National Ambulatory Medical Care Survey - Community Health Centers: 2012 Summary Tables □ Page 1 National Ambulatory Medical Care Survey – Community Health Centers: 2012 State and National Summary Tables The Ambulatory and Hospital Care Statistics Branch is pleased to release, for the first time, nationally representative estimates of ambulatory care visits made to both physicians and non- physician clinicians (physician assistants (PAs), nurse practitioners (NPs), and nurse midwives) at community health centers (CHCs) in the United States. Although national samples of CHC physicians and non-physician clinicians (NPCs) have provided data on CHC visits since 2006, prior to 2012, NAMCS web tables only included visits to CHC physicians, while data on visits to PAs, NPs, and nurse midwives were limited to selected reports. In 2012, the CHC component of NAMCS was redesigned as a stand-alone national survey that permits, for the first time, estimates of visits to CHCs located in the 34 most populous states. Visit estimates for the following states are presented: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, and Wisconsin. Estimates for the remaining states are grouped by Census Division. Three tables present state estimates in addition to the tables presenting national estimates of visits to CHC providers and their characteristics. The CHC sampling frame for the 2012 NAMCS was comprised of a list of Federally Qualified Health Center (FQHC) service delivery sites from the Health Resources and Services Administration’s Bureau of Primary Health Care and the Indian Health Service. Three types of CHCs were eligible for NAMCS: FQHCs that received Public Health Service Act, Section 330 funding; FQHCs that applied for Section 330 funding but were not funded (also called “Look- alikes”); and urban Indian Health Service outpatient clinics. The 2012 NAMCS utilized a three- stage probability design that involved probability samples of FQHC service delivery sites within targeted states/Census Divisions, a sample of physicians and non-physician clinicians (physician assistants, nurse practitioners, and nurse midwives) within service delivery sites, and patient visits within each sampled provider practice. Estimates of 2012 office visits to non-CHC physicians are not included in these summary tables. Those estimates are available at: http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2012_namcs_web_tables.pdf. The 2012 NAMCS CHC sample included 2,008 CHC service delivery sites. A total of 849 service delivery sites did not meet all of the criteria and were ruled out of scope (ineligible) for the study. Of the 1,159 in-scope service delivery sites, 945 participated, yielding an unweighted CHC response rate of 81.5 percent (81.1 percent, weighted). A sample of 2,279 providers scheduled to see patients during the sample week was selected from CHC service delivery sites. A total of 1,923 participated in the study; this figure includes 1,752 providers that completed Patient Record forms (PRFs) and 171 providers who did not complete PRFs because they saw no patients at the service delivery site during their sample week due to vacations, illness, or other reasons for being temporarily not in practice. Of the 1,923 providers who
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National Ambulatory Medical Care Survey - Community Health Centers: 2012 Summary Tables □ Page 1
National Ambulatory Medical Care Survey – Community Health Centers: 2012 State and National Summary Tables
The Ambulatory and Hospital Care Statistics Branch is pleased to release, for the first time, nationally representative estimates of ambulatory care visits made to both physicians and non-physician clinicians (physician assistants (PAs), nurse practitioners (NPs), and nurse midwives) at community health centers (CHCs) in the United States. Although national samples of CHC physicians and non-physician clinicians (NPCs) have provided data on CHC visits since 2006, prior to 2012, NAMCS web tables only included visits to CHC physicians, while data on visits to PAs, NPs, and nurse midwives were limited to selected reports. In 2012, the CHC component of NAMCS was redesigned as a stand-alone national survey that permits, for the first time, estimates of visits to CHCs located in the 34 most populous states. Visit estimates for the following states are presented: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, and Wisconsin. Estimates for the remaining states are grouped by Census Division. Three tables present state estimates in addition to the tables presenting national estimates of visits to CHC providers and their characteristics.
The CHC sampling frame for the 2012 NAMCS was comprised of a list of Federally Qualified Health Center (FQHC) service delivery sites from the Health Resources and Services Administration’s Bureau of Primary Health Care and the Indian Health Service. Three types of CHCs were eligible for NAMCS: FQHCs that received Public Health Service Act, Section 330 funding; FQHCs that applied for Section 330 funding but were not funded (also called “Look-alikes”); and urban Indian Health Service outpatient clinics. The 2012 NAMCS utilized a three-stage probability design that involved probability samples of FQHC service delivery sites within targeted states/Census Divisions, a sample of physicians and non-physician clinicians (physician assistants, nurse practitioners, and nurse midwives) within service delivery sites, and patient visits within each sampled provider practice. Estimates of 2012 office visits to non-CHC physicians are not included in these summary tables. Those estimates are available at: http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2012_namcs_web_tables.pdf.
The 2012 NAMCS CHC sample included 2,008 CHC service delivery sites. A total of 849 service delivery sites did not meet all of the criteria and were ruled out of scope (ineligible) for the study. Of the 1,159 in-scope service delivery sites, 945 participated, yielding an unweighted CHC response rate of 81.5 percent (81.1 percent, weighted). A sample of 2,279 providers scheduled to see patients during the sample week was selected from CHC service delivery sites. A total of 1,923 participated in the study; this figure includes 1,752 providers that completed Patient Record forms (PRFs) and 171 providers who did not complete PRFs because they saw no patients at the service delivery site during their sample week due to vacations, illness, or other reasons for being temporarily not in practice. Of the 1,923 providers who
National Ambulatory Medical Care Survey - Community Health Centers: 2012 Summary Tables □ Page 2
participated in the study, 1,570 providers completed PRFs fully or adequately (i.e. submitted at least half of expected PRFs, or saw no patients during their sample week) and 353 participated minimally (i.e., fewer than half of the expected number of PRFs were submitted). Within provider practices, data are abstracted from medical records for up to 30 sampled visits during a randomly assigned 1-week reporting period. In all, 34,698 PRFs were submitted. The unweighted visit response rate was 61.4 percent (59.1 percent, weighted), based on the number of full respondents only, including those who saw no patients during their reporting week. The weighted participation rate was 69.0 percent, based on the number of full and adequate responders, including those who saw no patients during their reporting week. Among the 34 states, visit response ranged from 22%-96% (weighted).
