NCHS Data Brief ■ No. 161 ■ July 2014

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Age Differences in Visits to Office-based Physicians by 

Patients With Diabetes: United States, 2010

Jill J. Ashman, Ph.D.; Anjali Talwalkar, M.D., M.P.H.; and Shelby A. Taylor, M.P.H.

Key findings

Data from the National 

Ambulatory Medical Care 

Survey

• Office-based physician 

visits by patients with diabetes 

increased 20%, from 94.4 

million in 2005 to 113.3 million 

in 2010, but the rate did not 

change between 2005 and 

2010. 

• The visit rate for diabetes 

increased with age and 

averaged 1,380 visits per 1,000 

persons aged 65 and over in 

2010.

• A majority of visits made by 

patients with diabetes (87%) 

were by those with multiple 

chronic conditions, and the 

number of chronic conditions 

increased with advancing age.

• Medications were prescribed 

or continued at a majority of 

visits (85%) made by patients 

with diabetes, with the number 

of medications prescribed or 

continued increasing as age 

increased.

Diabetes is a chronic condition which affects nearly 29 million Americans 

and is a major cause of other chronic conditions, including heart disease, eye 

disease, and stroke (1). Diabetes was the seventh leading U.S. cause of death 

in 2009 and 2010 (2,3). Management of diabetes costs nearly $245 billion 

annually, and patients with diabetes have medical expenditures approximately 

2.3 times higher than those for patients without diabetes (4). This data brief 

shows the trend from 2005 through 2010 for visits to office-based physicians 

by patients with diabetes, and describes age differences in the utilization of 

health care by patients with diabetes in 2010.

Keywords: health care utilization • office-based physician care • NAMCS

Did the number of office-based physician visits by patients 

with diabetes increase between 2005 and 2010?

• Overall office-based physician visits by patients with diabetes increased 

20% from 94.4 million in 2005 to 113.3 million in 2010 (Figure 1).

0

20

40

60

80

100

120

140

2005 2006 2007 2008 2009 2010

Number of visits

Under 25

125–44

145–64

165 and over

1All ages

Figure 1. Number of office-based physician visits by patients with diabetes, by age: United States, 

2005–2010

1

Linear trend is significant (p < 0.05) based on a weighted least-squares regression test.

NOTE: Data for 2010 are based on a sample of 3,434 office-based physician visits by patients with diabetes, representing a 

weighted total of 113.3 million visits (11% of all office-based physician visits). 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey.
NCHS Data Brief ■ No. 161 ■ July 2014

■  2  ■

• Visits by patients with diabetes represented about 11% of all office-based physician visits 

in 2010.

• From 2005 to 2010, the number of visits by patients with diabetes increased across all age 

categories except for those younger than 25, with the largest percentage increase (34%) 

occurring in the 25–44 age range.

• The volume of visits was much higher for older age groups, with those aged 65 and 

over having 53.7 million visits in 2010 compared with those under age 25, who had 2.6 

million visits.

Did the visit rate for patients with diabetes vary by age and across time?

• The rate of physician office visits by patients with diabetes was not statistically different 

from 2005 to 2010 for all age groups (Figure 2).

• In both 2005 and 2010, the rate of office-based physician visits by patients with diabetes 

increased with advancing age. 

• The highest visit rate in 2010 among patients with diabetes was for those aged 65 and over 

(1,380 visits per 1,000 persons), and the lowest visit rate was for those under age 25 

(20 visits per 1,000 persons).

Figure 2. Rate of visits to office-based physicians for patients with diabetes, by age: United States, 2005 and 2010

Age group

1Increase by age is statistically significant (p < 0.05) based on a weighted least-squares regression test. Differences among subgroups were evaluated with 

two-tailed t-tests and are statistically significant (p < 0.05) for all age groups. However, no differences were observed across time for any of the age groups.

NOTE: Visit rates are based on the set of estimates of the U.S. civilian noninstitutionalized population as developed by the U.S. Census Bureau’s Population Division.

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey.

All Under

25

25–44 45–64 65 and

over1

All Under

25

25–44 45–64 65 and

over1

320

20

110

530

1,290

370

20

140

570

1,380

Visits per 1,000 persons

0

200

600

400

1,000

800

1,400

1,200

2005 2010
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Did a majority of patients with diabetes who visited office-based physicians 

in 2010 have other chronic conditions, and did the number of chronic 

conditions vary by age?

