U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

NCHS Data Brief ■ No. 234 ■ January 2016

State Variation in Preventive Care Visits, by Patient 

Characteristics, 2012 

Esther Hing, M.P.H., and Michael Albert, M.D., M.P.H.

Key findings 

Data from the National 

Ambulatory Medical Care 

Survey, 2012

● In 2012, 61.4 preventive 

care visits were made to 

office-based physicians per 

100 persons. The female rate 

(76.6 visits per 100 females) 

exceeded the male rate (45.4 

visits per 100 males) by 69%.

● Among the 34 most 

populous states, the rate of 

preventive care visits exceeded 

the national rate in 1 state 

(Connecticut) and was lower 

than the national rate in 11 

states (Arkansas, Indiana, Iowa, 

Michigan, Missouri, North 

Carolina, Oklahoma, Oregon, 

Pennsylvania, South Carolina, 

and Washington). 

● The rate of preventive 

care visits to primary care 

physicians in the 34 most 

populous states exceeded 

the national rate in 1 state 

(Connecticut) and was lower 

than the national rate in 7 states 

(Arkansas, Indiana, Iowa, 

Missouri, North Carolina, 

Pennsylvania, and Washington). 

Preventive care visits such as general medical examinations, prenatal visits, 

and well-baby visits give physicians and other health professionals the 

opportunity to screen for diseases or conditions, as well as to promote healthy 

behaviors that may delay or prevent these conditions and reduce subsequent 

use of emergency or inpatient care. In this report, the rate of preventive care 

visits to office-based physicians is examined by state, patient demographics, 

and physician specialty. Estimates are based on data from the National 

Ambulatory Medical Care Survey (NAMCS), a nationally representative 

survey of visits to office-based physicians. 

Keywords: office-based physicians • primary care • National Ambulatory 

Medical Care Survey

Preventive care visits varied by patient age and sex.

● In 2012, 61.4 office visits per 100 persons were made for preventive care 

Figure 1. Preventive care visit rate per 100 persons, by sex and age: United States, 2012

 
NCHS Data Brief ■ No. 234 ■ January 2016

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(Figure 1). The rate among females (76.6 visits per 100 females) was 69% higher than the 

rate for males (45.4 visits per 100 males).

● No differences were seen in preventive care visit rates by sex among children under age 18 

years and adults aged 65 and over.

● Overall, preventive care visit rates were higher for children under age 18 years (73.2 per 100 

persons) and for those aged 65 and over (81.1 per 100 persons) than for adults aged 18–44 

(53.2 per 100 persons) and 45–64 (51.8 per 100 persons). A similar pattern was observed for 

males in these age groups. 

● The preventive care visit rate for women aged 18–44 (87.1 per 100 women) exceeded the 

rate for women aged 45–64 (60.5 per 100 women).

● The preventive care visit rates for women aged 18–44 (87.1 per 100 women) and 45–64 

(60.5 per 100 women) exceeded the rates for men in those age groups (18.5 and 42.5 per 

100 men, respectively).

The rate of preventive care visits varied among the 34 most populous 

states.

● The rate of preventive care visits in the 34 most populous states ranged from 33.1 visits per 

100 persons in Arkansas to 120 visits per 100 persons in Connecticut (Figure 2). 

 

Figure 2. Preventive care visit rate per 100 persons, by selected states: United States, 2012 

 
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● The rate of preventive care visits per 100 persons exceeded the national rate in Connecticut 

and was lower than the national rate in 11 states (Arkansas, Indiana, Iowa, Michigan, 

Missouri, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, and 

Washington). 

The percentage of preventive care visits made by males to primary care 

physicians exceeded the percentage made by females.

● Overall, 58.2% of preventive care visits were made to primary care physicians (Figure 3). 

Primary care physicians include general or family practitioners, internists, and pediatricians.

● The percentage of preventive care visits to primary care physicians made by males (76.3%) 

exceeded those made by females (48.0%).

● The percentage of preventive care visits to primary care physicians for men aged 18–44 

(70.8%) and 45–64 (66.4%) exceeded those for women (21.8% and 44.1%, respectively). 

● The percentage of preventive care visits to primary care physicians by children under age 18 

years and those aged 65 and over did not vary by gender. 

Figure 3. Percentage of preventive care visits made to primary care physicians by sex and age: United States, 2012

 
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The rate of preventive care visits to primary care physicians varied among 

the 34 most populous states.

● In 2012, 35.7 preventive care visits were made to primary care physicians for every 100 

persons in the United States (Figure 4).

● Among the 34 most populous states, the rate of preventive care visits to primary care 

physicians ranged from 18.6 visits per 100 persons in Washington to 59.3 visits per 100 

persons in Connecticut. 