The 2012 NAMCS was conducted from December 28, 2011 through December 26, 2012. The U.S. Bureau of the Census was the data collection agent for the 2012 NAMCS. For the first time, NAMCS was collected electronically using a computerized instrument developed by the U.S. Census Bureau. The physician, office staff, or a Census field representative completed a PRF for a sample of up to 30 visits during a randomly assigned 1-week reporting period. The PRF may be viewed at http://www.cdc.gov/nchs/data/ahcd/NAMCS_30A_2012.pdf
Data processing and medical coding were performed by SRA International, Inc., Durham, North Carolina. As part of the quality assurance procedure, a 10 percent quality control sample of NAMCS survey records were independently recoded and compared. Differences were adjudicated by a quality control supervisor with error rates reported to NCHS. Coding error rates for the 10 percent sample ranged between 0.3 and 1.0 percent. For further details, see 2012 NAMCS Public Use Data File Documentation at the website: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf
Web table estimates include physician and non-physician clinician visits to CHCs. Visit estimates are based on sample data weighted to produce annual national estimates and include standard errors. Because of the complex multistage design of NAMCS, a sample weight is computed for each sample visit that takes all stages of design into account. The survey data are inflated or weighted to produce unbiased national annual estimates. The visit weight includes four basic components: inflation by reciprocals of selection probabilities, adjustment for nonresponse, population ratio adjustments, and weight smoothing. Estimates of the sampling variability were calculated using Taylor approximations in SUDAAN, which take into account the complex sample design of NAMCS. Detailed information on the design, conduct, and estimation procedures of 2012 NAMCS are discussed in the NAMCS Public Use Data File Documentation at the website: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf
As in any survey, results are subject to sampling and non-sampling errors. Non-sampling errors include reporting and processing errors as well as biases due to nonresponse and incomplete response. In 2012, race data were missing for 23.5 percent of visits, and ethnicity data were missing for 15.3 percent of visits. Starting with 2009 data, NAMCS adopted the technique of model-based single imputation for NAMCS race and ethnicity data. Race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2012 NAMCS – CHC Public Use Data File Documentation at the website: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf
Information on missing data for other variables is provided in table footnotes.
National Ambulatory Medical Care Survey - Community Health Centers: 2012 Summary Tables □ Page 3
In the following tables, estimates are not presented if they are based on fewer than 30 cases in the sample data; only an asterisk (*) appears in the tables. Estimates based on 30 or more cases include an asterisk if the relative standard error of the estimate exceeds 30 percent.
Suggested citation: Hing E, Okeyode T, Rui P. National Ambulatory Medical Care Survey – Community Health Centers: 2012 State and National Summary Tables. Available from: http://www.cdc.gov/nchs/ahcd/ahcd_products.htm.
Type of community health center330 Grantee 59,283 (3,187) 90.7 (3.2) ... ...Look-alike *6,040 (2,203) *9.2 (3.2) ... ...Urban Indian Health Service clinic *10 (8) *0.0 (0.0) ... ...
Electronic medical recordsYes—all electronic 49,602 (3,284) 75.9 (3.2) ... ...Yes—part paper and part electronic 5,439 (1,212) 8.3 (1.8) ... ...No 9,997 (1,937) 15.3 (2.9) ... ...Unknown or blank *294 (181) *0.5 (0.3) ... ...
Table 1. Community health center visits, by selected clinician and facility characteristics: United States, 2012
Number of visits in thousands(standard error in thousands)
Percent distribution(standard error of percent)
Number of visits per100 persons per year1-3
(standard error of rate)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 5
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Table 1. Community health center visits, by selected clinician and facility characteristics: United States, 2012
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
… Category not applicable.*Figure does not meet standards of reliability or precision.0.0 Quantity is greater than zero but less than 0.05.1Visit rates are based on the July 1, 2012 set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, U.S. Census Bureau.2Population estimates by metropolitan statistical area definitions status are based on estimates of the civilian noninstitutional population of the United States as of July 1, 2012 from the 2012 National Health Interview Survey, National Center for Health Statistics, compiled according to November 2012 Office of Management and Budget definitions of core-based statistical areas. See https://www.census.gov/programs-surveys/metro-micro.html for more about metropolitan statistical area definitions.3For geographic and metropolitan statistical areas, population denominators are different for each category and thus do not add to the total population rate. For other variables, the denominator is the total population.4Physician specialty and specialty type are defined in the 2012 National Ambulatory Medical Care Survey Public Use Data File documentation available at:https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. 5Number of visits (numerator) and population estimate (denominator) consists of children under 15 years of age.6Number of visits (numerator) and population estimate (denominator) consists of females 15 years old and over.7MSA is metropolitan statistical area.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 6
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
SOURCE: NCHS, National Ambulatory Medical Care Survey.
*Figure does not meet standards of reliability or precision.1Visit rates are based on the July 1, 2012 set of estimates of the civilian nonistitutionalized population of the United States as developed by the Population Division, U.S. CensusBureau.
