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Monitoring Health Care in America
Quarterly Fact Sheet – December 1995
Spotlight on: Office Visits to Neurologists
An average of 7.3 million visits are made annually to neurologists in the U.S. according to 1991-92 data. This is up from just under 5 million visits per year in 1985 and 3 million visits annually in 1980. In 1991-92, the visitation rate to neurology specialists was 3 visits per 100 people. Females are more likely to visit neurologists (3.3 visits per 100 population) than males (2.5 visits per 100 population). Six percent of patients who visit neurologists are referred by another physician. Fifteen percent are new patients, while three out of five are old patients visiting for old reasons.
Visit characteristics
The biggest reason for patient visits to neurologists is the headache (23 percent). The most frequent diagnoses at these visits are convulsions (10.6 percent of all visits) and migraines (10.3 percent of visits). Convulsions are reported more frequently among men (13 percent of all visits vs. 9 percent of all visits for women), while migraines are reported more frequently among women (14 percent vs. 6 percent for men). Migraine was the most frequently reported principal diagnosis for adults aged 25-44 years (421,000 visits, 16.4 percent of all visits). For children under 15 years of age, hyperkinetic syndrome of childhood was the most frequent principal diagnosis (13.3 percent of all visits).
There were 331,000 diagnoses of Parkinson’s disease in 1991-92, or 4.6 percent of all visits. Parkinson’s disease was also the most frequently reported diagnosis for patients 65 years of age and over, and it was the seventh leading diagnosis for people aged 45-64 years. Multiple Sclerosis (MS) was the fourth leading diagnosis among adults 25-44 years of age and the fifth leading diagnosis for people aged 45-64 years. There were 244,000 diagnoses of MS in 1991-92, accounting for 3 percent of all visits. Epilepsy was diagnosed on 150,000 occasions, or 2 percent of all visits, and was the 10th leading diagnosis for adults 25-44 years of age.
Drug mentions
Neurologic drugs were mentioned at over a quarter of all visits, the greatest proportion being anticonvulsants (1.3 million mentions or 16 percent of the total). Drugs used for pain relief, including general analgesics and antiarthritics, were mentioned at 22 percent of all visits. Psychopharmacologic drugs such as antidepressants, antianxiety drugs, and sedatives and hypnotics were mentioned in about one out of five visits. The most frequently prescribed drugs were anticonvulsants Tegretol and Dilantin, followed by Sinemet, used for extrapyramidal movement disorders.
Source of payment
Private or commercial insurance was the expected source of payment at 44 percent of all visits. Medicare accounted for 22 percent, followed by patient-paid (13.5 percent), and HMOs or other prepaid plans (11.4 percent). Medicaid was the expected source of payment for 7 percent of all visits.
More on neurologic disorders and health care utilization
In 1993 Americans made 717.2 million office visits to physicians, and nearly 8.4 million of these visits were to physicians specializing in neurology. There were 909,000 procedures on the nervous system performed on hospital inpatients in 1993. Over one-third of those were spinal tap procedures. In addition, there were 629,000 computerized axial tomography scans performed on the head. In 1993 over 5.2 million visits to hospital emergency departments were for symptoms relating to the nervous system, resulting in more than 6.1 million principal diagnoses of diseases relating to the nervous system or sense organs. There were an additional 1.6 million visits to hospital outpatient departments due to neurological reasons, resulting in nearly 3.8 million diagnoses of neurological disease.
For more information or to arrange an interview with the author, please contact NCHS, Office of Public Affairs (301) 458-4800, or via e-mail at paoquery@cdc.gov.
Data Sources
Advance Data From Vital and Health Statistics
No. 264. 1993 Summary: National Hospital Discharge Survey. 12 pp. (PHS) 95-1250 [PDF – 108 KB]
No. 267. Office Visits to Neurologists: United States, 1991-92. 20 pp. (PHS) 95-1250 [PDF – 234 KB]
No. 270. National Ambulatory Medical Care Survey: 1993 Summary. 20 pp. (PHS) 96-1250 [PDF – 262 KB]
No. 271. National Hospital Ambulatory Medical Care Survey: 1993 Emergency Department Summary. 16 pp. (PHS) 96-1250. [PDF – 199 KB]