From Vital and Health Statistics of the National Center for Health Statistics Number 99 � September 28, 1984 

WIOPERWOF‘fHE 

PUBLWATIO;4SWWCH 

EDITORIAL LIBRARY 

Health Care of Adolescents by Office-Based Physicians: 

National Ambulatory Medical Care Survey, 1980-81 

by Beulah K. Cypress, Ph. D., Division of Health Care Statistics 

Introduction 

Adolescents 11–20 years of age do not utilize physician 

services as frequently as other persons do. Among age groups 

of patients visiting ofilce-based physicians in 1980 and 1981, 

adolescents 11–20 yearn of age had the lowest visit rate (figyre 1). 

lthough persons 11–20 years old constituted 17 percent of the 

opulation of the United States, they made only 11 percent of 

@ the ofilce visits. However, this does not necessarily indicate 

100 ~ 

OLJJJJJ


Under 11–20 21-24 2544 45-64 65 years 

11 years years years years years and over 

Age 

oFigure 1. Average annual rate of office visits by age of patient 

United States, 1980-81 

a low incidence of illness for this group because they also had 

a higher incidence of acute conditions than older age groups in 

the population did. The low rate of oi%ce visits maybe related 

to the self-limiting nature of most acute conditions that usually 

do not require as many return visits to the physician’s ofllce as 

chronic condhions do. 

This report examines the na~e of the conditions presented 

by adolescents and the health care provided by ofllce-based 

physicians. It is based on data collected in the National Ambulatory Medical Care Survey (NAMCS) during the 2-year period 

January 1980–December 1981. NAMCS is a sample survey 

of ofiice-based physicians conducted annually through 1981 by 

the National Center for Health Statistics. Data will be collected 

again in 1985. Because the estimates presented in this report 

are based on a sample rather than on the entire universe of office visits, they are subject to sampling variability. A brief description of the sample design and guidelines for judging the 

precision of the estimates are provided in the “Technical notes” 

at the end of the report. Definitions of key terms used in the 

survey also are provided. 

Patient characteristics 

Because of the many developmental changes patients 11–20 

years of age undergo during this period of life, data on visit 

characteristics are presented for “early” adolescence, 11–14 

years, and “late” adolescence, 15–20 years. Table 1 indicates 

that the latter group visited at a higher rate than the former, 

and, as in NAMCS data for other age groups, females 15–20 

years of age visited at a higher rate than males the same age 

did. The visit rate for white adolescents exceeded that of black 

adolescents. 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service 
2 achancedata 

Table 1. Average annual office visit rate of adolescents and all 

other age groups by sex, race, and age: United Statas, 1980-81 

Age 

All 

77–74 15-20 71-20 other 

Sex and race years years years ages 

Sex Rate per 100 population 

Both sexes . . . . . . . . . . . . . . . . 140 179 165 281 

Female . . . . . . . . . . . . . . . . . . . 142 219 191 326 

Male . . . . . . . . . . . . . . . . . . . . . 13B 139 139 231 

Race 

White . . . . . . . . . . . . . . . . . . . . 151 192 177 291 

Black . . . . . . . . . . . . . . . . . . . . . 89 124 111 239 

Other . . . . . . . . . . . . . . . . . . . . . 95 50 67 127 

Visit characteristics 

Table 2 includes data on the condition and management of 

adolescent patients, and the specialties most likely to provide 

their health care. For contrast, similar information is provided 

on visits by all other patients. As suggested in the introduction, 

adolescents tend to make proportionately fewer return visits to 

the same physician than other patients. About half their visits 

were made by patients the physician had seen before, who were 

returning for care of old problems, compared with about 65 percent by returning patients in all other age groups. The higher 

than average proportion of acute problems as the major reason 

for visit reflects the higher incidence of acute conditions found 

in the adolescent population. Nonillness care is proportionately 

greater in late adolescence than in early adolescence because 

visits for prenatal care and gynecological examinations are more 

likely at that age. Table 3 shows the 20 most frequent reasons 

given by patients for their visits. Symptoms of acute illness 

such as cough, throat, or ear problems accounted for 13 percent of the reasons presented by the younger group. General 

medical examination and physical examinations for extracurricular activities and for school were reasons in 11 percent of 

visits. Acne, skin rash, allergy medication, and allergy, not 

otherwise speciiled, were also common reasons for visit for this 

group. Prenatal examination and acne account for about 15 percent of the visits by the older group. The juxtaposition of these 

two reasons provides some insight into the rapid changes that 

occur during adolescence. 

The diWinction between the health care needs of patients 

in the early and late stages of adolescence is also evident in the 

kinds of diagnoses rendered during their visits to physicians. 

For the younger group, diseases of the respiratory system (21 percent) was the leading diagnostic category, followed by diagnoses 

in the supplementary classification (chiefly examinations, 16 percent), and injury and poisoning (16 percent, table 2). For the 

older group, diagnoses in the supplementary classification (25 percent) were the most common, with diseases of the skin and subcutaneous tissue ranked second with 14 percent. Diseases of 

the respiratory system and injury and poisoning each accounted 

for 13 percent. 

The developmental process is more clearly exemplified by 

an examination of the distribution of specific principal diagnoses. The 20 most frequent principal diagnoses are shown i 

table 4. The variability in the degree of maturation that is typQ , 

ical of adolescence is reflected by the two leading diagnoses 

made for patients 15–20 years of age normal pregnancy (9 percent) and diseases of the sebaceous glands (chiefly acne other 

than varioliformis, 7 percent). Acne accounted for 8 percent of 

males’ visits and 6 percent of females’ visits, but the difference 

is not statistically significant. General medical examination is 

prominent on the list of diagnoses for each adolescent age group. 