Table 2. Community health center visits, by selected states: United States, 2012
Number of visits in thousands (standard error in thousands)
Number of visits per 100 persons per year1
(standard error of rate)
NOTE: Numbers may not add to totals because of rounding.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 7
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Patient age and sex
All visits 65,333 (3,180) 100.0 ... 21.2 (1.0)
AgeUnder 15 years 14,691 (1,390) 22.5 (1.8) 24.0 (2.3)
Under 1 year 3,167 (408) 4.8 (0.6) 80.4 (10.4)1–4 years 4,502 (469) 6.9 (0.6) 28.0 (2.9)5–14 years 7,021 (627) 10.7 (0.8) 17.1 (1.5)
15–24 years 7,930 (569) 12.1 (0.7) 18.5 (1.3)25–44 years 17,369 (1,029) 26.6 (0.9) 21.5 (1.3)45–64 years 19,179 (1,267) 29.4 (1.3) 23.4 (1.5)65 years and over 6,163 (572) 9.4 (0.7) 14.7 (1.4)
65–74 years 3,926 (393) 6.0 (0.5) 16.5 (1.7)75 years and over 2,238 (226) 3.4 (0.3) 12.4 (1.2)
Sex and ageFemale 40,747 (2,158) 62.4 (1.0) 25.8 (1.4)
Under 15 years 7,134 (678) 10.9 (0.9) 23.9 (2.3)15–24 years 5,864 (485) 9.0 (0.6) 27.5 (2.3)25–44 years 12,403 (835) 19.0 (0.9) 30.2 (2.0)45–64 years 11,533 (813) 17.7 (0.8) 27.3 (1.9)65–74 years 2,345 (249) 3.6 (0.3) 18.5 (2.0)75 years and over 1,468 (162) 2.2 (0.2) 13.6 (1.5)
Male 24,586 (1,322) 37.6 (1.0) 16.3 (0.9)Under 15 years 7,556 (749) 11.6 (1.0) 24.2 (2.4)15–24 years 2,066 (171) 3.2 (0.2) 9.5 (0.8)25–44 years 4,967 (350) 7.6 (0.4) 12.5 (0.9)45–64 years 7,647 (570) 11.7 (0.7) 19.2 (1.4)65–74 years 1,580 (168) 2.4 (0.2) 14.2 (1.5)75 years and over 770 (99) 1.2 (0.1) 10.5 (1.3)
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 3. Community health center visits, by patient age and sex: United States, 2012
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
Number of visits per 100 persons per year1 (standard error of rate)
...Category not applicable.1Visit rates are based on the July 1, 2012 set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, U.S. Census Bureau.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 8
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Selected states
All visits 40,654 (2,583) 24,678 (1,720) 13.0 (1.0) 8.0 (1.0)
*Figure does not meet standards of reliability or precision.1Visit scheduled for sampled physician.2Nonphysician clinician includes physician assistant, nurse practitioner, and nurse midwife. Includes visits scheduled for sampled nonphysician clinician.3Visit rates are based on the July 1, 2012, set of estimates of the civilian noninstitutionalized population of the United States as developed by the Population Division, U.S. Census Bureau.
NOTE: Numbers do not add to total because estimates are only available for 34 states. Missouri visit rates and their standard errors were updated on 6/12/18 to reflect a corrected state population denominator.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 9
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
WhiteBlack or African American Other7 2,909 (301) 4.5 (0.4) 12.0 (1.2) 2,287 (262) 4.1 (0.4)
NOTE: Numbers may not add to totals because of rounding.
...Category not applicable.1"Reported plus imputed" includes race that was reported directly by physician offices and that was imputed for the 23.5% of visits for which race was not reported.2"Reported plus imputed" includes ethnicity that was reported directly by physician offices and that was imputed for the 15.3% of visits for which ethnicity was not reported.3"Reported only" calculations are based on 49,963,000 visits with race reported directly by physician offices. The 23.5% of visits for which race was missing are excluded from the denominator so readers can compare differences between estimates that include and exclude imputed race values.4"Reported only" calculations are based on 55,305,000 visits with ethnicity reported directly by physician offices. The 15.3% of visits for which ethnicity was missing are excluded from the denominator so readers can compare differences between estimates that include and exclude imputed ethnicity values.5Visit rates are based on the July 1, 2012 set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, U.S.Census Bureau.6The race groups white, black or African American, and other include persons of Hispanic and not Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data. The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2012 National Ambulatory Medical Care Survey Community Health Center Public Use Data File documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. For 2012, race data were missing for 23.5% of visits, and ethnicity data were missing for 15.3% of visits.7Other race includes visits by Asian, Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, and persons with more than one race.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 5. Community health center visits, by selected patient age and race and ethnicity: United States, 2012
Number of visits in thousands (standard error in thousands)
Reported plus imputed1,2 Reported only3,4
Percent distribution(standard error of percent)
Number of visits in thousands(standard error in thousands)
Number of visits per 100 persons per year (standard
error of rate)5
Percent distribution(standard error
of percent)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 10
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
NOTE: Numbers may not add to totals because of rounding. More than one category could be indicated.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 6. Expected sources of payment at community health center visits: United States, 2012
Number of visits in thousands1
(standard error in thousands)Percent of visits
(standard error of percent)
...Category not applicable.*Figure does not meet standards of reliability or precision.1Combined total of expected sources of payment exceeds "all visits" and "percent of visits" exceeds 100% because more than one source of payment may be reported per visit.2CHIP is Children's Health Insurance Program.3The visits in this category are also included in both the Medicare and Medicaid or CHIP categories.4"No insurance" is defined as having only self-pay, no charge, or charity as payment sources. The individual self-pay and no charge or charity categories are not mutually exclusive.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 11
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Prior-visit status, primary care provider, and referral status
All visits 65,333 (3,180) 100.0 ...
Visit to PCP1 41,037 (2,514) 62.8 (2.3)Visit to non-PCP1,2 17,642 (1,783) 27.0 (2.3)
Referred for this visit 2,737 (717) 4.2 (1.1)Not referred for this visit 11,062 (1,515) 16.9 (2.1)Unknown if referred3 3,844 (564) 5.9 (0.8)
Unknown if PCP1 visit2,3 6,653 (745) 10.2 (1.1)
Established patientAll visits 56,051 (2,852) 100.0 (0.0)Visit to PCP1 37,779 (2,388) 67.4 (2.4)Visit to non-PCP1,2 13,240 (1,459) 23.6 (2.2)
Referred for this visit *1,938 (637) *3.5 (1.1)Not referred for this visit 8,583 (1,220) 15.3 (2.0)Unknown if referred3 2,719 (447) 4.9 (0.8)
Unknown if PCP1 visit2,3 5,033 (632) 9.0 (1.1)
New patientAll visits 9,282 (790) 100.0 (0.0)Visit to PCP1 3,259 (295) 35.1 (3.4)Visit to non-PCP1,2 4,403 (693) 47.4 (4.3)
Referred for this visit *799 (263) 8.6 (2.5)Not referred for this visit 2,479 (494) 26.7 (4.1)Unknown if referred3 1,125 (264) 12.1 (2.4)
Unknown if PCP1 visit2,3 1,620 (198) 17.5 (2.3)
Table 7. Primary care provider and referral status of community health center visits, by prior-visit status: United States, 2012
SOURCE: NCHS, National Ambulatory Medical Care Survey.
NOTE: Numbers may not add to totals because of rounding.
...Category not applicable.*Figure does not meet standards of reliability or precision.1PCP is patient's primary care provider as indicated by a positive response to the question "Are you the patient's primary care physician/provider?"2Referral status was only asked for visits to non-PCPs and visits with unknown PCP status. Among these visits, referral information was unknown for 32.8% of visits.3The unknown category includes blanks.
