Dtiorders, 

Second Edition (DSM-11), which is also used by 

the mental health community, is compatible 

with ICDA at the three-digit level of specificity, 

which is used in this report.4 DSM-11 includes a 

4Amencan Psychiatric Association Committee on 

Nomen~lat~e and Statistics: Diagnostic and Statktical 

Manual of Mental Disorders, 2d ed. American Psychiatric 

Association. Washington, D.C. 1968. 

glossary of operational definitions of terms 

which the nonmedical reader may find useful. 

A diagnosis of neurosis was clearly the foremost clinical determination made by psychiatrists, accounting for 42-percent of all visits. 

Personality disorders (about 14 percent) increased the total to more than half of all visits. 

TWO psychotic states, schizophrenia (11 percent) and affective psychosis (about 5 percent) 

were among the highest ranking illnesses. 

The group of visits which were coded in the 

symptoms and ill-defined condkions ICDA class 

of senility and ill-defined diseases (790-796) 

were chiefly listed as depression (790.2). Apparently the physician indicated that these visits 

were not of psychotic or psychoneurotic origin, 

which are usually assigned to mental disorders 

(290-315). 

An examination of the characteristics of 

psychiatric office practice is largely a study of 

treatment of mental disorders in the setting of 

ambulatory office care. While not all patients 

with mental problems visited psychiatrists’ offices in preference to other physicians, almost all 

visits to psychiatrists involved mental ailments, as 

previously shown. Of the 48.5 million visits to 

all specialists for mental disorders during 

1975-76, 54 percent, or 26.2 million, were to 

office based psychiatrists. As illustrated in figure 

4, visits to other specialists were mainly diagnosed as neuroses. Psychiatrists had the major 

portions of visits for the psychotic problems 

schizophrenia (92 percent) and affective 

psychoses (73 percent). Visits by patients requiring guidance for transient and situational disturbances also occurred more frequently in 

-

Table 2. Nurrber, percent, and cumulative percent of offica visits to psychiatrists by 7 most common principal diagnoses classified by 

ICDA code in rank order of number of visits: United States, 197$76 

Number of 

Rank principal diegnos”si and ICDA mde 

visits in 

thousands 

Percent of visits (lsmulatiw 

percant 

, 

Neuroses ... .. .. .. .... .. . . .. .. .. .. .. .. ... . .. . .. . .. . ... . .. ....3w 12,824 41.9 41.9 

Personality disorders .. . . .... . ... .. ... . .. .. .. . ... .. ....301 4,117 13.5 55.4 

Schizophrenia .... .. .. .. .. .. .. .. .. .. .. .. . ... . .. ... .. .. ....295 3,445 11.3 66.7 

Trensient and situational dieturbencas . . ... ..3O7 2,188 7.2 73.9 

Affective psychoses . ... . .. .. .. .... .. .... .. .. .. .. .. .. ...2w 1,404 4.6 78.5 

Nervousness and debility (depression) .. ......790 1,115 3.6 82.1 

Medical or special examination ... .. ... . .. ... .. ..YGs3 570 1.9 84.0 

~oup~s and codes are bawd on the E&hth R&~@j InternationalC’hsSifkWtiOISOf DhsM% AdaPted for u= ‘n ‘k -. 1 ~hgno~ic 

United Sfrstes 
4 &ncedata 

Figure 4. PERCENT DISTRIBUTION OF OFFICE VISITS FOR 

MENTAL OISORDERS BY MOST VISITED SPECIALTY: 

UNITED STATES, 1975-76 

J 

psychiatrists’ offices than in those of other spe­

;i~ists (table 3). 

The Patient Record used in NAMCS was 

developed as a general purpose data collection 

instrument for the purpose of capturing the 

most pertinent information about ambulatory 

office care visits. The practice of psychiatry, 

unique in its diagnostic and therapeutic procedures, cannot be as succinctly characterized by 

the NAMCS data as can some other specialties. 