Gynecological examination and contraceptive management 

emerge as diagnoses in late adolescence. 

Adolescents are more likely to visit dermatologists and 

less likely to visit internists than other patients are. It is not unexpected that visits to obstetrician-gynecologists were more 

likely during late adolescence (14 percent) than during the earlier 

period. 

The diagnostic services and therapy likely to be utilized 

when adolescents visit ofilce-based physicians do not differ 

considerably from those used when other patients visit (table 2). 

The higher proportion of office surgery performed for adolescents than for other age groups was probably the result of the 

former’s greater tendency to have injuries. Family planning 

was included in about 5 percent of visits by patients 15–20 

years of age, a higher than average proportion. However, diet 

counseling was relatively less frequent than average. The importance of proper nutrition at thk stage of life may need greate 

emphasis. Physicians also tend to make proportionately fewe @

blood pressure measurements for patients under 21 years of 

age than for those older. 

One or more drugs were included in about 57 percent of 

adolescents’ visits, and a single drug was more likely to be prescribed than were two, three, or more. NAMC S data indicate 

that multiple drug prescription is more liiely to occur during 

visits by middle-aged and older patients than during those by 

younger patients. For these young patients, antibiotics, antihistamine drugs, skin and mucous membrane preparations, and 

analgesics and antipyretics accounted for over 60 percent of 

drug mentions (table 5). The specific drugs most frequently 

prescribed during their visits are listed in table 6 according to 

the drug name recorded by the physician on the NAMCS Patient Record form (the NAMCS data collection instrument). 

The generic substances represented by these drugs are shown 

in table 7 with a description of their most common therapeutic 

uses. 

Visits lasting less than 11 minutes were more likely for adolescents than for other age groups. About 46 percent of encounters with physicians by patients 11–14 years of age and 

51 percent of those by patients 15–20 years of age were less 

than 11 minutes in duration, compared with 42 percent of those 

by all other age groups (table 2). In about 6 percent of the 

youngest group’s visits, patients were not seen by the physician 

but by a member of the staff. This higher than average propo 

tion of “O-minute” visits probably reflects the visits in which* 

patients were given allergy relief or shota (table 6). 

The disposition of the visit is oflen related to the likelihood of acute or chronic conditions. Generally, patients with 
3


Table 2. Number of office visits made by adolescents and all other age groups and percent distribution by selected visit characteristics, 

— according to age: United Statas, 1980-81 

Age Age 

— P 

Characteristic 

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

Total . . . . . . . . . . . . . . . . . . . . . . . . . . 

Sex 

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

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

Race 

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

Black . . . . . . . . . . . . . . . . . . . . . . . . . . 

Another . . . . . . . . . . . . . . . . . . . . . . . 

Hispanic origin 

Hispanic . . . . . . . . . . . . . . . . . . . . . . . 

Non-Hispanic . . . . . . . . . . . . . . . . . . . 

Prior visit status 

New patient . . . . . . . . . . . . . . . . . . . . 

Old patient, new problem . . . . . . . . . 

Old patient, old problem . . . . . . . . . . 

Major reason for visit 

Acute problem . . . . . . . . . . . . . . . . . . 

Chronic problem, routine. . . . . . . . . . 

hronic problem, flareup . . . . . . . . . . 

ostsurge~ or postinjury. . . . . . . . . . 

Nonillness care . . . . . . . . . . . . . . . . . . 

Principal diagnosis categorf 

and ICD-9-CM codel 

infectious and parasitic 

diseases . . . . . . . . . . . . . ..001 -l3g 

Neoplasms . . . . . . . . . . ...140-239 

Endocrine, nutritional and metabolic 

diseases, and immunity 

disorders . . . . . . . . . . . ...240-279 

Mental disorders. . . . . . ...290-319 

Diseases of the newous system and 

sense organs. . . . . . . . ...320-389 

Diseases of the circulatory 

system . . . . . . . . . . . . . . ..39 O-459 

Diseases of the respiratory 

system . . . . . . . . . . . . . . ..46O-5l 9 

Diseases of the digestive 

system . . . . . . . . . . . . . ...520-579 

Diseases of the genitourinary 

system . . . . . . . . . . . . . ...580-629 

Diseases of the skin and 

subcutaneous tissue. . ...680-709 

Diseases of the musculoskeletal 

system and connective 

tissue . . . . . . . . . . . . . . . ..71 O-739 

Symptoms, signs, and ill-defined 

conditions. . . . . . . . . . ...780-799 

Injury and poisoning. . . . . . 800–999 

Supplementary’ 

classification. . . . . . . . . . . VO1 -V82 

11other diagnoses . . . . . . . . . . . . . . 

nknown diagnoses. . . . . . . . . . . . . . 

71-14 15–20 All other 

years years ages 

Number in thousands 

40,269 87,172 1,033,482 

Percent distribution 

100.0 100.0 100.0 

49.4 61.3 60.6 

50.6 38.7 39.4 

88.8 89.7 89.4 

9.4 9.7 9.5 

1.8 0.7 1.1 

4.6 5.4 4.5 

95.4 94.6 95.5 

18.3 20.8 13.7 

31.7 26.1 21.6 

50.0 53.2 64.7 

47.2 41.0 35.6 

20.5 19.4 29.1 

6.2 5.7 9.6 

9.4 9.9 8.7 

16.8 24.0 17.1 

6.2 5.5 2.9 

“0.7 0.9 2.9 

“0.7 1.5 4.2 

2.2 2.9 4.3 

11.1 6.3 9.6 

“0.5 1.1 10.8 

20.7 13.3 12.2 

3.0 2.8 4.4 

2.7 6.0 6.0 

8.7 13.6 5.2 

4.8 3.6 7.2 

3.4 2.5 3.4 

16.1 12.5 7.5 

16.4 24.9 16.9 

1.4 1.5 1.3 

1.6 1.0 1.2 

17– 14 15-20 All other 

Characteristic years years ages 

Diagnostic servicesz 

None . . . . . . . . . . . . . . . . . . . . . . . . . . 