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 12
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 8. Primary care provider and referral status, according to physician specialty: United States, 2012
...Category not applicable.*Figure does not meet standards of reliability or precision.1PCP is patient's primary care provider as indicated by a positive response to the question "Are you the patient's primary care physician/provider?"2Referral status was asked only for visits to non-PCPs and visits with unknown PCP status. Among these visits, referral information was unknown for 32.8% of visits.3The unknown category includes blanks.
Percent distribution (standard error of percent)
Visit to PCP1
Referred by otherphysician or nonphysician
clinician
Not referred by other physician or
nonphysician clinician
Unknown if referred3
Unknown if PCP1
visit2,3
Visit to non-PCP1,2
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 13
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Continuity-of-care visit characteristic
All visits 65,333 (3,180) 38,286 (2,548) *2,368 (737) 24,678 (1,720)
Prior-visit status and number of visits in last 12 monthsEstablished patient2 56,051 (2,852) 33,559 (2,377) *2,262 (714) 20,230 (1,364)
New patient 14.2 (1.0) 12.3 (1.0) 4.5 (0.9) 18.0 (1.8)
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
*Figure does not meet standards of reliability or precision....Category not applicable.1Specialty types are defined in the 2012 National Ambulatory Medical Care Survey Public Use Data File documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf.2Number of previous visits by established patients to responding physician in last 12 months (excludes sampled visit).
Table 9. Continuity-of-care community health center visit characteristics according to type of clinician and specialty type: United States, 2012
Physician specialty or type of clinician1
All specialties Primary care Non-primary care Nonphysician clinician
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 14
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
All visits 65,333 (3,180) 100.0 ... 100.0 ... 100.0 ...
...Category not applicable.1Based on A Reason for Visit Classification for Ambulatory Care (RVC) defined in the 2012 National Ambulatory Medical Care Survey Public Use Data file documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. 2Based on 40,747,000 visits made by females.3Based on 24,586,000 visits made by males.
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 10. Twenty leading principal reasons for community health center visits, by patient's sex: United States, 2012
Principal reason for visit and RVC code1
Number of visits in thousands1 (standard error
in thousands)Percent distribution
(standard error of percent)Percent distribution
(standard error of percent)Percent distribution
(standard error of percent)
Female2 Male3
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 15
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
SOURCE: NCHS, National Ambulatory Medical Care Survey.
...Category not applicable.*Figure does not meet standards of reliability or precision.1Preventive care includes routine prenatal, well-baby, screening,insurance or general exams (see "major reason for this visit" question on Patient Record Sample Card at:https://www.cdc.gov/nchs/data/ahcd/2012_NAMCS_PRF_Sample_Card.pdf. 2The race groups white, black or African American, and other include persons of Hispanic and not Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data. The race imputaion is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2012 National Ambulatory Medical Care Survey Public Use Data file documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. For 2012, the race data were missing for 23.5% of visits, and ethnicity data were missing for 15.3% of visits.3Other race includes visits by Asian, Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, and persons with more than one race.4Combined total of individual sources exceeds "all visits" and percent of visits exceeds 100% because more than one source of payment may be reported per visit.5CHIP is Children's Health Insurance Program.6The visits in this category are also included in both the Medicaid or CHIP and Medicare categories.7No insurance is defined as having only self-pay, no charge or charity as payment sources.8Other includes workers' compensation, unknown or blank, and sources not classified elsewhere.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 17
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Patient and visit characteristics
All preventive care visits4 17,330 (1,202) 100.0 ... 5.6 (0.4) 62.9 (3.0) 36.0 (2.9)
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
1Visit rates for age, sex, and race and ethnicity are based on the July 1, 2012 set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, U.S. Census Bureau. Visit rates for expected source(s) of payment are based on the 2012 National Health Interview Survey estimates of health insurance.2Primary care specialty defined in the 2012 public use file documentation, available at: https:ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. 3Nonphysician clinician includes physician assistants, nurse practitoners, and nurse midwives.4Preventive care includes routine prenatal, well-baby, screening, insurance or general exams (see "major reason for this visit" question on Patient Record Sample Card at: https://www.cdc.gov/nchs/data/ahcd/2012_NAMCS_PRF_Sample_Card.pdf). 5The race groups white, black or African American and other include persons of Hispanic and not Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2009 data, National Center for Health Statistics has adopted the technique of model-based single imputation for NAMCS race and ethnicity data. The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2012 NAMCS Public Use Data File documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012.pdf. For 2012, race data were missing for 23.9% of visits, and ethnicity data were missing for 13.2% of visits.6Other race includes visits by Asian, Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, and persons with more than one race.7Combined total of individual sources exceeds "all visits" and percent of visits exceeds 100% because more than one source of payment may be reported per visit.8CHIP is Children's Health Insurance Program.9No insurance is defined as having only self-pay, no charge, or charity as payment sources. The visit rate was calculated using "uninsured" as the denominator from the 2012 estimates of health insurance coverage from the National Health Interview Survey.10Other includes workers' compensation, unknown or blank, and sources not classified elsewhere.
...Category not applicable.
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U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
All visits 65,333 (3,180) 100.0 ...Infectious and parasitic diseases 001–139 2,411 (193) 3.7 (0.3)Neoplasms 140–239 *655 (288) *1.0 (0.4)Endocrine, nutritional, and metabolic diseases, and immunity disorders 240–279 6,579 (773) 10.1 (1.0)
Mental disorders 290–319 4,954 (834) 7.6 (1.2)Diseases of the nervous system and sense organs 320–389 3,316 (286) 5.1 (0.4)Diseases of the circulatory system 390–459 5,488 (455) 8.4 (0.6)Diseases of the respiratory system 460–519 6,794 (514) 10.4 (0.7)Diseases of the digestive system 520–579 1,783 (140) 2.7 (0.2)Diseases of the genitourinary system 580–629 2,836 (230) 4.3 (0.3)Diseases of the skin and subcutaneous tissue 680–709 2,059 (165) 3.2 (0.2)Diseases of the musculoskeletal and connective tissue 710–739 4,490 (351) 6.9 (0.4)Symptoms, signs, and ill–defined conditions 780–799 5,441 (363) 8.3 (0.4)Injury and poisoning 800–999 1,671 (134) 2.6 (0.2)Supplementary classification2 V01–V90 14,977 (1,208) 22.9 (1.4)All other diagnoses3 ... 1,465 (144) 2.2 (0.2)Blank ... 415 (120) 0.6 (0.2)
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 13. Primary diagnosis at community health center visits, classified by major disease category: United States, 2012
Major disease category and ICD–9–CM code range1
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of
percent)
...Category not applicable.*Figure does not meet standards of reliability or precision.1Based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services. Official version: International Classification of Diseases, Ninth Revision, Clinical Modification, Sixth Edition. DHHS Pub No. (PHS) 11–1260).2Supplementary classification is preventive and follow–up care and includes general medical examination, routine prenatal examination, and health supervision of an infant or child, and other diagnoses not classifiable to injury or illness.3Includes diseases of the blood and blood–forming organs (280–289); complications of pregnancy, childbirth, and the puerperium (630–677); congenital anomalies (740–759);certain conditions originating in perinatal period (760–779); and entries not codable to the ICD–9–CM (e.g. "illegible entries," "left against medical advice," "transferred," entries of"none," or "no diagnoses").