The types of diagnostic procedures described on 

the Patient Record were not heavily utilized 

during visits to psychiatrists as table 4 shews. 

Only from about 3 to 9 percent of visits included the usual medical procedures. However, 

Table 3. Number of office visits to all specialists and percent of 

offica visits to psychiatrists, by selected diagnoses classified 

by ICDA codes: United States, 1975-76 

, 

Number of 

visits to all Percent of 

thousands psychiatrists 

Schizophrenia ..... .... .. ... .. . .. .... .. .. .295 3,764 91.5 

Affectiva psychoses...296 ... . .... . .. ...296 1,923 73.0 

Neuroses ..... .. .. .... .. .. .... . ... .. ... .. ....300 25,698 49.9 

Transient and situational 

disturbances . ..... . ..... ... .. .. . ... ... 307 2,913 75.1 

Diagnosis and ICDA codel 

specialists in visits to 

Nervousness and debility 

(depression) ........ ...... ........ .....790 6,132 18.2 

lDiagnostic groups and codes are based on the Eighth Revision International Classification of Diseases, Adapted for Use 

in the United States. 

Table 4. Number and percent of office visits to psychiatrists, by 

salectad diagnostic and tharapautic sarvices ordered or provided: United States, 1975-76 

Number of 

Diagnostic or visits in Percanl of 

therapeutic service thousands 

Limitad history and 

examination ....................... .......... 2,745 

General examination ............ ............ 1,263 

Clinical lab test ...... .. .... .. .................. 751 

8100d pressura check .. ........ .... ......... 1,639 

Drug prescribed ...................... ........ .. 7,732 

Injection or immunization ............ ... 814 

Counseling ............................. .......... 1,597 

Psychotherapy .......... .............. .. ....... 26,337 

visits 

9.0 

4.1 

2.5 

5.4 

25.3 

2.7 

5.2 

86.0 

since NAMCS did not provide separately for 

diagnostic procedures more common to psychiatry such electroencephalograph and psychological testing, there is no way to estimate the 

scope of diagnostic activity. Many of these techniques are embedded in the single NAMCS c;tegory, “psychotherapy.” Unable to select a more 

specific category, psychiatrists checked this term 

for 86 percent of their visits. The definition of 

“psychotherapy” as used in NAMCS, shown in 

the Technical Notes, covers a wide variety of 

techniques, some diagnostic and some therapeutic. Therefore it is not possible to determine 

whether the 86 percent includes diagnostic, 

therapeutic, or other types of services. 

As with diagnostic services, data regarding 

certain therapeutic techniques such as psychoanalysis, sociological services, hypnotherapy, 

group therapy, or shock therapy were not available through NAMCS. Drugs were administered 

or prescribed for about 25 percent of visits 

which was less than the average proportion of 44 

percent of visits to all specialists. Drug therapy 

was selected more often for the psychotic diagnoses, schizophrenia and affective psychoses, 

than for the nonpsychotic diagnoses, personality 

disorders and neuroses. 

Highly correlating with the proportion of 

return visits, 89 percent of psychiatrists’ visits 

ress-dted in the instruction to return at a specified time. In only 4 percent of visits was no 

followup planned. The disposition of very few 

visits was admittance to a hospital. 

In view of the importance of direct physician-patient communication during psychiatric 

visits, it is not unexpected that the average dura-
amcedaa5 

Table 5. Number and percent distribution of office visits to 

psychiatrists by duration of visit: United States, 1975-76 

Number of 

Duration of visit visits in Percent 

thousands distribution 

All visits ... .. .... .. .. .. .. .. .... .. .... .. .... .. . . 30,616 100.0 

r 

O-5 minutes . ...... .. .. .... . . .... .. .. .. .. .... .. .. . 758 2.5 

6-10 minutes .................................... 892 2.9 

11-15 minutes .. .. .. .. .... ..... . .. ... ... . .. . .. .. 1,197 3.9 

16-30 minutes .. .. .... .. .. .. .. .. .. .. ... . .... .. . . 5,434 17.8 

31-60 minutes .. .. .. .. .. .. .... .. .. ... . .. .. .. ... . 21,181 69.2 

61 minutes or more .. .. .... .. .. .. .. .. .. .. .. .. 1,153 3.8 I I 

tion of psychiatric encounters exceeded that of 

other physicians. The mean contact duration 

was 15.3 minutes (*0.2) for aII physician visits 

and 46.9 minutes (*1.8 5) for psychiatrists’ 