Limited history and/or 

examination . . . . . . . . . . . . . . . . . . . 

General history and/or 

examination . . . . . . . . . . . . . . . . . . . 

Pap test . . . . . . . . . . . . . . . . . . . . . . . . 

Clinical laborato~ test. . . . . . . . . . . . 

X-ray . . . . . . . . . . . . . . . . . . . . . . . . . . 

Blood pressure check. . . . . . . . . . . . . 

Electrocardiogram. . . . . . . . . . . . . . . . 

Vision test . . . . . . . . . . . . . . . . . . . . . . 

Endoscopy . . . . . . . . . . . . . . . . . . . . . . 

Mental status examination. . . . . . . . . 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . 

Nonmedication therapyz 

None . . . . . . . . . . . . . . . . . . . . . . . . . . 

Physiotherapy . . . . . . . . . . . . . . . . . . . 

Office surgery . . . . . . . . . . . . . . . . . . . 

Family planning . . . . . . . . . . . . . . . . . 

Psychotherapy or therapeutic 

listening . . . . . . . . . . . . . . . . . . . . . . 

Diet counseling . . . . . . . . . . . . . . . . . . 

Family or social counseling . . . . . . . . 

Medical counseling . . . . . . . . . . . . . . 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . 

Number of medications 

None . . . . . . . . . . . . . . . . . . . . . . . . . . 

1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

3 or more . . . . . . . . . . . . . . . . . . . . . . 

Physician specialty 

General and family practice. . . . . . . . 

internal medicine . . . . . . . . . . . . . . . . 

Pediatrics . . . . . . . . . . . . . . . . . . . . . . 

Obstetrics and gynecology . . . . . . . . 

Dermatology . . . . . . . . . . . . . . . . . . . . 

General surgery . . . . . . . . . . . . . . . . . . 

Ophthalmology . . . . . . . . . . . . . . . . . . 

Otolaryngology . . . . . . . . . . . . . . . . . . 

Psychiatry . . . . . . . . . . . . . . . . . . . . . . 

All other specialties . . . . . . . . . . . . . . 

Duration of visit 

O minutes3 . . . . . . . . . . . . . . . . . . . . . 

l–5 minutes . . . . . . . . . . . . . . . . . . . . 

6–10 minutes . . . . . . . . . . . . . . . . . . . 

11–15 minutes . . . . . . . . . . . . . . . . . . 

16-30 minutes . . . . . . . . . . . . . . . . . . 

31minutes or longer . . . . . . . . . . . . . 

Disposition of visi@ 

No followup planned . . . . . . . . . . . . . 

Return at specified time. . . . . . . . . . . 

Return if needed . . . . . . . . . . . . . . . . . 

Telephone followup planned. . . . . . . 

Referred to other physician . . . . . . . . 

Returned to referring physician. . . . . 

Admit to hospital . . . . . . . . . . . . . . . . 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . 

Percent distribution 

13.0 9.8 7.8 

62.1 64.3 64.4 

15.9 15.3 15.5 

“0.4 4.B 4.5 

20.3 23.9 21.8 

9.2 7.4 7.4 

15.8 29.5 35.4 

“0.5 0.5 3.3 

8.2 5.6 5.7 

“0.2 “0.4 1.0 

“0.9 1.4 1.5 

3.3 3.9 5.1 

57.3 52.9 53.8 

4.6 5.3 4.8 

13.2 11.7 6.8 

“0.5 4.9 1.9 

2.3 3.7 5.1 

3.8 4.6 8.5 

2.5 2.2 2.1 

19.5 20.3 23.4 

3.4 2.4 2.5 

43.8 43.3 37.5 

34.3 31.5 30.7 

15.3 17.0 17.9 

6.6 8.3 13.9 

34.1 35.8 32.6 

2.8 5.8 13.4 

29.3 8.3 10.6 

“0.9 13.9 9.3 

6.4 11.1 3.8 

3.3 4.7 5.4 

4.9 3.9 5.5 

2.6 2.1 2.3 

1.7 2.3 2.8 

14.1 12.1 14.4 

5.6 2.2 2.5 

15.6 17.8 12.1 

30.7 32.9 29.8 

26.0 25.5 28.1 

18.6 17.3 21.2 

3.7 4.3 6.3 

19.7 17.6 10.7 

47.2 53.2 61.8 

28.2 24.1 22.4 

3.8 3.5 3.4 

2.6 2.7 2.6 

“0.7 ‘0.4 0.8 

1.2 1.6 2.4 

“0.2 “0.3 0.2 

1Based on U.S. Public Health Service and Health Care Financing Administration: International Classification of Diseases, 9th Revision, Clinical Modification 

(ICO-9-CM). DHHS Pub. No. [PHS) 80-1260. Public Health Sewice. Washington. U.S. Governmen~ Printing Mice, Sept- 1980,


‘Percents will not total 100.0 because more than 1 aawice or therapy may have been provided during a visit.


3Visits in which there was no face-to-face encounter between patient and physician.


4Percents will not total 100.0 because more than 1 diapoaition waa poaaible.