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 20
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 14. Twenty leading primary diagnosis groups for community health center visits, by type of provider: United States, 2012
Nonphysician clinician3
*Figure does not meet standards of reliability or precision. ...Category not applicable.1Based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services.Official version: International Classification of Diseases, Ninth Revision, Clinical Modification, Sixth Edition. DHHS Pub No. (PHS) 11–1260). However, certain codes have been combined in this table to form larger categories that better describe the utilization of ambulatory care services.2Based on 40,654,000 visits scheduled with physicians.3Based on 24,678,000 visits scheduled with nonphysician clinicians (physician assistants, nurse practioners, and nurse midwives).4Includes all other diagnoses not listed above, as well as unknown and blank diagnoses.
Number of visits in thousands (standard error in thousands)
Percent distribution(standard error of
percent)
Physician2
Percent distribution(standard error of
percent) Percent distribution
(standard error of percent)Primary diagnosis group and ICD–9–CM code(s)1
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 21
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Patient characteristics
All injury visits2 3,108 (268) 100.0 ... 1.0 (0.1)
AgeUnder 15 years 620 (93) 19.9 (2.6) 1.0 (0.2)
Under 1 year * ... * ... * ...1–4 years 143 (28) 4.6 (0.9) 0.9 (0.2)5–14 years 454 (79) 14.6 (2.2) 1.1 (0.2)
15–24 years 426 (63) 13.7 (1.8) 1.0 (0.1)25–44 years 814 (106) 26.2 (2.3) 1.0 (0.1)45–64 years 995 (131) 32.0 (2.8) 1.2 (0.2)65 years and over 254 (47) 8.2 (1.5) 0.6 (0.1)
65–74 years 161 (40) 5.2 (1.2) 0.7 (0.2)75 years and over *94 (29) *3.0 (0.9) *0.5 (0.2)
Sex and ageFemale 1,682 (179) 54.1 (2.7) 1.1 (0.1)
Under 15 years 292 (60) 9.4 (1.7) 1.0 (0.2)15–24 years 224 (45) 7.2 (1.4) 1.1 (0.2)25–44 years 440 (73) 14.2 (1.7) 1.1 (0.2)45–64 years 562 (89) 18.1 (2.2) 1.3 (0.2)65–74 years 98 (26) 3.1 (0.8) 0.8 (0.2)75 years and over *65 (24) *2.1 (0.7) *0.6 (0.2)
Male 1,427 (136) 45.9 (2.7) 0.9 (0.1)Under 15 years 328 (49) 10.6 (1.5) 1.1 (0.2)15–24 years 201 (37) 6.5 (1.1) 0.9 (0.2)25–44 years 374 (58) 12.0 (1.6) 0.9 (0.1)45–64 years 432 (70) 13.9 (1.8) 1.1 (0.2)65–74 years * ... * ... * ...75 years and over * ... * ... * ...
Reported plus imputed:Hispanic or Latino 952 (142) 30.6 (3.9) 1.8 (0.3)Not Hispanic or Latino 2,157 (227) 69.4 (3.9) 0.8 (0.1)
White 1,682 (216) 54.1 (4.1) 0.9 (0.1)Black or African American 323 (42) 10.4 (1.4) 0.9 (0.1)Other4 152 (33) 4.9 (1.1) 0.6 (0.1)
Table 15. Injury visits to community health centers, by selected patient characteristics: United States, 2012
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
Number of visits per 100 persons per year1 (standard
error of rate)
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U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Table 15. Injury visits to community health centers, by selected patient characteristics: United States, 2012
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
...Category not applicable.*Figure does not meet standards of reliability or precision.1Visit rates for age, sex, race, and ethnicity are based on the July 1, 2012 set of estimates of the civilian noninstitutional population of the United States as developed by the Population Division, U.S. Census Bureau.2The National Ambulatory Medical Care Survey definition of injury visits, as shown in this table, changed in 2010 and includes only first-, second-, and third-listed reason for visit and diagnosis codes that are injury or poisoning related. Adverse effects and complications are excluded. Reason for visit was coded using A Reason for Visit Classificationfor Ambulatory Care; diagnosis was coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services. Official version: International Classification of Diseases, Ninth Revision, Clinical Modification,Sixth Edition. DHHS Pub No. (PHS) 11–1260). Injury visits, using this definition, accounted for 4.8 % (SE = 0.3) of community health center visits in 2012. For more information on why this definition changed, see the 2012 National Ambulatory Medical Care Survey–Community Health Center Public Use Data File Documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. 3The race groups white, black or African American, and other include persons of Hispanic and not Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data. The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2012 National Ambulatory Medical Care Survey–Community Health Center Public Use Data File documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. For 2012, race data were missing for 20.1% of injury visits, and ethnicity data were missing for 14.3% of injury visits.4Other race includes visits by Asian, Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, and persons with more than one race.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 23
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Intent
All visits for injury, poisoning, and adverse effect1 3,358 (277) 100.0 ...Unintentional injury or poisoning 1,501 (156) 44.7 (2.5)Intentional injury or poisoning 76 (17) 2.3 (0.5)Injury or poisoning, unknown intent 1,515 (159) 45.1 (2.7)Adverse effect of medical treatment or surgical care or adverse effect of medicinal drug 267 (43) 7.9 (1.3)
Table 16. Community health center visits related to injury, poisoning, and adverse effects: United States, 2012
...Category not applicable.1Data are based on the "Injury/Poisioning/Adverse effect" item of the survey instrument (Patient Record form) in conjunction with first-, second-, and third-listed reason for visit and diagnosis codes related to injury, poisoning, and adverse effects of medical or surgical care or adverse effects of medicinal drug. Reason for visit was coded using A Reason for Visit Classification for Ambulatory Care; diagnosis codes are based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services. Official version: International Classification of Diseases, Ninth Revision, Clinical Modification, Sixth Edition. DHHS Pub No.(PHS) 11–1260). Visits related to injury, poisoning, and adverse effect accounted for 5.1% (SE = 0.3) of all community health center visits in 2012.