visits. According to the data listed in table 5 

over 69 percent of visits to psychiatrists lasted 

from 31 to 60 minutes. Only 4 percent were 

more than 60 minutes long, and 9 percent consumed less than 16 minutes. 

TECHNICAL NOTES 

SOURCE OF DATA: The information presented 

in this report is based on data coIIected in the 

National Ambulatory Medical Care Survey 

(NAMCS) during 1975 and 1976. The target 

population of NAMCS encompasses office visits 

within the conterminous United States made by 

ambulaory patients to physicians who are principzdly engaged in office practice. The National 

Opinion Research Center, under contract to 

NCHS, was the organization responsible for the 

survey’s field operation. 

SAMPLE DESIGNi NAMCS utilized a multistage probability design that involves samples of 

primary sampling units (PSU’S), physician practices within PSU’S, and patient visits within 

practices. Each year a sample of practicing 

physicians is selected from master files maintained by the American Medical Association and 

the American Osteopathic Association. The 

1975-76 sample included 468 psychiatrists with 

a response rate of 88 percent for the 2 years. 

These physicians are requested to complete 

Patient Records5 for a systematic random sample of office visits taking place within their practice during a randomly assigned weekly reporting period. Participating psychiatrists completed 

7,462 Patient Records during the 2 year period. 

Characteristics of the physician’s practice, such 

as primary specialty and type of practice, are 

obtained during an induction interview. A de-

� 

5See figure I. 

tailed description of the NAMCS design and 

procedures may be found in Series 13, Number 

33, of Vital and Health Statistics. 

SAMPLING ERRORS: Since the estimates for 

this report are based on a sample rather than the 

entire universe, they tie subject to sampling variability. The relative stand=d error of an estimate is primarily a measure of sampling variability. The relative standard error of an estimate 

is obtained by dividing the standard error of the 

estimate by the estimate itself and is expressed 

as a percent of the estimate. ReIative standard 

errors of selected aggregate statistics are shown 

in table I. The standard errors appropriate for 

the estimated percentages of office visits are 

shown in table II. 

. 

Table 1. Approximate relative standard error of estimated 

numbers of office visits, NAMCS 1975-76 

Estimate Relative standard 

in error in 

thousands percentage points 

600 ........................................................ 30.2 

1,000 ..................................................... 23.5 

2,000 ..................................................... 16.7 

4,000 ..................................................... 12.0 

10,000 ................................................... 8.0 

40,000 ................................................... 4.8 

200,000 ................................................. 3.4 

1,000,000 .............................................. 3.1 

Example of use of table: An aggregate estimate of 25,000,000 

visits has a relative standard error of 6.4 percent or a standard error of 1,600,000 vWs (6.4 percent of 25,000,000). 

@ 
6


A-


Table II. Approximate stendard errors of percentages for ROUNDING: Aggregate estimates of office 

estimatednurrbers of off ice visits, NAMCS 1975-76 visits presented in the tables are rounded to the 

Estimated percentage nearest thousand. The rates and percents, howBaeeof percentage ever, were claculated on the basis of original, un­ (number of visits 1 or 5 or lOor 20

80

or 30 or 5(J rounded figures. Due to rounding of percents, the in thousands) 99 95 90 70 

sum of percentages may not equal 100.0 percent. 

Standard error in percentage points DEFINITIONS: An ambulatory patient is an in-

........................ 3.0 6.5 9.0 12.0 13.8 15.0 dividual presenting himself for personal health 

1,000 .... ......... .... .. . 2.3 5.1 7.0 9.3 10.7 11.6 services who is neither bedridden nor currently 

2,000. . .. ................ 