0 
4 admncedata 

Table 3. Number of office visits made by adolescents and percent distribution by the 20 most frequent principal reasons for visit, according to 

age: United States, 1980-81 

Number of Number of 

Age, principal reason visits in Percent Age, principal reason visits in Percent 

for visit, and RVC code 1 thousands distribution for visit, and RVC code 1 thousands distribution 

11-14 years 15-20 years 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . 40,269 100.0 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87,172 100.0 

Symptoms referable to throat . . S455 2,646 6.6 Prenatal examination, routine . . . X205 6,985 8.0 

Generel medical examination . . . . . . . Xl 00 2,431 6.0 Acne or pimples . . . . . . . . . . . . . . . . .. S830 5,811 6.7 

Allergy medication . . . . . . . . . . . . . . .. TIOO 1,780 4.4 Symptoms referable to throat . . . . . . . S455 4,937 5.7 

Earache, or ear infection . . . . . . . . . . S355 1,482 3.7 General medical examination . . . . . . . Xl 00 2,892 3.3 

Acne orpimples ... . . . . . . . . . . . . . .. S83O 1,356 3.4 Skin rash. . . . . . . . . . . . . . . . . . . . . . . . S860 2,0B4 2.4 

Cough . . . . . . . . . . . . . . . . . . . . . . . . .. S44O 1,196 3.0 Postoperative visit . . . . . . . . . . . . . . . . T205 1,761 2.0 

Skin rash . . . . . . . . . . . . . . . . . . . . . . .. S860 1,187 2.9 Progress visit, not otherwise 

Physical examination for extracurricular specified . . . . . . . . . . . . . . . . . . . . . .. T800 1,737 2.0 

activities . . . . . . . . . . . . . . . . . . ... .. A115 1,091 2.7 Cough . . . . . . . . . . . . . . . . . . . . . . . . . . S440 1,452 1.7 

Knee symptoms . . . . . . . . . . . . . . . . .. S925 860 2.1 Abdominal pain, cramps, spasms . . . . S550 1,441 1.7 

Progress visit, not otherwise Physical examination required for 

specified . . . . . . . . . . . . . . . . . . . . . .. T800 723 1.8 school . . . . . . . . . . . . . . . . . . . . . . . .. AIIO 1,423 1.6 

Physical examination required for Allergy medication . . . . . . . . . . . . . . .. TIOO 1,329 1.5 

school . . . . . . . . . . . . . . . . . . . . . . . .. AIIO 708 1.8 Physical examination for extracurricular 

Headache, pain in head. . . . . . . . . . . . S21O 678 1.7 activities . . . . . . . . . . . . . . . . . . . . . .. AI15 1,268 1.5 

Stomach pain, cramps and spasms. S545 670 1.7 Earache, or ear infection . . . . . . . . . . . S355 1,239 1.4 

Eye examination . . . . . . . . . . . . . . . . .. X230 644 1.6 Knee symptoms . . . . . . . . . . . . . . . . .. S925 1,138 1.3 

Poatoperative visit . . . . . . . . . . . . . . . T205 626 1.6 Headache, pain in head. . . . . . . . . . . . S210 1,120 .3 

Fear . . . . . . . . . . . . . . . . . . . . . . . . . .. SO1O 575 1.4 Head cold, upper respirato~ infection 

Warts, not otherwise specified . . . . . . S850 555 1.4 (coryza) . . . . . . . . . . . . . . . . . . . . . . .. S445 1,062 .2 

Allergy, not otherwise specified . . . . . S090 555 1.4 Back symptoms . . . . . . . . . . . . . . . . .. S905 1,044 .2 

Vision dysfunctions . . . . . . . . . . . . . . . S305 543 1.3 Eye examination . . . . . . . . . . . . . . . . .. X230 965 .1 

Head cold, upper respiratory infection Gynecological examination . . . . . . . . . X225 889 .0 

(coryza) . . . . . . . . . . . . . . . . . . . . . . .. S445 491 1.2 Warts, not otherwise specified . . . . . . SB50 878 .0 

Residual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48.3 Residual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52.4 

1Based on: National Center for Health Statistics, D, Schneider, L. Appleton, and T. McLemore: A reason for visit classification for ambulatory care (RVC). Vfta/ and 

Hea/th Statistics. Series 2, No. 78. DHEW Pub. No. (PHS) 79–1 352, Public Health Service. Washington. U.S. Government Printing Office, Feb.0 1979. 

chronic conditions are more likely to be scheduled for return shows, the proportion of visits that cuhninated with this instrucvisits than are those with acute self-limiting conditions. tion is higher in late adolescence than in early, but both groups 

Because the youngest group (1 1–14 years) had proportion- have lower proportions of visits in which return visits were 

ately more acute problems than other patients, they were also scheduled than other age groups did. 

least likely to be told to return at a specified time. As table 2 
ackmdda5 

TabIe 4. Number of office visits made by adolescents and percent distribution by the 20 most frequent principal diagnoses, according to age 

United States, 1980-81 

@ 

e 

Number of Number of 

Age, principal diagnosis, visits in Percent Age, principal diagnosis, visits in Percent 

and ICD-9-CM codel thousands distribution and lCD-9–CM codel thousands distribution 

11–14 years 15-20 yeara 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40,269 100.0 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87,172 100.0 