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 24
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
NOTE: Numbers mat not add to totals because more than one chronic condition may be reported per visit.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 17. Presence of selected chronic conditions at community health center visits, by patient age and sex: United States, 2012
*Figure does not meet standards of reliability or precision....Category not applicable.1Presence of chronic conditions was based on the checklist of chronic conditions and reported diagnoses. Combined total visits by patients with chronic condtions exceeds 100% because more than one chronic condition may be reported per visit.2COPD is chronic obstructive pulmonary disease.3CHF is congestive heart failure.
Age Sex
Percent of visits (standard error of percent)
Percent distribution (standard error of percent)
Total Under 45 years 45–64 years 65–74 years 75 years and over
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 25
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
SOURCE: NCHS, National Ambulatory Medical Care Survey.
...Category not applicable.*Figure does not meet standards of reliability or precision.- Quantity zero.1Combined total of diagnostic, screening, and non-medication treatment services exceeds "all visits" and percent of visits exceeds 100% because more than one service may be reported per visit.2Based on 40,654,000 visits scheduled with physicians.3Based on 24,678,000 visits scheduled with nonphysician clinicians (physician assistants, nurse practitioners, and nurse midwives).4Includes up to 9 write-in procedures from the Services item on the Patient Record form. Procedures are coded to the International Classification of Diseases, Ninth Revision, ClinicalModification, Volume 3, Procedure Classification. Records with write-in procedures that overlap checkboxes (for example, procedure 93.11, "Physical therapy exercises: Assisting exercise," which could also be coded in the item 9 checkbox for physical therapy) are edited to ensure that the check box is marked; in this way the check box always provides a summary estimate, but should not be added to the corresponding ICD–9–CM procedure to avoid doublecounting. Procedures codes were reviewed against checkboxes for x-ray, bone mineral density, CT scan, echocardiogram, other ultrasound, mammography, MRI, other imaging, EKG or ECG, complementary and alternative medicine, physical therapy, speech and occupational therapy, psychotherapy, excision of tissue, wound care, cast, biopsy, and splint or wrap. Procedures that could not be included in one of these checkboxes are included in the estimated total number of visits with services, but are not shown separately.5HIV is human immunodeficiency virus.6HPV is human papilloma virus; DNA is deoxyribonucleic acid.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 28
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Patient characteristic
Number of visits in
thousands Total
All visits to PCPs2 27,367 100.0 34.9 (1.5) 41.6 (1.0) 17.0 (1.0) 6.5 (0.6)
Age18–24 years 2,892 100.0 56.7 (2.7) 36.2 (2.5) 6.5 (1.3) * ...25–44 years 8,937 100.0 46.7 (2.1) 37.7 (1.6) 11.4 (0.9) 4.2 (0.6)45–64 years 11,295 100.0 25.2 (1.8) 44.6 (1.2) 21.4 (1.6) 8.8 (1.1)65–74 years 2,673 100.0 22.7 (2.5) 46.6 (2.4) 24.6 (1.8) 6.1 (1.3)75 years and over 1,570 100.0 18.3 (2.3) 44.2 (3.4) 23.7 (2.7) 13.8 (2.7)
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Percent distribution (standard error of percent)
...Category not applicable.*Figure does not meet standards of reliability or precision.1Blood pressure (BP) levels were categorized using the following hierarchical definitions. Severely high BP is defined as 160 mm Hg systolic or above, or 100 mm Hg diastolic or above. Moderately high BP is defined as 140–159 mm Hg systolic or 90–99 mm Hg diastolic. Mildly high BP is defined as 120–139 mm Hg systolic or 80–89 mm Hg diastolic. Not High is defined as any BP <120 mm Hg systolic and <80 mm Hg diastolic. Similar to 2010 but in contrast to prior years, low BP has been combined with normal BP in 2010 because there is no accepted clinical demarcation between normal and low on the population level. High BP classification was based on the "Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7)." "Mildly high" BP corresponds to the JNC-7 prehypertensive range. "–Moderately high" BP corresponds to the JNC-7 stage 1 hypertensive range. "Severely high" BP corresponds to the JNC-7 stage 2 hypertensive range.2PCP is primary care physician. PCP includes general and family practice, internal medicine, pediatrics, and obstetrics and gynecology. For further details, see primary care specialty type in the 2012 National Ambulatory Medical Care Survey—Community Health Center Public Use Data File documentation available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. Visits where blood pressure was recorded represent 98.2% (SE = 0.3) of all community health center visits made to PCPs by adults (aged 18 and over).3The race groups white, black or African American, and other include persons of Hispanic and not Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data. The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2012 National Ambulatory Medical Care Survey—Community Health Center Public Use Data File documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. Where blood pressure was taken, race data were missing for 23.3% of visits, and ethnicity data were missing for 15.0% of visits.