● For the 34 most populous states, the rate of preventive care visits to primary care physicians 

exceeded the national rate in Connecticut and was lower than the national rate in seven 

states (Arkansas, Indiana, Iowa, Missouri, North Carolina, Pennsylvania, and Washington). 

Figure 4. Rate of preventive care visits to primary care physicians per 100 persons, by selected states: United States, 

2012 

 
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Summary

Primary health care and community-based prevention efforts have the potential to control the 

cost and growth of chronic illnesses (1). Visits to office-based physicians and other medical 

professionals provide patients with the opportunity to receive clinical preventive services that 

may delay or prevent chronic illness, as well as prevent the subsequent use of emergency or 

inpatient care (1). In 2012, 61.4 office visits per 100 persons were for preventive care services. 

The rate of preventive care visits for females was 69% higher than for males. Overall, 58.2% of 

preventive care visits were made to primary care physicians. The percentage of preventive care 

visits to primary care physicians made by males (76.3%) was 59% higher than the percentage for 

females (48.0%). This difference was due to higher female than male percentages of preventive 

care visits made to non-primary care physicians in the 18–44 and 45–64 age groups. The higher 

percentage of preventive care visits made to non-primary care physicians among women aged 

18–64 compared with similarly aged men may be related to gynecological or obstetric care for 

women in this age group (2). In 2012, the rate of preventive care visits to primary care physicians 

per 100 persons exceeded the national rate in one state (Connecticut) and was lower than the 

national rate in seven states (Arkansas, Indiana, Iowa, Missouri, North Carolina, Pennsylvania, 

and Washington). 

Definition

Primary care physicians: Include office-based physicians in the specialties of family or general 

medicine, internal medicine, and pediatrics.
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Data source and methods

Data for this report are from NAMCS, which is conducted by the Centers for Disease Control 

and Prevention’s (CDC) National Center for Health Statistics (NCHS). NAMCS is an annual, 

nationally representative survey of office-based physicians and their visits. The target universe 

of NAMCS is physicians classified as providing direct patient care in office-based practices. 

Radiologists, anesthesiologists, and pathologists are excluded. Visits to community health center 

physicians are also excluded from this analysis. The sample, drawn from the master files of 

the American Medical Association and American Osteopathic Association, consists of 9,574 

physicians. 

In 2012, the NAMCS survey sample size was increased fivefold to allow for state-level estimates 

in the 34 most populous states. The unweighted physician response rate was 58.7% (59.7% 

weighted). Participating physicians provided 76,330 visit records. The unweighted visit response 

rate for the 2012 survey was 39.3% (39.4% weighted). Response rates for targeted states ranged 

from 31.1% to 58.5%, weighted (3).

Data analyses were performed using the statistical packages SAS, version 9.3 (SAS Institute, 

Cary, N.C.), and SAS-callable SUDAAN, version 11.0 (RTI International, Research Triangle 

Park, N.C.). The physician office location where the visit occurred was used to generate 

state-level estimates. Statements of difference in estimates are based on two-tailed t tests with 

significance at the p < 0.05 level. Terms relating to differences such as “greater than” or “less 

than” indicate that the difference is statistically significant. A lack of comment regarding the 

difference between any two estimates does not mean that the difference was tested and found to 

be not statistically significant. 
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About the authors

Esther Hing and Michael Albert are with CDC’s National Center for Health Statistics, Division of 

Health Care Statistics, Ambulatory and Hospital Care Statistics Branch. 

References

1. Kirk A. Research insights: Prevention and health reform. AcademyHealth Issue Brief. 2009. 

Available from: http://www.academyhealth.org/files/publications/AH_RI_Health%20Care%20

reform.pdf. 

2. Kale MS, Federman AD, Ross JS. Visits for primary care services to primary care and 

specialty care physicians, 1999 and 2007. Arch Intern Med 172(18):1421–3. 2012.

3. Hing E, Shimizu IM, Talwalkar A. Nonresponse bias in estimates from the 2012 National 

Ambulatory Medical Care Survey. National Center for Health Statistics. Vital Health Stat 2(171). 

2016 [Forthcoming]. 
NCHS Data Brief ■ No. 234 ■ January 2016

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Suggested citation

Hing E, Albert M. State variation 

in preventive care visits, by patient 

characteristics, 2012. NCHS data brief, no 

234. Hyattsville, MD: National Center for 

Health Statistics. 2016.

Copyright information

All material appearing in this report is in 

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

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate

Director for Science

Division of Health Care Statistics 

Clarice Brown, M.S., Director

Alexander Strashny, Ph.D., Associate 

Director for Science

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