4poo ...... ........ .... .. . 

10,000 ................... 

1.6 

1,2 

0.7 

3.6 

2.5 

1.6 

4.9 

3.5 

2.2 

6.6 

4.7 

2.9 

;: 

3.4 

8.2 

5.8 

3.7 

admitted to any health care institution on the 

premises. 

40,000 .............. ..... 0.4 0.8 1.1 1.8 An office is a place that the physician iden200,000 ................. 0.2 0.4 0.5 ;:; ~8 o.8 tifies as a location for his ambulatory patients. 1,000,000 .............. 0,1 0.2 0.2 0.3 0.3 0.4 

Responsibility over time for patient care and 

Example of use of table: An estirnrste of 20 percent basad on professional services rendered there generally an asgregate estirnete of 80,000,000 visits haa a standard error or 

1.3 percent. The relative standard error of 20 percent is 6.5 (1.3 resides with the individual physician rather than 

percent + 20 percent). an institution. 

Figure 1. PATlENT RECORD 

ASSURANCE OF CONFKIENTIALITV—AII,Ot.rmatloo~hl.h ~ouM permitidenohcamnof an,~ 

a PmCttce,w m e,!abhsh,ne”twAIb+ held..nf,dent,d. wII be “SKI.“1” b“ WSO”, w@@ ,“ and1- B~? 

theP.,PQSWof thewwy .nd wII ..1 bed,~d.sed., ,ele~wdt. otheImw.i M used‘w anyOIIW EJUIPX8. 

1. DATE OF VISIT PATIENT RECORD 

NATIONAL AMBULATORY MEDICAL CARE SURVEY .~ 

2.	 OATEOF elRTH 4. COLOR on 5. PATIENT% PRINCIPAL PilOaLEM(S) 6. SERIOUSNESSOF 7. HAVE YOU EVERSEEN RACE COMPLAINT(S), OR SVMPTOM(S) ~ VISIT PSOaLEU IN FTEH 5a THIS PATIENT eEFORE? 

(In patient’s own words) (Check one) 

, � WHITE !L3v~ zCINO MW+==7+ — I L VERY SERIOUS 

3.	 SEX I O NEGROI . . MOST 

aLACK IMPORTANT I G SERIOUS II YES. fof the problem 

~ U FEMALE > � OTHER , ~ ~~,G~~~y ~ERlou~ ;ndica~ed in ITEM 5a? 

I � MALE � UNKNOWN I b OTHER . � NOT SERIOUS I u YES zONIJ I 

8.	 MAJOR REASON(S) FOEITHIS VISIT 

— (c,+~.i .// w., ,emo.s) 9. PNYSICIAX% PRINCIPAL OIAGNOSIS ~ VISIT

a. DIAGNOSIS ASSOCIATE WITH ITEM 5a ENTRY 

I n ACUTE PIF08LEM . : WELL ADULT/CHILD EXAM 

~~ � ACUTE PROBLEM, FOLLOW-UP , ,7 FAMILY PLANNING 

J! � CHRONIC PROBLEM, ROUTINE ~~~m COUNSELING jADVICE 

,. � CHRONIC PROaLEM, FLARE-UP , ~ IMMUNIZATION 

* � PRENATAL CARE . D REFERREO BY OTHER PHYS/AGENCY b OTHER SIGNIFICANT CURRENT OIAGNOSES 

,S � POSTNATAL CARE , U ADMINISTRATIVE PURPOSE (In ordav of importance) 

“? O POSTOPERATIVE CARE . L OTHER (sP,C,/”) 

1 

I 

(Operad.e procedure) 

10. OIAGNOSTIQ’THERAPEUTIC SERVICES OSIOEREO/PROVIOEOTENSVESET/Ch3ck#.41rh#~) 11. DISPOSITION INIS VISIT 12. OURATION OF 

0] O NoNE II � DRUG PRESCRIBED (Ched *II I*1 apply) ~ VISIT (Time 

actually spent with 

02 � LIMITED HISTORYtSXAM 12 � X.RAY phpsician) 