General medical examination . . . . . . . . V70 

Allergic rhinitia . . . . . . . . . . . . . . . . . ...477 

Diseases of sebaceous glandsz. . . . ...706 

Acute phawngitis . . . . . . . . . . . . . . . ...462 

Acute upper respiratory infections of 

multiple or unspecified sites . . . . . ...465 

Suppurative snd unspecified otitis 

media . . . . . . . . . . . . . . . . . . . . . . . . . ...382 

Asthma . . . . . . . . . . . . . . . . . . . . . . . ...493 

Disorders of refraction and 

accommodation . . . . . . . . . . . . . . . ...367 

Routine infant or child health 

check . . . . . . . . . . . . . . . . . . . . . . . .. V20.2 

Certain adverse effects not elsewhere 

classified . . . . . . . . . . . . . . . . . . . . ...995 

Acute tonsillitis . . . . . . . . . . . . . . . . . ...463 

Other diseases due to viruses and 

chlamydiae . . . . . . . . . . . . . . . . . . . ...078 

Contact dermatitis and other 

eczema . . . . . . . . . . . . . . . . . . . . . . . . . 692 

Fracture of radius and ulna. . . . . . . . ...813 

Disorders of external ear . . . . . . . . . ...380 

Curvature of spine . . . . . . . . . . . . . . . . ..737 

Bronchitis, not specified as acute or 

chronic . . . . . . . . . . . . . . . . . . . . . . ...490 

Observation and evaluation for suspected 

conditions . . . . . . . . . . . . . . . . . . . . . ..V71 

ther noninfective gastroenteritis and 

colitis . . . . . . . . . . . . . . . . . . . . . . . . ...558 

Followup examination . . . . . . . . . . . . . . V67 

Residual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2,832 7.0 

1,760 4.4 

1,629 4.0 

1,297 3.2 

1,296 3.2 

1,177 2.9 

1,109 2.8 

1,054 2.6 

930 2.3 

808 2.0 

791 2.0 

770 1.9 

684 1.7 

551 1.4 

527 1.3 

460 1.1 

*435 1.1 

*422 1.0 

“41 3 1.0 

“405 1.0 

. . . 52.1 

Normal pregnancy . . . . . . . . . . . . . . . ..V22 

Diseases of sebaceous glands. . . . . ...706 

General medical examination . . . . . . . . V70 

Acute pharyngitis . . . . . . . . . . . . . . . ...462 

Acute upper respiratory infections of 

multiple or unspecified sitea . . . . . ...465 

Special investigations and 

examinations4 . . . . . . . . . . . . . . . . . . ..V72 

Disorders of refraction and 

accommodation . . . . . . . . . . . . . . . ...367 

Allergic rhinitis . . . . . . . . . . . . . . . . . ...477 

Other diseases due to viruses and 

chlamydiae . . . . . . . . . . . . . . . . . . . ...078 

Followup examination . . . . . . . . . . . . . . V67 

Acute tonsillitis . . . . . . . . . . . . . . . . . ...463 

Contact dermatitis and other 

eczema . . . . . . . . . . . . . . . . . . . . . . . . . 692 

Suppurative and unspecified otitis 

media . . . . . . . . . . . . . . . . . . . . . . . . ...382 

Contraceptive management. . . . . . . . . . V25 

Asthma . . . . . . . . . . . . . . . . . . . . . . . ...493 

Disorders of menstruation and other 

abnormal bleeding from female genital 

tract . . . . . . . . . . . . . . . . . . . . . . . . . ...626 

Bronchitis, not specified as acute or 

chronic . . . . . . . . . . . . . . . . . . . . . . ...490 

Disorders of external ear . . . . . . . . . ...380 

Chronic sinusitis . . . . . . . . . . . . . . . . ...473 

Neurotic disorders . . . . . . . . . . . . . . ...300 

Residual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

7,926 9.1 

7,306 8.4 

5,457 6.3 

2,439 2.8 

2,242 2.6 

1,756 2.0 

1,525 1.7 

1,482 1.7 

1,427 1.6 

1,345 1.5 

1,254 1.4 

1,146 1.3 

955 1.1 

866 1.0 

851 1.0 

820 0.9 

78.8 0.9 

731 0.8 

722 0.8 

719 0.8 

. . . 52.3 

1Based on U.S. Public Health Service and Health Care Financing Administration: hrterrrationa/ Classification of Diseases, 9th Revision, Clinical Modification€

(ICD-9-CM). DHHS Pub. No. (PHS) 80-1260. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1980.


‘Chiefly 706.1, acne other than varioliformis.


3Chiefly 995.3, allergy unspecified.


4Chiefly V72.3, gynecological examination.

�

6 acklncedata 

Table 5. Number of drug mentions in ofFice visits made by adolescents and all other age groups and percent distribution by therapeutic 

category, according to age: United States, 1980–81 

Age 

11-14 ?5-20 All other 

Therapeutic category! years years ages 

Number in thousands 

All categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34,950 81,382 1,214,414 

Percent distribution 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 

Antihistamine drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.7 9.0 6.1 

Anti-infective agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.4 29.6 14.5 

Antibiotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.3 27.2 12.2 

Autonomic drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3 3.3 3.8 

Blood formation and coagulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “0.4 1.0 1.3 

Antianemia drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ‘0.4 1.0 0.8 

Cardiovascular drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “0.5 “0.7 10.9 

Central newous system drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.9 9.5 16.9 

Analgesics andantipyretics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.6 6.3 9.0 

Psychotherapeutic agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “0.3 0.9 2.5 

Sedatives and hypnotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *1.O 1.5 3.8 

Diagnostic agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 0.8 0.4 

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 0.8 0.4 

Electrolytic, caloric, and water balance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “0.6 1.0 8.8 

Expectorants andcough preparations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1 3.2 2.7 

Eye, ear, nose and throat preparations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 3.4 3.7 

Anti-infectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 1.4 0.9 

Anti-inflammatory agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “1.0 0.8 0.7 

Gastrointestinal drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *1.5 2.2 3.6 

Hormones and synthetic substitutes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 6.2 8.5 

Adrenals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 2.6 

Contraceptives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “0.4 4.2 

Serums, toxoids and vaccines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.6 3.0 

Toxoids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9 1.8 

Vaccines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 1.1 2.0 

Skin andmucous membrane preparations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.9 7.6 7.0 

Anti-infectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.8 3.2 1.7 

Anti-inflammatory agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 4.1 2.9 

Cell stimulants andproliferants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *1.O 1.6 0.2 

Keratolytic agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 5.6 0.6 

Spasmolytic agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 “0.7 1.7 

Vitamins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “0.8 4.4 3.4 

Other, unclassified or undetermined. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 2.4 3.1 

1Based on American Society of Hospital Pharmacists, Inc.: The American Hospital Formulary Service. Washington. Jan, 1980. 
7


Table 6. Number and percent distribution of drug mentions in office visits made by adolescents (and percent distribution) by age and most 

frequently named drugs: United States, 1980-81 

� Number Number 

Age and in Percent Age and in Percent name of drugl thousands distribution name of drug~ thousands distribution 

11-14 years 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Allergy relief orshots . . . . . . . . . . . . . . . . . . 

Ampicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Penicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Aspirin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tetracycline . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tuberculin tine test . . . . . . . . . . . . . . . . . . . . 

E.E.S.(e~thromycin) . . . . . . . . . . . . . . . . . . . 

Erythromycin . . . . . . . . . . . . . . . . . . . . . . . . . 

Amoxicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Dimetapp . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Pen-Vee K . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Actifed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

V-Cillin (penicillin) . . . . . . . . . . . . . . . . . . . . . 

Cleocin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Poliomyelitis vaccine . . . . . . . . . . . . . . . . . . . 

Diphtheria tetanus toxoids . . . . . . . . . . . . . . 

Residual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

15-20 years 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tetracycline . . . . . . . . . . . . . . . . . . . . . . . . . . 

Allergy relief orshots . . . . . . . . . . . . . . . . . . 

Cleocin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Penicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

mpicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

thromycin . . . . . . . . . . . . . . . . . . . . . . . . . 

15-20 years—Con. 

34,950 100.0 Retin-A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2,878 8.2 

1,090 3.1 

1,032 3.0 

937 2.7 

912 2.6 

835 2.4 

609 1.7 

554 1.6 

533 1.5 

503 1.4 

461 1.3 

461 1.3 

*433 1.2 

“427 1.2 

“405 1.2 

’360 1.0 

. . . 64.6 

81,382 100.0 

3,724 4.6 

2,354 2.9 

2,307 2.8 

2,195 2.7 

2,065 2.5 

1,446 1.8 

Aspirin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Desquam-X (benzoyl peroxide). . . . . . . . . . . 

Minocin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Actifed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Ortho-novum . . . . . . . . . . . . . . . . . . . . . . . . . 

Tuberculin tine test . . . . . . . . . . . . . . . . . . . . 

E-mycin (e~hromycin) . . . . . . . . . . . . . . . . . 

Pen-Vee K . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Prednisone . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Keflex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

E.E.S.(erythromycin) . . . . . . . . . . . . . . . . . . . 

Lo/ovral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Prenatal vitamins . . . . . . . . . . . . . . . . . . . . . . 

Benzac (benzoyl peroxide) . . . . . . . . . . . . . . 

Diphtheria tetanus toxoids . . . . . . . . . . . . . . 

Tetanus toxoid . . . . . . . . . . . . . . . . . . . . . . . . 

Dimetapp . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Cortisporin . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Skin preparation . . . . . . . . . . . . . . . . . . . . . . . 

Bead@. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

8enzoyl (benzoyl peroxide). . . . . . . . . . . . . . 

Sumycin (tetracycline). . . . . . . . . . . . . . . . . . 

Benzagel (benzoyl peroxide). . . . . . . . . . . . . 

Drixoral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Monistat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Residual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1,335 1.6 

1,253 1.5 

946 1.2 

911 1.1 

858 1.1 

831 1.0 

812 1.0 

806 1.0 

777 1.0 

692 0.9 

687 0.8 

629 0.8 

624 0.8 

624 0.8 

618 0.8 

572 0.7 

564 0.7 

542 0.7 

509 0.6 

496 0.6 

478 0.6 

476 0.6 

471 0.6 

457 0.6 

457 0.6 

*446 0.5 

. . . 60.5 

Based on the physician’s entry on the Patient Record form. 
8 admncedata 

Table 7. Number of generic drugs utilized in office visits made by adolescents by age and the 30 most frequently used generic substances 

described by their most common therapeutic uses: United States, 1980–81 

Number Numbe 

Age, generic substance, and in Age, generic substance, and in 

most common therapeutic use thousands most common therapeutic use thousands 

11-14 yesrs 

Penicillin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Erythromycin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . 

Phenylpropanolamine (sympathomimetic) . . . . . . . . . . . . . 

Phenylephrine (sympathomimetic) . . . . . . . . . . . . . . . . . . . . 

Ampicillin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Pseudoephedrine (antihistaminic, cough suppressant) . . . . 

Chlorpheniramine (anti histaminic) . . . . . . . . . . . . . . . . . . . 

Tetracycline (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Guaifenesin (cough suppressant) . . . . . . . . . . 

Amoxicillin (antibiotic)........,.. . . . . . . . . . . . . . . . . . . . 

Aspirin (analgeaic, antipyretic) . . . . . . . . . . . . . . . . . . . . . 

Neomycin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tuberculin (tuberculosis skin tast) . . . . . . . . . . . . . . . . . . . . 

Hydrocortisone (anti-inflammatory). . . . . . . . . . . . . . . . . . . . 

Brompheniramine (expectorant) . . . . . . . . . . . . . . . . . . . . 

Benzoyl peroxide (keratolytic, acne treatment) . . . . . . . . . 

Codeine (analgesic, antitussiva) . . . . . . . . . . . . . . . . . . . 

Polymyxin B (antibacterial) . . . . . . . . . . . . . . . . . . . . . . . . . . 