Table 20. Initial blood pressure measurement recorded at community health center visits to primary care physicians for adults aged 18 and over, by selected patient characteristics: United States, 2012
Initial blood pressure1
Not high Mildly high Moderately high Severely high
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U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Patient characteristic
Number of visits in
thousands Total
All visits to nonphysician clinicians2 17,586 100.0 36.5 (1.3) 41.7 (1.1) 15.7 (0.8) 6.2 (0.6)
Age18–24 years 2,408 100.0 55.7 (2.5) 36.5 (2.4) 6.9 (1.3) * ...25–44 years 7,079 100.0 44.5 (1.9) 39.5 (1.6) 12.2 (1.0) 3.9 (0.6)45–64 years 6,479 100.0 24.8 (1.5) 45.5 (1.7) 20.7 (1.3) 9.0 (0.9)65–74 years 1,036 100.0 20.1 (2.8) 44.7 (3.1) 22.1 (2.7) 13.1 (2.0)75 years and over 584 100.0 19.2 (3.1) 42.0 (4.7) 27.1 (3.6) 11.7 (2.5)
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Percent distribution (standard error of percent)
...Category not applicable.*Figure does not meet standards of reliability or precision.1Blood pressure (BP) levels were categorized using the following hierarchical definitions. Severely high BP is defined as 160 mm Hg systolic or above, or 100 mm Hg diastolic or above. Moderately high BP is defined as 140–159 mm Hg systolic or 90–99 mm Hg diastolic. Mildly high BP is defined as 120–139 mm Hg systolic or 80–89 mm Hg diastolic. Not High is defined as any BP <120 mm Hg systolic and <80 mm Hg diastolic. Similar to 2010 but in contrast to prior years, low BP has been combined with normal BP in 2010 because there isno accepted clinical demarcation between normal and low on the population level. High BP classification was based on the "Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7)." "Mildly high" BP corresponds to the JNC-7 prehypertensive range. "Moderately high" BP corresponds to the JNC-7 stage 1 hypertensive range. "Severely high" BP corresponds to the JNC-7 stage 2 hypertensive range.2Visits where blood pressure recorded represent 94.9% (SE = 1.6) of all community health center visits made to nonphysician clinicians by adults (aged 18 and over). Nonphysician clinicians include physician assistants, nurse practitioners, and nurse midwives.3The race groups white, black or African American, and other include persons of Hispanic and not Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2009 data, the National Center for Health Statistics adopted the technique of model-based single imputation for NAMCS race and ethnicity data. The race imputation is restricted to three categories (white, black, and other) based on research by an internal work group and on quality concerns with imputed estimates for race categories other than white and black. The imputation technique is described in more detail in the 2012 National Ambulatory Medical Care Survey–Community Health Center Public Use Data File documentation, available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/doc2012_chc.pdf. Where blood pressure was taken, race data were missing for 20.0% of visits, and ethnicity data were missing for 14.6% of visits.4Other race includes visits by Asian, Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, and persons with more than one race.
Table 21. Initial blood pressure measurement recorded at community health center visits to nonphysician clinicians for adults aged 18 and over, by selected patient characteristics: United States, 2012
Initial blood pressure1
Not high Mildly high Moderately high Severely high
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U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Medication therapy3
All visits 65,333 (3,180) 100.0 ... 100.0 ... 100.0 ...
Visits with mention of medication4 48,857 (2,559) 74.8 (1.9) 74.4 (2.7) 75.4 (1.8)Visits without mention of medication 16,369 (1,529) 25.1 (1.9) 25.5 (2.7) 24.4 (1.8)Blank 107 (25) 0.2 (0.0) *0.1 (0.0) *0.2 (0.1)
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 22. Medication therapy and number of medications mentioned at community health center visits, by type of provider: United States, 2012
Physician1 Nonphysician clinician2
Number of visits in thousands (standard error in thousands)
Percent of visits (standard error
of percent)
Percent of visits (standard error
of percent)
Percent of visits (standard error
of percent)
*Figure does not meet standards of reliability or precision....Category not applicable.1Based on 40,654,000 visits scheduled with physicians.2Based on 24,678,000 visits scheduled with nonphysician clinicians (physician assistants, nurse practioners or nurse midwives).3Includes prescription drugs, over-the-counter preparations, immunizations, and desensitizing agents.4A drug mention is documentation in a patient's record of a drug provided, prescribed, or continued at a visit. Up to ten drug mentions were collected per visit in 2012 compared to a maximum of 8 drug mentions collected in 2011. Also defined as drug visits.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 31
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Physician speciality and type of nonphysician clinician
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 23. Communtiy health center visits and drug mentions, by physician specialty and type of nonphysician clinician: United States, 2012
* Figures does not meet standards of reliability or precision....Category not applicable.1Visits at which one or more drugs were provided or prescribed.2A drug mention is documentation in a patient's record of a drug provided, prescribed, or continued at a visit. Up to ten drug mentions were collected per visit in 2012 compared to a maximum of eight drug mentions collected in 2011. Also defined as drug visits.3Percent of visits that included one or more drugs provided or prescribed (number of visits divided by number of office visits multiplied by 100).4Average number of drugs that were provided or prescribed per 100 visits (total number of drug mentions divided by total number of visits multiplied by 100).
Percent of office visits with drug mentions3
(standard error of percent)
Drug mention rates4
(standard error of rate)
Drug mentions2Drug visits1
Number in thousands (standard error in thousands)
Percent distribution (standard error
of percent)
Number in thousands (standard error in thousands)
Percent distribution (standard error
of percent)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 32
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Number of occurrences in thousands (standard error
in thousands)Percent of drug mentions2
(standard error of percent)
Table 24. Twenty most frequently mentioned drugs, by therapeutic drug category at community health center visits: United States, 2012
1Based on Multum Lexicon second level therapeutic drug category (see https://www.cerner.com/solutions/drug-database). 2Based on an estimated 177,374,000 drug mentions at community health center visits in 2012.3Includes narcotic and nonnarcotics and nonsteroidal anti-inflammatory drugs.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 33
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Drug name1 Total Therapeutic drug category3
All drug mentions 177,374 (11,378) 100.0 ... 100.0 31.9 (1.7) 66.7 (1.8) 1.4 (0.4) ...
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Table 25. Twenty most frequently mentioned drug names at community health center visits, by new or continued status: United States, 2012
*Figure does not meet standards of reliability or precision.1Based on Multum Lexicon terminology, drug name reflects the active ingredients(s) of a drug provided, prescribed, or continued.2Unknown includes drugs provided or prescribed that did not have either the new drug or continued drug checkboxes marked.3Based on Multum Lexicon second-level therapeutic drug category (see https://www.cerner.com/solutions/drug-database).