03 � GENERAL HISTORVIEXAM 13 0 IN-ECTION , c NO FOLLOW-UP PLANNEO 

04 D CLINICAL LA8. TEST M � IMMUNIZATIONIDESEMSITKATION 2 ~ RETURN AT SPECIFIEO TIME 

05 � 8LOOEI PRESSURE CHECK 1S ~ PHYSIOTHERAPY , 0 RETURN IF NEEDEO, P.R.N 

06 � EKG 16 � MEDICAL COUNSELING . G TELEPHONE FOLLOW. UP pLANNEO 

07 0 HEARING TEST 17 � p3vcf+07HERApYfTHERAPEuTIc s � REFERREO TO OTHER 

PHYSICIANIAGENCY 

MINUTES 

03 ff VISION TEST LISTENING 

09 0 ENCOSCOPY ~ z RtTURNEO TO REFERRING 

PHYSICIAN 

10 n OFFICE SURGERY I :., AOMIT TO HOSPITAL 

I I I HRA.34.3 DEPARTMENT 06 HEALTH, EOUCATION AND WELFARE O. M.& ~S-S72106 REV, 8.74 PUBLIC HEALTH SERVICE 

HEALTH RESOURCES ADMINISTRATION EXPIRATION OATE 12/31/75 

NATIONAL CENTER FOR HEALTH STATISTICS 
--------------------- ---

--------------------------

-----------------------------

BdmcOd-7 

A visit is a direct personal exchange between 

an ambulatory patient and a physician or a staff 

member working under the physician’s supervision for the purpose of seeking care and 

rendering health services. 

A physician is a duly licensed doctor of 

medicine (M.D.) or doctor of osteopathy (D. O.) 

currently in practice who spends time in caring 

for ambulatory patients at an office location. 

Excluded from NAMCS are physicians who specialize in anesthesiology, pathology, radiology; 

physicians who are federally employed; physicians who treat only institutionalized patients; 

physicians employed full time by an institution; 

.-. 

and physicians who spend no time seeing ambulatory patients. 

Medical counseling: Instructions and recommendations regarding any health problem, including advice or counsel about diet, change of 

habit, or behavior. Physicians are instructed to 

check this category only if the medical counseling is a significant part of the treatment. 

Psych o t h erapy/therapeutk listening: All 

treatments designed to produce a mental or 

emotional response through suggestion, persuasion, reeducation reassur~ce> Or suPPOfi~ ‘.ncludin g psychological counseling, hypnosis, 

psychoandytis, and transactional therapy. 

SYMBOLS 

Data not available—-—---—€

Cate.ow not applicable . . .€

Quantity zero—€

Quantity more.than Obut less than 0.05--–- 0.0€

Figure does not meet standards of€ r~li~ility or pr~~~on—-.-.-.--.--.-—-- *

8 aciwlncedata 

Recent Issues of Advatice Data From Vital and Health Statistics 

No. 37.	 Office Vkits to Dermatologists, National Am- No. 34. Office Vkits to Otolaryngologists, National 

bulatory Medlczd Care Survey: United States, Ambulatory Medical Care Survey: United 

1975-76 (In preparation) States, 1975-76 (In preparation) 

No. 36. Contraceptive Utilization in the United States: No. 33. Office Vk.its to Orthopedic Surgeons, National 

1973 and 1976 (Issued: August 18, 1978)	 Ambulatory ‘Medical Care Survey: United 

States, 1975-76 (Issued: July 18, 1978) 

No. 35.	 An Overview of Nursing Home Characteristics: 

Provisional Data from the 1977 National 

Nursing Home Survey (In preparation) 

A complete list of Advance Data From Vital and Health Statistics is available from the Scientific and Technical 

Information Branch. 

NCHS POSTAGE ANO FEES PAl O 

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