Over the past two decades, pediatric hospitalist programs have become a common part of inpatient care in many health care markets. However, many primary care pediatricians may still include inpatient care in their practices. We sought to determine trends in provision of hospital care by pediatricians practicing in ambulatory settings.
We used the National Ambulatory Medical Care Survey (NAMCS), a nationally‐representative sample of ambulatory visits conducted by the National Center for Health Statistics. We analyzed the data at the level of the physician considering variables such as practice, physician, and community characteristics. We defined providing hospital care as answering yes to the question regarding making any hospital visit in the last normal week of practice. We generated descriptive statistics for the practice, physician and community characteristics, and used bivariate tests of association to explore the relationship between practice characteristics and provision of hospital care.
There were 634 pediatricians who participated in the survey from 2005‐2010. Overall, 62.3% of pediatricians reported providing hospital care in the previous week. Pediatricians were more likely to report providing inpatient care compared to 42.2% of family physicians and 58.1% of internists, (p<0.001). The proportion of pediatricians providing inpatient care ranged from 67% in 2005 to 58% in 2010. Pediatricians with more than 75% of patients with Medicaid were less likely to provide inpatient care (42.6%, p=0.007). Those who practiced in a community clinic setting also provided inpatient care less frequently than those in a private practice setting (34.9% vs 66.7%, p<0.001). Physician employment status was associated with provision of inpatient care with those who owned their practice providing inpatient care 68.2% of the time versus 55.1% of physicians in an employment model and 46.8% of physicians working on a contract basis, p=0.012. Practice location in a metropolitan area and region of the country were not associated with the provision of inpatient care.
Many pediatricians still provide inpatient care in spite of rapid growth in hospital pediatrics. Physician practice characteristics are associated with provision of inpatient care.
To cite this abstract:Johnson L, Pomeroy B, Thompson A. Ambulatory Pediatricians Providing Hospital Care: Data from a National Survey. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 90. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/ambulatory-pediatricians-providing-hospital-care-data-from-a-national-survey/. Accessed May 23, 2019.