Number of mentions in thousands
(standard error in thousands)
Percent distribution (standard error of percent)
New Continued Unknown2
Percent distribution (standard error
of percent)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 34
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
R.N. or L.P.N. seen with physician 9,397 (1,277) 14.4 (2.0)R.N. or L.P.N. seen without physician 2,663 (420) 4.1 (0.6)
Physician assistant (PA) 10,690 (1,237) 16.4 (1.7)PA seen with physician 629 (167) 1.0 (0.3)PA seen without physician 10,062 (1,213) 15.4 (1.6)
Nurse practitioner or midwife (NPNM) 12,532 (1,000) 19.2 (1.4)NPMW seen with physician 229 (51) 0.3 (0.1)NPMW seen without physician 12,303 (999) 18.8 (1.4)
Table 26. Providers seen at community health center visits: United States, 2012
0.0 Quantity is greater than zero but less than 0.05.*Figure does not meet standards of reliability or precision....Category not applicable.1Combined total of individual providers exceeds "all visits" and "percent of visits" exceeds 100%, because more than one provider may be reported per visit. The sample of visits wasdrawn from all scheduled visits to a sampled provider during the 1-week reporting period. At 35.4% of these visits, a physician assistant, nurse practitoner, or nurse midwife was seen.In addition, at many visits, patients were seen by multiple providers.2R.N. is registered nurse.3L.P.N. is licensed practical nurse.
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Number of visits in thousands1
(standard error in thousands)Percent of visits
(standard error of percent)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 35
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Disposition
All visits 65,333 (3,180) ... ...
Return at specified time 42,656 (2,607) 65.3 (2.5)Referred to other physician 8,164 (713) 12.5 (0.9)Refer to emergency room or admit to hospital 396 (50) 0.6 (0.1)Other disposition 17,306 (1,389) 26.5 (1.8)Blank *2,545 (1,073) *3.9 (1.6)
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Number of visits in thousands1
(standard error in thousands)Percent of visits
(standard error of percent)
Table 27. Disposition of community health center visits: United States, 2012
...Category not applicable.*Figure does not meet standards of reliability or precision.1Combined total of individual dispositions exceeds "all visits," and "percent of visits" exceeds 100% because more than one disposition may be reported per visit.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 36
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Time spent with physician or nonphysician clinician
All visits 65,333 (3,180) 100.0 ...
Visits at which a physician was seen 39,895 (2,586) 61.1 (2.2)Visits at which nonphysician clinician was seen 21,911 (1,645) 33.5 (2.0)Neither physician or nonphysician clinician was seen at visit 3,527 (597) 5.4 (0.9)
Total visits seen by physician1 39,895 (2,586) 100.0 ...1–5 minutes *474 (188) *1.2 (0.5)6–10 minutes 3,682 (801) 9.2 (1.9)11–15 minutes 17,508 (1,908) 43.9 (3.4)16–30 minutes 15,006 (1,272) 37.6 (2.7)31–60 minutes 2,941 (301) 7.4 (0.7)61 minutes and over 284 (64) 0.7 (0.2)
Total visits seen by nonphysician clinician2 21,911 (1,645) 100.0 ...1–5 minutes 162 (43) 0.7 (0.2)6–10 minutes 2,049 (432) 9.4 (1.8)11–15 minutes 7,500 (885) 34.2 (2.7)16–30 minutes 9,461 (776) 43.2 (2.2)31–60 minutes 2,508 (288) 11.4 (1.1)61 minutes and over 231 (56) 1.1 (0.2)
Table 28. Time spent with physician or nonphysician clinician: United States, 2012
...Category not applicable.1Time spent with physicians only reported for visits where a physician was seen; includes 1.3% of visits jointly seen by physician and nonphysician clinician. Time spent with physicians was missing for 33.3% of visits where a physician was seen. Estimates presented include imputed values for missing data.2Time spent with nonphysician clinicians only reported for visits where a physician assistant, nurse practioner, or nurse midwife was seen (without a physician present). Time spent with nonphysician clinicians was missing for 43.4% of visits where a nonphysician clinician was seen. Estimates presented include imputed values for missing data.
NOTE: Numbers may not add to totals because of rounding.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
Number of visits in thousands (standard error in thousands)
Percent distribution (standard error of percent)
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 37
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Physician speciality or type of nonphysician clinician
Mean time in minutes spent
with physician or nonphysician
clinicianStandard error
of mean 25th percentile Median 75th percentile
Physician1 19.8 0.5 14.2 14.9 22.3General and family practice 19.7 0.6 14.2 14.9 21.8Internal medicine 18.7 1.2 13.3 14.9 21.1Pediatrics 20.5 1.1 14.3 14.9 23.5Obstetrics and gynecology 19.4 1.0 14.2 14.7 22.2All other specialities 22.9 1.3 14.2 18.8 28.8
Table 29. Mean time spent with physician or nonphysician clinician, by type of clinician, and physician speciality: United States, 2012
1Only visits where a physician was seen, including visits seen by physician and nonphysician clinician. Time spent with physicians was missing for 33.3% of visits where a physician was seen. Estimates presented include imputed values for missing data.2Only visits where a nonphysician clinician was seen are included (without a physician present). Time spent with nonphysician clinicians was missing for 43.4% of visits where a nonphysician clinicians was seen. Estimates presented include imputed values for missing data.
SOURCE: NCHS, National Ambulatory Medical Care Survey.
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 38
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Table 30. Number of in-scope community health center (CHC) service delivery sites in total sample, CHC response rates, number of sampled providers and provider response rate, number of participating providers, and participation rate by division and selected states: National Ambulatory Medical Care Survey, 2012
National Ambulatory Medical Care Survey—Community Health Centers: 2012 Summary Tables Page 39
U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics
Table 30. Number of in-scope community health center (CHC) service delivery sites in total sample, CHC response rates, number of sampled providers and provider response rate, number of participating providers, and participation rate by division and selected states: National Ambulatory Medical Care Survey, 2012
NOTE: Division and state represent location of interview. A total of 34 states were targeted for separate estimation. States not targeted for separate estimation were grouped into "division remainders" and sampled accordingly.
1Data are derived from a list of Federally Qualified Health Center (FQHC) service delivery sites from the Health Resources and Services Administration's Bureau of Primary Health Care and Indian Health Service and represent the total FQHC service delivery sites eligible for NAMCS.2Respondents are providers for whom at least one-half of their expected number of Patient Record forms were completed (full responders) and also include providers who saw no patients during their sampled week. 3Response rate is the number of respondents divided by the number of sampled providers times the CHC response rate divided by 100.4Participants are providers for whom at least one Patient Record form was completed (full and minimal responders) and also include providers who saw no patients during their sampled week.5Participation rate is the number of participants divided by the number of sampled providers time the CHC response rate divided by 100.