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Preliminary Estimates of Visits to Health Centers in the United States

The National Ambulatory Medical Care Survey (NAMCS) Health Center Component, conducted by the National Center for Health Statistics (NCHS), collects annual data on visits to health centers to describe patterns of utilization and provision of ambulatory care delivery in the United States. Health centers are local clinics that are community-based and provide comprehensive health care services to populations that are often vulnerable and underserved. Health centers are either federally qualified health centers (FQHCs), which receive federal funding from the Health Resources and Services Administration (HRSA), or FQHC look-alikes, which meet HRSA requirements but do not receive HRSA funding (1). The NAMCS Health Center Component collects data from FQHCs and FQHC look-alikes from the 50 U.S. states and the District of Columbia, and these data are used to develop nationally representative estimates.

This visualization depicts preliminary, biannual counts and rates of health center visits from January 2022-June 2023 by medical diagnosis chapters, stratified by selected patient characteristics. This visualization also depicts measures related to maternal health care at health centers to help expand the availability of data related to maternal health and maternal morbidity. Definitions for diagnostic chapters and maternal health-related diagnoses can be found below the visualization. Estimates are split into biannual time periods (January to June, and July to December) and are considered preliminary, meaning they may differ from final estimates. Future estimates will be added, as data become available.

Use the tabs at the bottom of the visualization to select between “Diagnosis Chapter” and “Maternal Health”. Use the drop-down menus at the top of the visualization to select the estimate type, estimate category, and group stratification of interest.

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Definitions

Diagnosis Chapters— Based on International Classification of Diseases, 10th Revision, Clinical Modification (ICD–10–CM) (2). Diagnosis chapters and the codes used to define them include:

Diagnosis Chapters— Based on International Classification of Diseases, 10th Revision, Clinical Modification (ICD–10–CM) (2).
Infectious and parasitic diseases (A00-B99)
Abnormal growths and tumors (C00-D49)
Blood-related and immune system diseases (D50-D89)
Hormonal, diet, and metabolic diseases (E00-E89)
Mental health, behavioral and brain development disorders (F01-F99)
Diseases of the nervous system (G00-G99)
Eye and related diseases (H00-H59)
Ear and related diseases (H60-H95)
Heart and circulatory-related diseases (I00-I99)
Lung and breathing-related diseases (J00-J99; U070; U071; U099)
Diseases of the digestive system (K00-K95)
Skin and tissue diseases (L00-L99)
Diseases of the musculoskeletal system (M00-M99)
Diseases of the urinary and genital systems(N00-N99)
Pregnancy, childbirth and the postpartum (O00-O9A)
Conditions originating around birth (P00-P96)
Birth defects and genetic issues (Q00-Q99)
Symptoms, signs, and abnormal test results (R00-R99)
Accidents, poisonings, and their effects (S00-T88)
Reasons for health issues from outside factors (V00-Y99)
Factors affecting health and interaction with healthcare (Z00-Z99)

Maternal and Reproductive Health Measures – Based on ICD–10–CM (2). Only visits by female patients between the ages of 12 and 55 were used to produce estimates. Maternal and reproductive health measures include:

Maternal and Reproductive Health Measures – Based on ICD–10–CM (2). Only visits by female patients between the ages of 12 and 55 were used to produce estimates.
Any maternal health visits (O00-O92; Z3A; Z30; Z31; Z32; Z33; Z34; Z36; Z37; Z39)
Prenatal care visits (O00-O82; Z3A; Z33; Z34; Z36)
Postpartum care visits (O85-O92; Z37; Z39)
Other reproductive care visits (Z30; Z31; Z32)

Calculated by dividing the number of health center visits by estimates of the U.S. civilian noninstitutionalized population from the year prior (obtained from the U.S. Census Bureau’s Population Division) for selected characteristics including age, sex, and race and ethnicity.

Race and Hispanic ethnicity were collected separately and converted into a single combined variable that includes ‘Black, non-Hispanic’, ‘Hispanic’, ‘Other, non-Hispanic’, and ‘White, non-Hispanic’. ‘Other, non-Hispanic’ includes American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander people, and people with two or more races. Missing values for race and ethnicity were not imputed, and therefore counts and rates by race and ethnicity are underestimates. See Table 2, below, for the percentage of visits with missing values.

Technical Notes

Weight Normalization: In some instances for a given time period, certain health center(s) did not provide any information for any of their visits on one or more variables used for this dashboard, including: age, sex, race and ethnicity, and diagnosis. Health centers were excluded if they were missing at least one of these variables at all visits in the time period of interest. Consequently, visit weights for the remaining health centers were normalized to account for health centers that were excluded. Normalized weights were calculated separately for each time period according to the following formula:

New weight = original weight * (sum of weights at all visits / sum of weights at included visits)

Estimates for a given time period were then calculated using this new weight for visits at health centers that were included for analysis. More information and details on weight normalization, including examples, can be found here.

Missing Data: Although normalization removed visits at health centers that had complete missingness for at least one variable, remaining health centers could still have missingness for variables for some of their visits. Table 1 describes the number of health centers whose visits were included in estimates for each time period, and Table 2 describes the unweighted percentage of included visits with missingness for variables used in the dashboard.

Table 1. Health Centers included in visualization, by time period

Types and number of Health Centers included in visualization, by time period
	Time Period
	Jan.-Jun. 2022	Jul.-Dec. 2022	Jan.-Jun. 2023
Total health centers in the survey	64	64	78
Health centers included in the visualization	47	47	54

Table 2. Unweighted percentage of visits with missing values at included health centers, by time period

Unweighted percentage of visits with missing values at included health centers, by time period
Variable	Time Period
Variable	Jan.-Jun. 2022	Jul.-Dec. 2022	Jan.-Jun. 2023
Age	0.0%	0.0%	0.0%
Sex	0.1%	0.0%	0.0%
Race/Ethnicity	9.5%	8.1%	9.6%
Diagnosis	27.7%	28.1%	27.0%

Preliminary Estimates: Data used in figures are preliminary and have not undergone final edits. The data presented will be updated every 6 months as additional data become available. Results in this visualization may differ from estimates produced from the final NAMCS Health Center Component data files.

Estimate Reliability: All preliminary estimates in this visualization were assessed for statistical reliability according the NCHS Data Presentation Standards for Rates and Counts. Estimates not meeting these reliability standards were suppressed in the visualization figures and tables above. In implementing these standards, the Kish formula was used to calculate design effect.

Feedback

Please send comments or questions to ambcare@cdc.gov.

Data Source

National Center for Health Statistics, National Ambulatory Medical Care Survey Health Center Component, January 2022-June 2023

Suggested Citation

National Center for Health Statistics. Preliminary Estimates of Visits to Health Centers in the United States. Generated interactively: , from https://www.cdc.gov/nchs/dhcs/prelim-hc-visits/index.htm

For more details on NAMCS Health Center Component, visit: National Ambulatory Medical Care Survey (cdc.gov)

References

Health Resources & Services Administration. What is a Health Center? 2024. Available from: https://bphc.hrsa.gov/about-health-center-program/what-health-center.
National Center for Health Statistics. Comprehensive Listing ICD-10-CM Files. 2024. Available from: https://www.cdc.gov/nchs/icd/Comprehensive-Listing-of-ICD-10-CM-Files.htm.