Characteristics of ambulatory care visits to family medicine specialists in Taiwan: a nationwide analysis.

An-Min Lynn,Cheng-Hao Hung,Tzeng-Ji Chen,Ming-Hwai Lin,Shinn-Jang Hwang,Tzu-Chien Shih

doi:10.7717/peerj.1145

Abstract

Although family medicine (FM) is the most commonly practiced specialty among all the medical specialties, its practice patterns have seldom been analyzed. Looking at data from Taiwan’s National Health Insurance Research Database, the current study analyzed ambulatory visits to FM specialists nationwide. From a sample dataset that randomly sampled one out of every 500 cases among a total of 309,880,000 visits in 2012, it was found that 18.8% (n = 116, 551) of the 619,760 visits in the dataset were made to FM specialists. Most of the FM services were performed by male FM physicians. Elderly patients above 80 years of age accounted for only 7.1% of FM visits. The most frequent diagnoses (22.8%) were associated acute upper respiratory infections (including ICD 460, 465 and 466). Anti-histamine agents were prescribed in 25.6% of FM visits. Hypertension, diabetes and dyslipidemia were the causes of 20.7% of the ambulatory visits made to FM specialists of all types, while those conditions accounted for only 10.6% of visits to FM clinics. The study demonstrated the relatively low proportion of chronic diseases that was managed in FM clinics in Taiwan, and our detailed results could contribute to evidence-based discussions on healthcare policymaking and residency training.

Highlights

Medicine (FM) specialists act as general practitioners and provide primary care services in the community, including solving minor cases, making referrals for major diseases, and providing and promoting preventive health services
The purpose of the current study was to explore the nationwide characteristics of ambulatory visits to Family medicine (FM) clinics recorded by Taiwan’s National Health Insurance (NHI) system in 2012
Among the ambulatory visits to FM specialists, 53.1% were made by female patients (n = 61,974) and 46.9% were made by male patients (n = 54,577)

Summary

Introduction

Medicine (FM) specialists act as general practitioners and provide primary care services in the community, including solving minor cases, making referrals for major diseases, and providing and promoting preventive health services. Because of an overemphasis on medical specialization over the past several decades, the importance of FM specialists has been increasingly noticed in terms of the benefits they provide to patients (Ryan et al, 2001; Shi et al, 2003; Baicker & Chandra, 2004; Cooper, 2009a; Cooper, 2009b; Baicker & Chandra, 2009) The associated issues, such as the practicing environments of FM specialists and primary care reforms, affect the government’s finances and public health (Bindman & Majeed, 2003; Van Weel & Del Mar, 2004; Chou et al, 2007; Skinner et al, 2009; Chang et al, 2011; Katz et al, 2012). Literature looking at the practice of FM on a nationwide basis remains sparse in most countries, including Taiwan

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