• Overall, a majority of office-based physician visits made by patients with diabetes (87%) 

were made by those with multiple chronic conditions (Figure 3), with the number of chronic 

conditions increasing as age increased. Eighteen percent of the visits made by patients aged 

25–44 with diabetes were by those with four or more chronic conditions, and percentages 

were higher for the two older age groups, 45–64 (36% of visits) and 65 and over (35%).

• Diabetes was the only chronic condition for 49% of the visits made by patients under age 

25, but the only chronic condition for 10% of the visits made by patients aged 65 and over.

1Increase by age is statistically significant (p < 0.05) based on a weighted least-squares regression test. 2Decrease by age is statistically significant (p < 0.05) based on a weighted least-squares regression test. 

NOTE: Data are based on a sample of 3,434 office-based physician visits by patients with diabetes, representing a weighted total of 113.3 million visits (11% of

all office-based physician visits). Estimates for visits by patients under age 25 were unreliable for two, three, and four or more chronic conditions.

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2010.

Figure 3. Percent distribution of number of diagnosed chronic conditions at office-based physician visits for patients 

with diabetes, by age: United States, 2010 Percent

0

20

40

60

80

100

2 or more CC

All 25–44 45–64 65 and over

33

18

36 35

33

22 22

30

10 12

27

28

26

13

23

31

Age group

Under 25

51

49

Four or more1

chronic

conditions (CC)

Three1

Two

One2
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Did patients with diabetes who went to the doctor visit frequently, and did 

visit frequency vary by age?

• More than 80% of visits by patients with diabetes (83%) were by those making multiple 

trips to the sampled doctor in the past 12 months (Figure 4).

• Regardless of age, more than one-half of the visits by patients with diabetes (55%) were by 

those who made an office visit to the sampled doctor four or more times in the past 12 months.

Percent

Figure 4. Percent distribution of number of office-based physician visits in past 12 months for patients with diabetes, by

age: United States, 2010

NOTE: Data are based on a sample of 3,434 office-based physician visits made by patients with diabetes, representing a weighted total of 113.3 million visits (11%

of all office-based physician visits). Estimates for visits by patients under age 25 were unreliable for one, two and three visits.

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2010.

0

20

40

60

80

100

1 visit

Less than 4 visits

2 visits

3 visits

4 or more

visits

All Under 25 25–44 45–64 65 and over

55

14

15 47

53 52

12

15

21

54

15

15

16

57

12

15

17 15

Age group
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Were medications prescribed or continued at office-based physician visits 

by patients with diabetes, and did this vary by age?

• Medications were prescribed or continued at a majority of office-based physician visits 

(85%) by patients with diabetes (Figure 5). The number of medications prescribed or 

continued increased as age increased.

• Five or more drugs were prescribed or continued at 38% of the visits by patients with 

diabetes aged 25–44, and at 60% of the visits by those aged 65 and over.

Percent

Figure 5. Percent distribution of the number of medications prescribed or continued at office-based physician visits for 

patients with diabetes, by age: United States, 2010

1

Decrease by age is statistically significant (p < 0.05) based on a weighted least-squares regression test. 2Increase by age is statistically significant (p < 0.05) based on a weighted least-squares regression test.

NOTE: Data are based on a sample of 3,434 office-based physician visits by patients with diabetes, representing a weighted total of 113.3 million visits (11% of all 

office-based physician visits). All estimates for visits by patients under age 25 were unreliable and are not shown.

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2010.

0

20

40

60

80

100

No drugs

1 drug

2–4 drugs1

5 or more

drugs2

All 25–44 45–64 65 and over

51

23

10

15

38

34

13

15

47

27

10

16

60

17

9

14

Age group
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Summary 

Diabetes affects nearly 29 million people in the United States (1). Overall, visits by patients with 

diabetes increased 20% from 2005 to 2010, but the visit rate did not increase. Diabetes is not the 

only health concern for the majority of patients who have it, with 87% of visits being made by 

patients who have additional chronic conditions. Moreover, visits by older patients were more 

likely to be made by those with multiple chronic conditions compared with visits by younger 

patients. Regardless of age, patients with diabetes use extensive health resources, as evidenced 

by frequent visits to the doctor (55% having visited the doctor four or more times in the past 

year) and extensive use of medications, with almost all visits by patients with diabetes (85%) 

including medications being prescribed or continued. Visits by older patients were more likely to 

include five or more drugs being prescribed or continued than visits by younger patients. One of 

the federal Healthy People 2020 goals is to reduce the disease and economic burden of diabetes 

(5). Continuing to examine office-based physician visits by patients with diabetes is especially 

important given changes in standards of care that may influence such visits.