Bacitracin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Theophyllina (vasodilator) ...,.... . . . . . . . . . . . . . . . . 

Triprolidine (antihistaminic). . . . . . . . . . . . . . . . . . . . . . . . 

Atropine (anticholinergic) . . . . . . . . . . . . . . . 

Hyoscyamine (anticholinergic) . . . . . . . . . 

Promethazine (antihistaminic). . . . . . . . . . . . . . . . 

Acetaminophen (analgesic, antipyretic) . . . . . . . . . . . . . 

Salicylic acid (antifungal, keratolytic) . . . . . . . . . . . . . . . . . 

Phenobarbital (anticonvulsant, sedative, hypnotic) . . . 

Scopolamine (hypnotic, sedative, anticholinergic) . . . . . . 

Clindamycin (antibiotic) . . . . . . . . . . . . . . . . 

Polio vaccine (immunization) . . . . . . . . . . . . . . . . . . . . . . . . 

2,179 

1,696 

1.645 

1,369 

1,308 

1,239 

1,232 

1,191 

1,112 

1,097 

1,025 

959 

835 

830 

803 

736 

714 

694 

660 

647 

584 

513 

508 

499 

498 

491 

463 

460 

*427 

“405 

15-20 years 

Tetracycline (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Panic illin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Erythromycin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Benzoyl peroxida (keratolytic, acne treatment) . . . . . . . . . . 

Estradiol (estrogen) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Aspirin (analgesic, antipyretic) . . . . . . . . . . . . . . . . . . . . . . . 

Clindamycin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Pseudoephedrina (antihistaminic, cough suppressant) . . . . 

Ampicillin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Multivitamins prenatal (vitamins) . . . . . . . . . . . . . . . . . . . . . 

Phenylpropanolam ina (sympathomimetic) . . . . . . . . . . . . . . 

Phanylephrine (sympathomimetic) . . . . . . . . . . . . . . . . . . . . 

Chlorphenirsmine (antihistaminic) . . . . . . . . . . . . . . . . . . . . 

Norethindrone (oral contraceptive) . . . . . . . . . . . . . . . . . . . . 

Hydrocortisone (anti-inflammatory). . . . . . . . . . . . . . . . . . . . 

Brompheniramine (expectorant) . . . . . . . . . . . . . . . . . . . . . . 

Tratinoin (karatolytic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Neomycin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Codeine (analgesic, antitussive) . . . . . . . . . . . . . . . . . . . . . . 

Acetaminophen (snalgesic, antipyretic) . . . . . . . . . . . . . . . . 

Iron preparations (iron deficiency) . . . . . . . . . . . . . . . . . . . . 

Polymyxin B (antibacterial) . . . . . . . . . . . . . . . . . . . . . . . . . . 

Amoxicillin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Guaifenesin (cough suppressant) . . . . . . . . . . . . . . . . . . . . . 

Salicylic acid (antifungal, keratolytic) . . . . . . . . . . . . . . . . . . 

Troprolidine (antihistaminic) . . . . . . . . . . . . . . . . . . . . . . . . 

Bacitracin (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Triamcinolone (anti-inflammatory) . . . . . . . . . . . . . . . . . . . . 

Minocycline (antibiotic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Norgeatrel (oral contraceptive) . . . . . . . . . . . . . . . . . . . . 

5,077 

4,031 

3,473 

3,367 

2,579 

2,461 

2,347 

2,302 

2,201 

2,128 

1,964 

1,712 

1,657 

1,615 

,445 

,390 

,335 

,278 

,272 

,246 

,186 

1,059 

1,058 

1,044 

1,021 

998 

983 
9


Technical notes 

c’ urce of data and sample design 

@ 

* 

The estimates presented in this report are based on the 

findings of the National Ambulatory Medical Care Survey 

(NAMCS), a sample survey of ofi-ice-based care conducted 

annually from 1973 through 1981 by the National Center for 

Health Statistics. The target universe of NAMCS is composed 

of oftlce visits made by ambulatory patients to non-Federal and 

noninstitutional physicians who are principally engaged in offlcebased, patient-care practice. Visits to physicians practicing in 

Alaska and Hawaii are excluded from the range of NAMCS, 

as are visits to anesthesiologists, pathologists, and radiologists. 

NAMCS uses a multistage probability sample design that 

involves a step sampling of primary sampling units (PSU’s), 

physicians’ practices within PSU’S, and patient visits within 

physicians’ practices. The physician sample (5,805 physicians 

for 1980 and 1981) was selected from master files maintained 

by the American Medical Association and the American Oste& 

pathic Association. Those members of the sample who proved 

to be in scope and eligible participated at a rate of 77.3 percent. 

Responding physicians completed visit records for a systematic 

random sample of office visits made during a randomly assigned 

weekly reporting period. Telephone contacts were excluded. 

During 1980 and 1981 responding physicians completed 89,447 

visit records on which they recorded 97,796 drug mentions. 

haracteristics of the physician’s practice, such as primary 

ecialty and type of practice, were obtained during an inducion interview. The National Opinion Research Center, under 

contract to the National Center for Health Statistics, was responsible for the field operations of the survey. 

Sampling errors and rounding 

The standard error is a measure of the sampling variability 

that occurs by chance because only a sample, rather than the 

entire universe, is surveyed. The relative standard error of an 

estimate is obtained by dividing the standard error by the estimate itself and is expressed as a percent of the estimate. In this 

report, any estimate that exceeds a relative standard error of 

30 percent is marked with an asterisk. Table I should be used 

to obtain the relative standard error for aggregates of office 

visits or for mentions of drugs by specific name (for example, 

Darvon). Table II should be used to obtain the relative standard error for drug mentions expressed as drug groups (for example, the analgesic drug family). 

