[Potentially avoidable visits to the physician's office: an exploratory observational study]

Area of Science:

• Health Services Research
• Primary Care Medicine
• Outpatient Healthcare Management

Background:

• Accurate data on physician office visits are crucial for balancing healthcare supply and demand.
• Post-2008 remuneration changes limit precise estimation of outpatient visits using only billing data.
• Direct observation is needed to understand visit frequency, reasons, and avoidability.

Purpose of the Study:

• To directly record the number and reasons for physician office visits.
• To estimate the potential avoidability of these patient contacts.
• To analyze visit patterns across different practice types, age groups, and genders.

Main Methods:

• Direct observation of all patient visits over one week in 11 general practitioner (GP) and specialist practices.
• Documentation included reason for visit, contact type, patient age, and gender.
• Descriptive analysis and Chi-squared tests were used to analyze frequencies and differences.

Main Results:

• A total of 3266 practice contacts were recorded (57% female, 43% male).
• Average visits per patient per quarter were 2.9 for GPs and 1.9 for specialists.
• For patients over 59, 50% of GP visits and 51% of specialist visits were for prescription refills or chronic disease monitoring, suggesting potential avoidability.

Conclusions:

• Extrapolated data suggest 16.9 physician office contacts per person annually.
• A significant portion of visits, particularly for older adults collecting prescriptions or for routine specialist check-ups, may be avoidable.
• Findings highlight the need for strategies to optimize outpatient healthcare utilization and reduce unnecessary physician contacts.