Definitions

Diagnosed diabetes: Since 2005, a National Ambulatory Medical Care Survey (NAMCS) 

question has asked, “Regardless of the diagnosis for the current visit, does the patient now have 

diabetes?” Diabetes is considered diagnosed if it was documented as a current condition in the 

patient’s medical record, regardless of the diagnoses at or specific reasons for the visit. This report 

includes all visits made by patients diagnosed with diabetes. Managing diabetes is the reason for 

some of these visits, but many other reasons such as a respiratory infection or an injury are also 

included.

Other diagnosed chronic conditions: Since 2005, a NAMCS question has asked, “Regardless 

of the diagnosis for the current visit, does the patient now have [insert chronic condition]?” 

Information is collected on 13 other chronic conditions besides diabetes, including arthritis, 

asthma, cancer, chronic kidney disease, chronic obstructive pulmonary disease, congestive heart 

failure, coronary artery disease, depression, hyperlipidemia, hypertension, obesity, osteoporosis, 

and stroke. Each of the chronic conditions listed (including diabetes) is considered diagnosed if it 

was documented as a current condition in the patient’s medical record, regardless of the specific 

reason for the visit.

Data sources and methods

All estimates are from the 2005–2010 NAMCS, a nationally representative survey of visits to 

nonfederal office-based physicians (excluding anesthesiologists, radiologists, and pathologists), 

conducted annually by the Centers for Disease Control and Prevention’s (CDC) National Center 

for Health Statistics (NCHS), Division of Health Care Statistics.

NAMCS uses a multistage probability design that involves probability samples of primary 

sampling units (PSUs), physicians within PSUs, and patient visits within practices. Because of the 

complex multistage design of NAMCS, the survey data must be inflated or weighted to produce 

national estimates. More details about the design of NAMCS have been published elsewhere (6).
NCHS Data Brief ■ No. 161 ■ July 2014

■ 7  ■

Differences among subgroups were evaluated with two-tailed t tests, using p < 0.05 as the level 

of significance. A weighted least-squares regression method was used to test the significance of 

trends for all figures. All reported comparisons were statistically significant unless otherwise 

indicated. Data analyses were performed using the statistical packages SAS version 9.2 (SAS 

Institute, Cary, N.C.) and SUDAAN version 9.0 (RTI International, Research Triangle Park, 

N.C.).

About the authors

Jill J. Ashman, Anjali Talwalkar, and Shelby A. Taylor are with CDC/NCHS, Division of Health 

Care Statistics.

References

1. CDC. National diabetes statistics report: Estimates of diabetes and its burden in the United

States, 2014. Atlanta, GA: U.S. Department of Health and Human Services. 2014.

2. Xu J. QuickStats: Number of deaths from 10 leading causes—National Vital Statistics System,

United States, 2010. MMWR 62(8):155. 2013. Available from: http://www.cdc.gov/mmwr/

preview/mmwrhtml/mm6208a8.htm.

3. Kochanek KD, Xu J, Murphy SL, et al. Deaths: Final data for 2009. National vital statistics

reports; vol 60 no 3. Hyattsville, MD: National Center for Health Statistics. 2011.

4. American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes

Care 36(4):1033–46. 2013.

5. Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human

Services. Healthy People 2020: Diabetes. Available from: http://www.healthypeople.gov/2020/

topicsobjectives2020/overview.aspx?topicid=8 [Accessed May 13, 2014].

6. National Center for Health Statistics. 2010 NAMCS micro-data file documentation.

Hyattsville, MD. 2010. Available from: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_

Documentation/NAMCS/doc2010.pdf.
NCHS Data Brief ■ No. 161 ■ July 2014

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Suggested citation

Ashman JJ, Talwalkar A, Taylor SA. 

Age differences in visits to office-based 

physicians by patients with diabetes: United 

States, 2010. NCHS data brief, no 161. 

Hyattsville, MD: National Center for Health 

Statistics. 2014.

Copyright information

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the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director

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