In this report, the determination of statistical signitlcance 

is based on the t-test with a critical value of 1.96 (0.05 level of 

signitlcance). Terms relating to dflerences, such as “higher” 

or “less,” indicate that the ditTerences are statistically signifi 

cant. Terms such as “similar” or “no difference” mean that no 

tatistical significance exists between the estimates being comed. A lack of comment in a comparison between any two 

timates does not mean that the difference was tested and was 

not signiilca.nt. 

In the tables of this report estimates have been rounded to 

the nearest thousand. For this reason, detailed estimates do not 

always add to totals. 

Table 1. Approximate relative standard errors of estimated numbers 

of office visits and of drug mentions when drug is listad by product 

name (for example, Darvon), based on all physician specialties: 

National Ambulatory Medical Care SuweY,1980-81 

Relative 

Estimated number of office visits standard 

or specific drug mentions error 

Number in thousands Percent 

*200. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *44.8 

*BOO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *31 .7 

*450 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “30.0 

600 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.0 

800 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.6 

1,000......................................... 20.2 

2,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.5 

5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5 

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 

20,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.6 

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 

100,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 

200,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6 

500,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5 

1,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 

EXAMPLE OF USE OF TABLE An aggregate estimate of 35,000,000 office 

visits has a relative standard error of 5.0 percent or a standard error of 

1,750,000 visita (5.0 percent of 35,000,000 visits). 

Tabla 11. Approximate relativa standard errors of estimated 

numbers of drug mantions when drugs appaar in groups (for 

example, the analgesic drug family), based on aII physician 

specialties National Ambulatory MedicaI Care Survey, 1980-81 

Relative 

Estimated number of standard 

grouped drug mentions error 

Number in thousands Percent 

*BOO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *54.2 

‘400 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *38.5 

*BOO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *31 .5 

*650 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830.0 

800. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.3 

1,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.5 

2,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.6 

5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.6 

10,000
........................................ 8.7 

20,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.8 

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.3 

100,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7 

200,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 

500,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 

1,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 

EXAMPLE OF USE OF TABLE An aggregate estimate of 30,000,000 drug 

mentions has a relative standard error of 7.0 percent or a standard error of 

2,100,000 mentions (7.0 percent of 30,000,000 mentions). 

Definitions 

An oflce is a place that physicians identi& as a location 

for their ambulato~ practice. Responsibility for patient care 

and professional services rendered in an office resides with the 

individual physician rather than an institution. 

A visitisa direct personal exchange between an ambulatory patient seeking health care and a physician, or staff member working under the physician’s supervision, who provides 

the health services. 
10 aduancedata 

A drug mention is the physician’s entry on the visit record 

of a pharmaceutical agent ordered or provided by any route of 

administration for prevention, diagnosis, or treatment. Generic 

as well as brand-name drugs are included as are nonprescription 

as well as prescription drugs. The physician records all new 

drugs and also records all continued medications if the patient 

is specifically instructed during the visit to continue the medication. 

An acute problem is a morbid condition with a relatively 

sudden or recent onset (within 3 months of the visit). 

A chronic problem is a morbid condition that existed for 

3 months or longer before the visit. The care indicated is of 

regular, maintenance nature. 

A chronic problem j7areup is a sudden exacerbation of oa 

preexisting chronic condition. 

Nonillness care denotes health examinations and care provided for presumably healthy persons. Examples of nonillness 

care include prenatal and postnatal care, annual physicals, wellchild examinations, and insurance examinations. 
dwmdata 11 

.-. 

. . . 

z 

* 

# 

Symbols 

Data not available 

Categoty not applicable 

Quantity zero 

Quantity more than zero but less than 

0.05 

Quantity more than zero but less than 

500 where numbers are rounded to 

thousands 

Figure does not meet standards of 

reliability or precision 

Figure suppressed to comply with 

confidentiality requirements 

0.0 
12 ackincedata


Recent Issues of Advance Data From Vital and Health Statistics 

No. 98. Diagnosis-Related Groups Using Data From the National 

Hospital Discharge Survey United States, 1981 (Issued July 20, 1984) 

No. 97. The Management of New Pain in Otlice-Based Ambulato~ 

Care: National Ambulatory Medical Care Survey, 1980 and 1981 

(Issued June 13, 1984) 

No. 96. Utilization of Analgesic Drugs in Office-Based Ambulatory 

Care: National Ambulatory Medical Care Survey, 1980-81 (Issued 

March 14, 1984) 

Suggested Citation 

National Center for Health Statistics, B. K. Cypress:


Health care of adolescents by office-based


physicians, National Ambulatory Medical Care


Survey, 1980–81 Advanca Data From Vital and


Health Statistics. No. 99. DHHS Pub. No.


(PHS) 84–1250. Public Health Service. Hyattsville,


Md., Sept. 28, 1984


U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Public Health Service 

National Center for Health Statistics


3700 East-West Highway


Hyattsville, Maryland 20782


OFFICIAL BUSINESS


PENALTY FOR PRIVATE USE, $300


To receive this publication regularly, contact


the National Center for Health Statistics by


calling 301 436–NCHS.


DHHS Publication No. (PHS) 84–1 250


No. 95. 1982 Summary: National Hospital Discharge Survey (J 

sued December 27, 1983) � 

No. 94. Discharge Status of Inpatients Discharged From ShortStay Hospitals: United States, 1965-81 (Issued November 22, 1983) 

Copyright Information 

This report may be reprinted without further 

permission. 

THIRD CLASS MAIL 

BULK RATE 

POSTAGE & FEES PAID 

PHS/NCHS 

PERMIT No. G-281 

m